Vendor Voices - A Real Partners Revenue Cycle Podcast

Optimizing Revenue Cycle from Epic Implementations through Internal Collaborations: Insights from John Freeman & Bret O’Connor of Revigate

Optimizing Revenue Cycle from Epic Implementations through Internal Collaborations: Insights from John Freeman & Bret O’Connor of Revigate Efficient revenue cycle management is crucial in healthcare.Today’s episode dives deep into how innovative consulting firms like Revigate are reshaping this landscape. Led by experienced operators, they emphasize results-driven strategies tailored to the complexities of healthcareorganizations. Key Topics: * The unique approach of Revigate as operator-led revenue cycle optimizers * Optimizers or consultants: Doing the work versus advising on the work * Challenges and solutions in Epic implementation and optimization * The evolving role of revenue integrity and charge capture strategies * Future revenue cycle challenges and technology's role, including AI * The importance of being kind, collaboration, and partnerships in driving results   Timestamps: 00:00 - Introduction 01:04 – Vendor Voices Snapshot Challenge 05:40 – Introducing John Freeman & Bret O’Connor 10:08 – The importance of “doing the work” in addition to advising; being optimizers over consultants 14:05 – Measuring client success in the revenue cycle consulting world: ROI 16:00 – Advantages of a smaller consulting firm: There is no B-Team. 18:55 – Strategies for Epic implementation, pitfalls to avoid, emphasizing revenue accountability, change management, and maximizing functionality 24:50 – The risks of approaching an EMR implementation without support 27:00 – The significance of revenue integrity efforts and proactive charge capture 33:20 – Predictions & advice for 2026 revenue cycle challenges: Do more with less, find the right partners, protectnet revenue, and leverage automation / AI 36:30 – Final Parting Advice: Be kind! Tips for fostering organizational collaboration and trust. Communicating the importance of revenue cycle outcomes. The episode was brought to you by: Real Partners Consulting [https://realpartnersconsulting.com/] Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ [https://www.linkedin.com/in/ryanpdowns/]  Connect with John Freeman: https://www.linkedin.com/in/john-freeman-crcr-235661b4/ [https://www.linkedin.com/in/john-freeman-crcr-235661b4/] Connect with Bret O’Connor: https://www.linkedin.com/in/bretoconnor/ [https://www.linkedin.com/in/bretoconnor/] We Want Your Input! If you’d like to suggest a specific topic or guest, feel free to reach out to me on LinkedIn or email at rdowns@realpartnersconsulting.com. Please rate and review – and be sure to subscribe to nevermiss an episode! Thank you for listening!

Provider, Vendor, Operator: Patient Access Insights with Keith Eggert of Abax Health

Provider, Vendor, Operator: Patient Access Insights with Keith Eggert of Abax Health Take a journey through the ins and outs of Patient Access with Keith Eggert – a former patient access employee turned VP of Revenue Cycle - and now COO of Abax Health. Gain valuable insights into the challenges, innovative solutions, and future trends shaping this critical part of the revenue cycle, including specific tips on best practice scheduling and referrals. Key Topics: * The strategic role of patient access in healthcare success * How proper referral management connects patients with care to optimize revenue * The significance of referrals, scheduling, and real-time KPIs * Navigating lengthy sales cycles and vendor-provider partnerships * A lookback on the historical trends of Patient Access * A future outlook on patient access challenges and uninsured populations * Building a true partnership mindset between vendors and providers * Practical advice: walk in your patient's shoes for process improvement Timestamps: 00:00 - Introduction 01:04 – Vendor Voices Snapshot Challenge 05:09 - Keith Eggert’s background and transition fromprovider to vendor 06:57 - Challenges of lengthy sales cycles andnavigating healthcare bureaucracy 11:48 - The potential impact of AI on the sales cycle 13:54 - The importance of a vendor-providerpartnership and collaboration 17:00 – The provider challenge of balancing day-to-dayops with vendor attention 21:12 – Historical challenges in Patient Access, long-termtrends 25:38 – Patient Access themes of 2025; uninsuredpatients and OBBBA influences 29:31 - Critical KPIs for patient access success 32:25 - Enhancing referral tracking and patientengagement during scheduling 35:19 - Strategies for increasing patient appointmentscheduling 38:50 - Final parting advice: walk in your patient’sshoes for continuous improvement   The episode was brought to you by: Real Partners Consulting [https://realpartnersconsulting.com/] Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ [https://www.linkedin.com/in/ryanpdowns/]  Connect with Keith Eggert: https://www.linkedin.com/in/keith-eggert-fhfma-1604434/ [https://www.linkedin.com/in/keith-eggert-fhfma-1604434/] We Want Your Input! If you’d like to suggest a specific topic or guest, feelfree to reach out to me on LinkedIn or email at rdowns@realpartnersconsulting.com. Please rate and review – and be sure to subscribe to nevermiss an episode! Thank you for listening!

