Rehabbing Your Revenue Cycle

How Internal Complexity Breaks Revenue for Healthcare Leaders to Prevent Denials and Delays

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick [https://www.linkedin.com/in/robert-kowalick-610502102/], Founder & CEO of Revenue Cycle Solutions, LLC [https://www.linkedin.com/company/revenue-cycle-solutionsllc/] and Ascend Solutions, LLC [https://www.linkedin.com/company/ascend-solutions-llc-co/], discusses how and why revenue cycles fail in healthcare practices. Robert explains that failure is usually caused by internally generated complexities, lack of a “revenue cycle team” alignment, and inadequate revenue cycle systems and controls. He emphasizes the importance of reducing complexity, improving collaboration, and understanding billing time demand and the need to balance that with a data driven billing time supply model to achieve better revenue cycle outcomes. Listeners will learn how revenue cycle complexity drives billing time demand and ultimately determines revenue cycle outcomes. Robert shares real data proving how internal revenue cycle processes, not payers, are the source of poor revenue cycle outcomes. He explains how reducing complexity by optimizing administrative workflows, and aligning teams can improve cash flow, lower costs, and create more stable and scalable healthcare businesses. Robert Kowalick is a revenue cycle expert who works closely with healthcare providers, especially physical therapy practices. He focuses on helping organizations identify, quantify and ultimately prevent revenue cycle failures through better data as the foundation for focus areas and action plans. His work for many years has centered on reducing revenue cycle complexities to build more efficient and effective revenue cycle operations and ultimately better healthcare businesses. EXPECT TO LEARN: -How revenue cycle complexity is the number one driver of billing time demand -Why most revenue cycle complexities come from internal revenue cycle processes external to the billing process -Why billing time supply must match billing time demand to keep AR clean and how to know what your billing time supply needs to be -Why functional silos prevent revenue cycle optimization -Why reducing complexity is the number one most effective revenue cycle strategy by far for improving revenue cycle outcomes: aligning teams, improving conversion of potential revenue to cash, minimizing days in AR and creating cost effective revenue cycle delivery systems TIMESTAMPS: [00:00] – Teaser [00:57] – Defining Revenue Cycle and Understanding If, When, and How Much [05:12] – Why Healthcare Businesses Are Revenue Cycle Dependent [09:27] – Universal Objectives of Revenue Cycle Management Explained [19:33] – How Team Structure and Functional Silos Lead to Failure [23:18] – Building a Collaborative Culture and Problem Solving Approach [26:28] – How Complexity Drives Time Demand in Revenue Cycle [32:50] – Internal Process Errors as the Primary Source of Complexity [37:35] – Impact of Complexity on Billing Time and Denial Management [42:33] – Fixed vs Variable Time Supply Models in Billing Operations [01:09:17] – Final Takeaways on Reducing Complexity and Improving Outcomes Company LinkedIn: 👉 Revenue Cycle Solutions, LLC - https://www.linkedin.com/company/revenue-cycle-solutionsllc/ [https://www.linkedin.com/company/revenue-cycle-solutionsllc/] 👉 Ascend Solutions, LLC - https://www.linkedin.com/company/ascend-solutions-llc-co/ [https://www.linkedin.com/company/ascend-solutions-llc-co/] Company Website: 👉 Revenue Cycle Solutions, LLC - https://revenuecyclesolutionsllc.com/ [https://revenuecyclesolutionsllc.com/] 👉 Ascend Solutions, LLC - https://ascendsolutionsllc.com/ [https://ascendsolutionsllc.com/] Follow Robert Kowalick on: 👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/ [https://www.linkedin.com/in/robert-kowalick-610502102/] Follow Rehabbing Your Revenue Cycle Podcast: 👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle [https://www.youtube.com/@RehabbingYourRevenueCycle] 👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/ [https://www.facebook.com/RehabbingYourRevenueCycle/] 👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/ [https://www.instagram.com/rehabbingyourrevenuecycle/]

IT and Systems Compliance and HIPAA Risk in the Era of AI with Live Compliance Founder and President, with Jim Johnson

