Vendor Voices - A Real Partners Revenue Cycle Podcast

Provider, Vendor, Operator: Patient Access Insights with Keith Eggert of Abax HealthTake 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 successHow proper referral management connects patients with care to optimize revenueThe significance of referrals, scheduling, and real-time KPIsNavigating lengthy sales cycles and vendor-provider partnershipsA lookback on the historical trends of Patient AccessA future outlook on patient access challenges and uninsured populationsBuilding a true partnership mindset between vendors and providersPractical advice: walk in your patient's shoes for process improvementTimestamps:00:00 - Introduction01:04 – Vendor Voices Snapshot Challenge05:09 - Keith Eggert’s background and transition fromprovider to vendor 06:57 - Challenges of lengthy sales cycles andnavigating healthcare bureaucracy11:48 - The potential impact of AI on the sales cycle13:54 - The importance of a vendor-providerpartnership and collaboration17:00 – The provider challenge of balancing day-to-dayops with vendor attention21:12 – Historical challenges in Patient Access, long-termtrends25:38 – Patient Access themes of 2025; uninsuredpatients and OBBBA influences29:31 - Critical KPIs for patient access success32:25 - Enhancing referral tracking and patientengagement during scheduling35:19 - Strategies for increasing patient appointmentscheduling38:50 - Final parting advice: walk in your patient’sshoes for continuous improvement The episode was brought to you by: Real Partners ConsultingConnect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/  Connect with Keith Eggert: 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 [email protected] rate and review – and be sure to subscribe to nevermiss an episode!Thank you for listening!

Making Financial Assistance Programs Easy & UncoveringHidden Revenue by Leveraging Technology with Nick McLaughlin - Founder of Breez HealthIn 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 providersChallenges with traditionalfinancial assistance workflows and how digitization improves patient engagementKey components of an effectivefinancial assistance program: clear policies, simple online applications, andproactive communicationImpact of federal regulations like501R and state-specific requirements on hospital complianceStrategies for leveragingtechnology and automation to reduce labor and increase efficiencyPreparing for regulatory shiftssuch as the One Big Beautiful Bill Act and increased Medicaid redeterminationsThe importance of promotingfinancial assistance to underinsured populations to enhance community benefitsThe role of structured,rules-based data processing versus AI in current solutionsThe ROI of effective financialassistance programs: improved patient experience, reduced audit risk, andlifetime patient valuePractical advice for healthsystems to streamline processes and prioritize patient-centric careTimestamps:00:00 - Introduction01:00 – Vendor Voices Snapshot Challenge06:23 - Founder Nick McLaughlin's background and motivation for starting Breez08:03 - The importance of creating simple, effective policies and applicationsfor financial assistance11:06 - Best practices for effective financial assistance programs and patientcommunication15:00 - Explanation of federal regulation 501R and its implications16:42 - Simplifying financial assistance programs amidst complex regulations18:15 - Finding the balance in income verification documents and streamliningeligibility assessments19:29 - Addressing backlog issues and improving application screening processes21:04 - Impact of regulatory press and the importance of promoting financialassistance22:21 - Challenges in hospital financial assistance programs: balancing the auditorapproach with the advocate approach24:26 - Building trust and connecting with patients' needs through advocacy25:41 - Navigating future regulatory changes, including the One Big BeautifulBill Act (OBBBA)26:16 - How technology can help manage increased volume of Medicaidredeterminations and coverage churn28:24 - The critical role of automation amid staffing shortages and risingworkload30:00 - Breez's use of rules-based logic over AI and the potential forstructured data processing31:36 - ROI for hospitals: community benefit, reduced audit risk, and lifetimepatient value36:14 - Final advice: focus on promoting financial assistance proactively andcaring for underinsured patients37:54 - Summing up: the importance of simplicity, communication, and compassionin financial assistance programs The episode was brought to you by: Real Partners Consulting Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/Connect with Nick McLaughlin: 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 [email protected] rate and review – and be sure to subscribe to nevermiss an episode!Thank you for listening!