Making Financial Assistance Programs Easy & Uncovering Hidden Revenue by Leveraging Technology with Nick McLaughlin - Founder of Breez Health

Making Financial Assistance Programs Easy & UncoveringHidden Revenue by Leveraging Technology with Nick McLaughlin - Founder of Breez Health In this episode, Nick McLaughlin, Founder and CEO of BreezHealth, shares insights on revolutionizing healthcare financial assistance programs with technology, simplifying patient experience, and preparing for upcoming regulatory changes. If you're involved in hospital revenue cycles orpatient access, these strategies could transform your approach. In this episode: * The mission of Breez Health tomake healthcare financial assistance easy for patients and providers * Challenges with traditionalfinancial assistance workflows and how digitization improves patient engagement * Key components of an effectivefinancial assistance program: clear policies, simple online applications, andproactive communication * Impact of federal regulations like501R and state-specific requirements on hospital compliance * Strategies for leveragingtechnology and automation to reduce labor and increase efficiency * Preparing for regulatory shiftssuch as the One Big Beautiful Bill Act and increased Medicaid redeterminations * The importance of promotingfinancial assistance to underinsured populations to enhance community benefits * The role of structured,rules-based data processing versus AI in current solutions * The ROI of effective financialassistance programs: improved patient experience, reduced audit risk, andlifetime patient value * Practical advice for healthsystems to streamline processes and prioritize patient-centric care Timestamps: 00:00 - Introduction 01:00 – Vendor Voices Snapshot Challenge 06:23 - Founder Nick McLaughlin's background and motivation for starting Breez 08:03 - The importance of creating simple, effective policies and applicationsfor financial assistance 11:06 - Best practices for effective financial assistance programs and patientcommunication 15:00 - Explanation of federal regulation 501R and its implications 16:42 - Simplifying financial assistance programs amidst complex regulations 18:15 - Finding the balance in income verification documents and streamliningeligibility assessments 19:29 - Addressing backlog issues and improving application screening processes 21:04 - Impact of regulatory press and the importance of promoting financialassistance 22:21 - Challenges in hospital financial assistance programs: balancing the auditorapproach with the advocate approach 24:26 - Building trust and connecting with patients' needs through advocacy 25:41 - Navigating future regulatory changes, including the One Big BeautifulBill Act (OBBBA) 26:16 - How technology can help manage increased volume of Medicaidredeterminations and coverage churn 28:24 - The critical role of automation amid staffing shortages and risingworkload 30:00 - Breez's use of rules-based logic over AI and the potential forstructured data processing 31:36 - ROI for hospitals: community benefit, reduced audit risk, and lifetimepatient value 36:14 - Final advice: focus on promoting financial assistance proactively andcaring for underinsured patients 37:54 - Summing up: the importance of simplicity, communication, and compassionin financial assistance programs   The episode was brought to you by: Real Partners Consulting [https://realpartnersconsulting.com/] Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ [https://www.linkedin.com/in/ryanpdowns/] Connect with Nick McLaughlin: https://www.linkedin.com/in/nick-mclaughlin-fhfma/ [https://www.linkedin.com/in/nick-mclaughlin-fhfma/] Show Note: If you’d like to suggest a specific topic or guest, feelfree to reach out to me on LinkedIn or email at rdowns@realpartnersconsulting.com. Please rate and review – and be sure to subscribe to nevermiss an episode! Thank you for listening!

Using AI to Unlock Healthcare Revenue, Breaking Down DRG Downgrades, & A Founder’s Journey with Cofactor CEO & Founder, Adi Tantravahi