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick [https://www.linkedin.com/in/robert-kowalick-610502102/] talks with Jim Johnson [https://www.linkedin.com/in/jamesvjohnson13], the Founder and President of Live Compliance [https://www.linkedin.com/company/live-compliance], which specializes in HIPAA compliance management in today’s fast-changing healthcare environment. Jim shares his expertise in helping healthcare organizations identify and mitigate technology and remote workforce HIPAA compliance risks. Robert and Jim discuss how Live Compliance has helped RCS eliminate HIPAA compliance risk after being forced to go 100% remote by COVID. Jim discusses how to safeguard Protected Health Information (PHI) and the potential consequences of a PHI breach. Jim highlights the challenges posed by remote workforces and the need for proper security measures, such as workstation controls and continuous staff training. His insights provide practical steps for healthcare providers to mitigate risks, ensure compliance, and protect PHI effectively. With over 20 years of experience in technology-based HIPAA compliance, Jim Johnson has a deep understanding of HIPAA regulations and technology risk management. After founding Live Compliance, Jim quickly recognized the growing challenges healthcare organizations face, especially with remote workforces and the increasing use of AI. By focusing on proper compliance strategies, staff training, and effective risk assessments, Jim has helped many healthcare providers safeguard patient information and reduce their risk of potentially business-ending PHI breaches. His expertise has been instrumental in empowering practices to maintain HIPAA compliance, secure sensitive data, and protect their long-term success in a rapidly evolving healthcare landscape. EXPECT TO LEARN -How Jim Johnson and Live Compliance help healthcare organizations maximize HIPAA compliance and reduce technology-based PHI risks. -How AI usage introduces new compliance risks and how to manage them effectively. -How remote workforces introduce new compliance risks and how to manage them effectively. -Why continuous staff training and testing are essential to maintaining compliance. -How regular risk assessments and compliance checks can prevent issues before they arise. -Why a proactive approach to compliance and security ensures long-term stability for healthcare practices. TIMESTAMPS [00:00:00] - Teaser [00:03:29] - Introduction to Jim Johnson [00:05:17] - What is PHI, Really? [00:15:54] - Workforce as the First Line of Defense [00:26:20] - Can You Trust ChatGPT with PHI? [00:41:53] - Top 5 Compliance Must-Haves [00:45:23] - AI in Revenue Cycle Management [00:56:09] - Peace of Mind Through Compliance [00:59:22] - Closing Thoughts Follow Jim Johnson on: 👉 LinkedIn - https://www.linkedin.com/in/jamesvjohnson13 [https://www.linkedin.com/in/jamesvjohnson13] Follow Live Compliance on: 👉 LinkedIn - https://www.linkedin.com/company/live-compliance [https://www.linkedin.com/company/live-compliance]  👉 Website - https://www.livecompliance.com/ [https://www.livecompliance.com/] 👉 Instagram - https://www.instagram.com/livecompliance/?hl=en [https://www.instagram.com/livecompliance/?hl=en] 👉 X - https://x.com/livecompliance [https://x.com/livecompliance] Follow Robert Kowalick on: 👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/ [https://www.linkedin.com/in/robert-kowalick-610502102/] 👉 Company Website - https://ascendsolutionsllc.com/ [https://ascendsolutionsllc.com/] Follow Rehabbing Your Revenue Cycle Podcast: 👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle [https://www.youtube.com/@RehabbingYourRevenueCycle]  👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/ [https://www.facebook.com/RehabbingYourRevenueCycle/] 👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/ [https://www.instagram.com/rehabbingyourrevenuecycle/]

The Right Data and How it Drives Automation Strategic Development Selection and Sequencing with Moative Co-Founder and CEO, Ashwin Ramasamy