Using AI to Unlock Healthcare Revenue, Breaking Down DRGDowngrades, & A Founder’s Journey with Cofactor CEO & Founder, Adi TantravahiIn 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 managementThe complexity of inpatientdenials: DRG downgrades and medical necessity issuesHow AI reduces appeal time from60-90 minutes to just a few minutesThe importance of accuratedocumentation and root cause analysis for preventing downgradesChallenges of tracking denials andappeals effectiveness within EHR systems like EpicThe evolving landscape of AI inhealthcare: from RPA to advanced language modelsThe year 2025 as the pivotalmoment for AI adoption in revenue cyclePractical tips for organizationsto quantify and address denial root causesHow structural healthcare issues,staffing shortages, and policy complexity drive the need for AI solutionsBuilding scalable processes withAI toolsEducational resources from CofactorAI, including guides on payer policies and sepsis denialsTimestamps:00:00 - Introduction and episode overview01:08 – Vendor Voices Snapshot Challenge04:50 – A founder's journey: from shadowing in a hospital to leading an AIhealthcare startup07:38 - The impact of AI adoption: 2025 as the AI revolution in revenue cycle08:15 - Surprising and humorous anecdotes from the industry09:52 - Challenges faced by healthcare providers and strategic advice11:02 - Success stories of early hospital launches and scalable strategies16:31 - Education on DRG downgrades and medical necessity denials17:23 - The significance of DRGs and documentation nuances19:46 - The phenomena of silent denials and their hidden costs22:13 - Practical steps to combat DRG downgrades and improve documentation25:01 - Evaluating appeals and maximizing success rates27:56 - How AI tools are currently transforming the revenue cycle industry30:11 - Clarifying the RPA versus AI in healthcare automation32:57 - Challenges and opportunities in expanding AI use, including ambientlistening and coding35:33 - The importance of viewing AI as a supportive vehicle, not a replacement36:56 - Healthcare systemic issues: staffing, policies, and technology needs37:40 - The "12 Days of Denials" series: quick educational videos forrevenue cycle teams39:00 - Final advice: leveraging educational content and resources to succeedThe episode was brought to you by: Real Partners Consulting Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ Connect with Adi 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 [email protected] rate and review – and be sure to subscribe to nevermiss an episode!Thank you for listening!

Insurance Discovery & Revenue Cycle Optimization withJeff Farmer of eInsightsExplore 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 engineHow eInsights identifiespreviously unknown insurance coverage, including secondary and retroactiveMedicaid eligibilityThe importance of scanning allaccounts continuously, not just high-probability segments like ED or self-payThe differences between insurancediscovery and eligibility checks—and why both are vitalCommon misconceptions: real-timediscovery isn't just for ED, and it's not only useful for self-pay patientsThe impact of comprehensiveinsurance discovery on cost reports, Medicaid secondary claims, and bad debtreductionHow a contingency fee modelguarantees ROI for hospitals using eInsights' solutionsStrategic advice for organizationsaiming to move from basic to best-in-class insurance discovery practicesTimestamps:(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 improvementThe episode was brought to you by: Real Partners Consulting Connect with Ryan Downs: https://www.linkedin.com/in/ryanpdowns/ Connect with Jeff Farmer: 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 [email protected] rate and review – and besure to subscribe to never miss an episode!Thank you for listening!

Welcome to Vendor Voices!In the world of healthcare finance, we often talk about the Revenue Cycle as a series of processes.And behind every one of those processes is a community of innovators, strategists, and problem-solvers who spend every day working to overcome some of the same challenges that you’re likely facing.Vendors aren't just suppliers of software or services.They’re some of the most knowledgeable voices in ourindustry. And it turns out they have a lot to say.I’m Ryan Downs.And this is Vendor Voices - a Real Partners Revenue Cycle Podcast.Vendor Voices was built to move the needle on financial outcomes - one vendor at a time.Whether or not you’re looking for a vendor, there’s immense value in understanding the trends they're seeing, the technologies they’re building, and the strategies they're deploying.This show is your opportunity to hear what those leaders are focused on - without being sold to.If you’re accountable for real financial outcomes in the revenue cycle space - and you’re looking for a smarter way to stay informed - you’re in the right place.Click subscribe on Apple, Spotify, or YouTube to never miss an episode. And if you like the content, be sure to share.This is Vendor Voices.