Using AI to Unlock Healthcare Revenue, Breaking Down DRGDowngrades, & A Founder’s Journey with Cofactor CEO & Founder, Adi Tantravahi In this episode, Adi Tantravahi, CEO and Founder of CofactorAI, shares insights into how AI-driven solutions are revolutionizing revenuecycle management, especially in tackling complex inpatient denials like DRGdowngrades and medical necessity denials. Discover strategies to improve appealeffectiveness, understand key healthcare coding concepts, and explore thefuture of AI in healthcare operations. Key Topics: * Introduction to Cofactor AI andits role in healthcare revenue cycle management * The complexity of inpatientdenials: DRG downgrades and medical necessity issues * How AI reduces appeal time from60-90 minutes to just a few minutes * The importance of accuratedocumentation and root cause analysis for preventing downgrades * Challenges of tracking denials andappeals effectiveness within EHR systems like Epic * The evolving landscape of AI inhealthcare: from RPA to advanced language models * The year 2025 as the pivotalmoment for AI adoption in revenue cycle * Practical tips for organizationsto quantify and address denial root causes * How structural healthcare issues,staffing shortages, and policy complexity drive the need for AI solutions * Building scalable processes withAI tools * Educational resources from CofactorAI, including guides on payer policies and sepsis denials Timestamps: 00:00 - Introduction and episode overview 01:08 – Vendor Voices Snapshot Challenge 04:50 – A founder's journey: from shadowing in a hospital to leading an AIhealthcare startup 07:38 - The impact of AI adoption: 2025 as the AI revolution in revenue cycle 08:15 - Surprising and humorous anecdotes from the industry 09:52 - Challenges faced by healthcare providers and strategic advice 11:02 - Success stories of early hospital launches and scalable strategies 16:31 - Education on DRG downgrades and medical necessity denials 17:23 - The significance of DRGs and documentation nuances 19:46 - The phenomena of silent denials and their hidden costs 22:13 - Practical steps to combat DRG downgrades and improve documentation 25:01 - Evaluating appeals and maximizing success rates 27:56 - How AI tools are currently transforming the revenue cycle industry 30:11 - Clarifying the RPA versus AI in healthcare automation 32:57 - Challenges and opportunities in expanding AI use, including ambientlistening and coding 35:33 - The importance of viewing AI as a supportive vehicle, not a replacement 36:56 - Healthcare systemic issues: staffing, policies, and technology needs 37:40 - The "12 Days of Denials" series: quick educational videos forrevenue cycle teams 39:00 - Final advice: leveraging educational content and resources to succeed The episode was brought to you by: Real Partners Consulting [https://realpartnersconsulting.com/] Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ [https://www.linkedin.com/in/ryanpdowns/]  Connect with Adi Tantravahi: https://www.linkedin.com/in/tantravahi/ [https://www.linkedin.com/in/tantravahi/] Show Note: If you’d like to suggest a specific topic or guest, feelfree to reach out to me on LinkedIn or email at rdowns@realpartnersconsulting.com. Please rate and review – and be sure to subscribe to nevermiss an episode! Thank you for listening!

Insurance Discovery & Revenue Cycle Optimization with Jeff Farmer, COO of eInsights

Insurance Discovery & Revenue Cycle Optimization withJeff Farmer of eInsights Explore the nuances of insurance discovery and its criticalrole in boosting hospital revenue as we sit down with Jeff Farmer, COO ofeInsights. Learn how comprehensive, real-time insurance discovery strategiescan recover missed revenue, improve cost reporting, and reduce patient billingissues. In this episode: * The origins of eInsights and itsinnovative insurance discovery engine * How eInsights identifiespreviously unknown insurance coverage, including secondary and retroactiveMedicaid eligibility * The importance of scanning allaccounts continuously, not just high-probability segments like ED or self-pay * The differences between insurancediscovery and eligibility checks—and why both are vital * Common misconceptions: real-timediscovery isn't just for ED, and it's not only useful for self-pay patients * The impact of comprehensiveinsurance discovery on cost reports, Medicaid secondary claims, and bad debtreduction * How a contingency fee modelguarantees ROI for hospitals using eInsights' solutions * Strategic advice for organizationsaiming to move from basic to best-in-class insurance discovery practices Timestamps: * (00:00) – Introduction: unlockinghidden revenue through insurance discovery * (01:18) – Jeff Farmer’s backgroundand eInsights' mission * (01:41) – Vendor Voices SnapshotChallenge * (06:05) – Why doesn’t everyone checkfor coverage everyone all the time: Complexity, the necessity for experiencedtechnologists, cost considerations, and the importance of full account coverage * (09:17) – Insurance discoveryversus eligibility checks * (11:02) – Market adoption and theprevalence of insurance discovery * (13:05) – The surprising extent ofinsurance gaps in hospitals * (15:32) –Insurance discovery beyondjust Medicaid / typical insurances discovered * (20:25) – The role of Medicaidenrollment history in insurance discovery * (21:09) – Beyond healthcare:identifying auto and workers' comp claims * (22:28) – Additional benefits:cost report improvements and bad debt recovery * (25:00) – Minimum steps fororganizations: real-time checks & continuous scanning * (26:22) – Moving from good togreat: comprehensive, always-on insurance search * (28:11) – Common misperceptions: limitingreal-time discovery to the ED * (31:31) – ROI-driven solutions andcontingency fee models ensuring guaranteed returns * (33:45) – Additional value:improving cost report metrics and Medicaid secondary claims * (37:44) – Key takeaway: start now,leverage comprehensive solutions * (38:49) – Final thoughts:maximizing revenue, reducing bad debt, and continuous improvement The episode was brought to you by: Real Partners Consulting [https://realpartnersconsulting.com/] Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ [https://www.linkedin.com/in/ryanpdowns/]  Connect with Jeff Farmer: https://www.linkedin.com/in/jeff-farmer-3b5a3410/ [https://www.linkedin.com/in/jeff-farmer-3b5a3410/] Show Note: If you’d like to suggest aspecific topic or guest, feel free to reach out to me on LinkedIn or email at rdowns@realpartnersconsulting.com. Please rate and review – and besure to subscribe to never miss an episode! Thank you for listening!