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick [https://www.linkedin.com/in/robert-kowalick-610502102/] talks with Ashwin Ramasamy [https://www.linkedin.com/in/ashwinramasamy/], Co-founder and CEO of Moative [https://www.linkedin.com/company/moative], a company helping businesses in energy, industrial, and healthcare sectors navigate AI and automation. Ashwin shares his journey of building and selling multiple tech companies before focusing on guiding industries through strategic automation transformations. Robert and Ashwin discuss how they came together to collaborate on RCS’s and Ascend’s joint automation evolution. In a nutshell, PDS is the only RCM data platform providing the “right data”. Ashwin and Robert discuss how PDS’ Revenue Cycle Complexity (RCC) data provides the actionable intelligence needed to integrate and align humans and automations in RCM workflows. AI facilitating RCC reduction while simultaneously expanding billing time supply is the two-pronged attack underway in RCS and Ascend. Robert believes this is the only automation development strategy that makes sense in RCM today and Ashwin agrees. RCC is the counterforce to accomplishing all revenue cycle objectives today. Robert and Ashwin are teaming up to prevent and fix the root causes of financial illness in US healthcare today. The right data, reducing complexities, optimizing processes with human and automation integration, is what is needed to build financially stable and scalable healthcare businesses today and Robert and Ashwin are teaming up to provide the pathway forward. RCC and the out-of-control billing time inflation it causes are at pandemic levels in US healthcare today. Ashwin and Robert discuss how AI can optimize business operations and revenue cycles by reducing complexity, improving efficiency and effectiveness. Ashwin emphasizes the importance of using the right data to quantify billing time demand and using intelligent AI to prevent complexity and improve time supply and outcomes. He provides insights on how leveraging AI-driven intelligence can create more scalable and efficient businesses in today's competitive landscape. With years of experience in building and selling tech companies, Ashwin Ramasamy had a strong foundation in technology but needed a deeper understanding of how AI could transform industries. Through his work at Motive, Ashwin has helped organizations use data and AI to reduce operational complexity, optimize business processes, and improve financial outcomes. Motive, RCS and Ascend are positioned to be key players in helping healthcare businesses become more scalable and competitive in a fast-evolving landscape. EXPECT TO LEARN -Why Robert and Ashwin have come together to create intelligent automation solutions for the Physical Therapy industry and beyond. -Why data driven workflow automation selection, sequencing and complexity reduction are crucial to maximizing AI investment outcomes. -Why data driven “humans in the loop” automation integration is the pathway forward and not replacing humans. -Why AI investments and plans have had such a high failure rate. -How Robert and Ashwin are strategically building and implementing AI into RCM workflows. * Why AI will not change the need for data quantifying RCM outcomes and automation effectiveness. TIMESTAMPS [00:00] – Teaser [01:33] – Introduction & Context [02:54] – Meet Ashwin Ramasamy [03:42] – The Core Business Problem in Revenue Cycle [10:43] – Complexity as the Hidden Cost in Billing [14:28] – The Problem with EMR & PMS Systems [18:02] – Redefining Revenue Cycle with AI [23:52] – Engineering the Billing Time Supply Model [26:27] – AI’s Role in Reducing Grunt Work and Scaling Intelligence [34:47] – Quantifying Complexity & Operational Time Inflators [39:52] – Training AI with Wisdom, Not Just Intelligence [44:36] – The Road Ahead: Integration Over Replacement Follow Ashwin Ramasamy on: 👉 LinkedIn - https://www.linkedin.com/in/ashwinramasamy/ [https://www.linkedin.com/in/ashwinramasamy/] 👉 X - https://x.com/Ashwinizer [https://x.com/Ashwinizer] 👉 Company LinkedIn - https://www.linkedin.com/company/moative [https://www.linkedin.com/company/moative] 👉 Company Website - https://www.moative.com/ [https://www.moative.com/] Follow Robert Kowalick on: 👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/ [https://www.linkedin.com/in/robert-kowalick-610502102/] 👉 Company Website - https://ascendsolutionsllc.com/ [https://ascendsolutionsllc.com/] Follow Rehabbing Your Revenue Cycle Podcast: 👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle [https://www.youtube.com/@RehabbingYourRevenueCycle] 👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/ [https://www.facebook.com/RehabbingYourRevenueCycle/] 👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/ [https://www.instagram.com/rehabbingyourrevenuecycle/]

Why the Right Data is as Important in Small Businesses as it is in Big Companies – Jennifer Frigault

In this episode of Rehabbing Your Revenue Cycle Podcast, host Robert Kowalick [https://www.linkedin.com/in/robert-kowalick-610502102/] welcomes Jennifer Frigault, PCC [https://www.linkedin.com/in/jenniferfrigault/], former SVP of Data and Analytics at Gannett, Inc / USA Today Co., Founder and Executive Coach at Spire Vision Leadership [https://www.linkedin.com/company/spirevisionleadership/], CEO Coach at Maui Mastermind [https://www.linkedin.com/company/maui-mastermind/] & Executive Leadership Coach at ExecOnline [https://www.linkedin.com/company/execonline/]. Jennifer shares her journey from heading up data initiatives at USA TODAY Co., Inc. [https://www.linkedin.com/company/usatodayco/] to helping small businesses improve financial, team, operations, sales, and marketing outcomes. She explains how her deep understanding of data, from predictive modeling to measuring must have metrics, is crucial for improving business outcomes. With her expertise, Jennifer is now helping clients in industries like healthcare optimize their processes and use data to drive better decisions, reduce complexity, and scale their businesses. Her story highlights the importance of leveraging data to maximize value and improve financial stability in challenging business environments. With over 20 years of experience in data strategy, Jennifer Frigault built a strong foundation in leading high-performing teams. Jennifer works with clients in various industries, including healthcare, to optimize processes using data. By identifying key areas for improvement and leveraging data for strategic decisions, Jennifer has helped clients increase efficiency, reduce complexity, and drive better financial outcomes. Her work empowers business owners to create more stable and scalable businesses, even in challenging environments. EXPECT TO LEARN -How Jennifer transitioned from senior vice president of data strategy in a multi-billion-dollar public company to helping small business owners through coaching. -Why having the right data is crucial for driving smarter business decisions and improving financial outcomes. -How data enables better decision-making around customer acquisition, marketing channels, and lifetime value. -How reducing revenue cycle complexity is the catalyst for improving practically every healthcare business outcome that impacts financial performance, stability and scalability all while helping business owners have a life outside of their successful business. -Why using the right data is key to identifying challenges, optimizing processes, and achieving business growth. -How aligning teams around common data-driven goals helps create a more stable and scalable business. TIMESTAMPS [00:00] – Teaser [03:22] – Jennifer’s Background: Data Strategy & Analytics Evolution [04:14] – The Role of Data in Scaling a Business [05:43] – Optimizing Patient Acquisition and Retention [07:42] – The Business Challenges in Physical Therapy [10:38] – Squeezed Margins and Rising Costs in Healthcare [13:16] – Using Data to Optimize Revenue Cycle Efficiency [16:29] – Expanding Services to Increase Client Lifetime Value [17:50] – The Core Business Must Be Solid Before Expansion [19:49] – Coding Optimization for Better Revenue [24:11] – Time Analytics and the 400% Efficiency Variance [26:22] – Reducing Complexity in Billing to Improve Cash Flow [29:15] – Identifying Root Causes of Billing Delays [32:21] – Balancing Billing Time Supply and Demand [35:35] – Connecting Teams Through Data Visualisation [38:04] – Overcoming Data Overload and Analysis Paralysis [40:08] – The Role of Marketing in Profitable Business Growth Follow Jennifer Frigault, PCC on: 👉 LinkedIn - https://www.linkedin.com/in/jenniferfrigault/ [https://www.linkedin.com/in/jenniferfrigault/] Company LinkedIn: 👉 Spire Vision Leadership - https://www.linkedin.com/company/spirevisionleadership/ [https://www.linkedin.com/company/spirevisionleadership/] 👉 Maui Mastermind - https://www.linkedin.com/company/maui-mastermind/ [https://www.linkedin.com/company/maui-mastermind/] 👉 ExecOnline - https://www.linkedin.com/company/execonline/ [https://www.linkedin.com/company/execonline/] https://www.moative.com/ Company Website: 👉 Spire Vision Leadership - https://spirevisionleadership.com/ [https://spirevisionleadership.com/] 👉 Maui Mastermind - https://mauimastermind.com/ [https://mauimastermind.com/] 👉 ExecOnline - https://www.execonline.com/ [https://www.execonline.com/] Follow Robert Kowalick on: 👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/ [https://www.linkedin.com/in/robert-kowalick-610502102/] 👉 Company Website - https://ascendsolutionsllc.com/ [https://ascendsolutionsllc.com/] Follow Rehabbing Your Revenue Cycle Podcast: 👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle [https://www.youtube.com/@RehabbingYourRevenueCycle] 👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/ [https://www.facebook.com/RehabbingYourRevenueCycle/] 👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/ [https://www.instagram.com/rehabbingyourrevenuecycle/]

Are Your Revenue Cycle Metrics Keeping Up with Healthcare Complexity? with Robert Kowalick - Part 2

If you haven't listened yet, start with Part 1 [https://youtu.be/goWO3wgBU2M] and then continue with Part 2 of this episode of Rehabbing Your Revenue Cycle, where host Robert Kowalick [https://www.linkedin.com/in/robert-kowalick-610502102/], Founder & CEO of Revenue Cycle Solutions, LLC [https://www.linkedin.com/company/revenue-cycle-solutionsllc/] and Ascend Solutions, LLC [https://www.linkedin.com/company/ascend-solutions-llc-co/], explains how understanding and tracking essential revenue cycle metrics provides the strategy for improving healthcare business financial outcomes. Our systems must provide the essential raw data from which meaningful metrics and analytics can be created.  RCM, like any other critical business pillar, needs strategic planning and focus areas that map into every revenue cycle task that impacts if, when, and how much providers are paid. In Revenue Cycle businesses, most team members do not understand their roles in the context of Revenue Cycle Objectives. Robert discusses how he has created the structure to provide this essential data story.  Robert also shares real-world examples and practical strategies for reducing complexities in revenue cycles and why this needs to be the central focus of all RCM operations. By creating the right data, metrics, and analytics, processes can be optimized, and healthcare businesses can enhance cash flow and build more financially stable and scalable businesses. As a top physical therapist with years of experience as a private practice owner, Robert transitioned into revenue cycle management after building and selling his own multi-location physical therapy practice. He now focuses on helping other healthcare providers optimize their businesses through a better data foundation, time analytics, and process optimization. Robert's expertise in both patient care and business operations has allowed him to create effective systems and strategies for improving revenue cycle performance. In this episode, Robert gets into the details of Revenue Cycle must have metrics and sets the stage for the next episode when Robert interviews Jennifer Frigault, the former head of data and strategy for USA Today Networks. EXPECT TO LEARN -How understanding and tracking key revenue cycle metrics can improve financial outcomes for healthcare practices -Why raw data and simple calculations are the foundation for creating more meaningful metrics and analytics -What raw data, calculations, metrics, and analytics are must-haves for any revenue cycle-dependent healthcare business -Why aligning all team members across the entire revenue cycle organization is critical to success, and how to do it. -How optimizing revenue cycle processes through data-driven insights can lead to a more profitable and scalable healthcare business. TIMESTAMPS: [00:00] – Teaser [01:11] – Gross Value of a New Patient as a Core Revenue Metric [03:45] – Patient AR vs Insurance AR: Must-Have Relative Metrics [06:51] – Measuring Time of Service Collection Shortfalls Per Visit [11:28] – Identifying Complexity by Function and Location [15:55] – Volume vs Production: Why Scale Alone Misleads [20:53] – AR Audit Frequency Based on ADO Score Condition [23:50] – Categorizing AR by Authorization, VOB, and Registration Errors [27:10] – Claim Break Rate: Open Claims Relative to Production [29:34] – Front Office Contribution to Claim Break Rates [31:40] – AR Follow-Up Score and Denial Rate Measurement [36:30] – 96% of Revenue Cycle Problems Originate Outside Billing [39:59] – Converting Data into Actionable Intelligence Each Month [42:27] – Expanding Complexity Tracking Beyond the Billing Function [43:05] – Future Episodes on AI, Data, and Revenue Cycle Innovation Company LinkedIn: 👉 Revenue Cycle Solutions, LLC - https://www.linkedin.com/company/revenue-cycle-solutionsllc/ [https://www.linkedin.com/company/revenue-cycle-solutionsllc/] 👉 Ascend Solutions, LLC - https://www.linkedin.com/company/ascend-solutions-llc-co/ [https://www.linkedin.com/company/ascend-solutions-llc-co/]  Company Website: 👉 Revenue Cycle Solutions, LLC - https://revenuecyclesolutionsllc.com/ [https://revenuecyclesolutionsllc.com/]  👉 Ascend Solutions, LLC - https://ascendsolutionsllc.com/ [https://ascendsolutionsllc.com/] Follow Robert Kowalick on: 👉 LinkedIn - https://www.linkedin.com/in/robert-kowalick-610502102/ [https://www.linkedin.com/in/robert-kowalick-610502102/] Follow Rehabbing Your Revenue Cycle Podcast: 👉 Youtube: https://www.youtube.com/@RehabbingYourRevenueCycle [https://www.youtube.com/@RehabbingYourRevenueCycle]  👉 Facebook: https://www.facebook.com/RehabbingYourRevenueCycle/ [https://www.facebook.com/RehabbingYourRevenueCycle/] 👉 Instagram: https://www.instagram.com/rehabbingyourrevenuecycle/ [https://www.instagram.com/rehabbingyourrevenuecycle/]