Did you ever wish that you had a physician revenue cycle expert and mentor with over 20 years of experience whispering success secrets in your ear? That’s exactly what you will get when you tune into For the Love of Revenue Cycle hosted by me, Vanessa Moldovan. My career and my life have brought me a wealth of knowledge and I can’t wait to share with you. My passion is to help others in the industry to reach their full potential and find success in the wonderful, crazy world of physician rev ...
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Change Healthcare is a leading healthcare technology company, focused on accelerating the transformation of the healthcare system through the power of the Change Healthcare Platform. We provide data and analytics-driven solutions to improve clinical, financial, administrative, and patient engagement outcomes in the U.S. healthcare system. Learn more at changehealthcare.com. *
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Ep. 33 Insurance AR: Claims with No Response
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Navigating Insurance AR: Tackling Claims with No Response In this episode, Vanessa Moldovan, CEO and host of 'For The Love of Revenue Cycle,' delves into the intricacies of Insurance Accounts Receivable (AR), focusing on claims with no response. Vanessa explains the significance of managing AR to maintain financial health and provides practical str…
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Live Denials Q&A 9/5/24 - Hospice, SNF, Home Health denials + takebacks
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In this episode, Vanessa Moldovan, CEO and Founder of 'For the Love of Revenue Cycle,' leads a live Q&A session on handling denials in medical billing. Participants from different sectors of the healthcare revenue cycle, including medical billing for home visits, nursing homes, and surgery centers, discuss challenges they face with denial codes, mo…
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Live Denials Q&A 8/1/24 - Navigating Out of Network Denials
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Show notes for today's live denials Q&A session: The differences in denials and appeals processes between in-network and out-of-network providers Strategies for appealing out-of-network denials, including involving patients and leveraging laws like the Arisa law Trends in payer requests for documentation and potential reasons behind sudden increase…
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Ep 32 Tech-Enabled RCM: Tips and Solutions with Mike Marshall + Vanessa
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Tech-Enabled RCM: Tips and Solutions with Mike Marshall + Vanessa In this episode, Vanessa welcomes Mike Marshall to discuss the intricacies of revenue cycle management (RCM) and the challenges faced by healthcare organizations. Mike is currently the Managing Director of the North American division of e5 Workflow, with a rich background in healthca…
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Live Denials Q&A 7/16/24 - payer denial trends creating complexity
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In this episode, Vanessa Moldovan hosts a Q&A session focused on the challenging issues of denials in revenue cycle management. Vanessa, along with the attendees, discusses the complexities around denial prevention, resolution, and best practices. The session covers specific payer issues, including downcoding by Anthem and Humana, as well as rampan…
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Ep. 31 Patient Accounts Receivable
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n episode 31 of 'For the Love of Revenue Cycle,' the host discusses patient accounts receivable (AR) in a clinic setting, emphasizing the importance of professional billing over facility billing. Key topics include naming conventions in billing systems, the role and definition of a guarantor, and the nuances between insurance processing and payment…
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Ep. 30 Denials/AR Introduction + FTLORC Announcement
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Get ready for Season 3 of For the Love of Revenue Cycle, premiering tomorrow with Episode 30! I'm back with a deep dive into denials and accounts receivable in the revenue cycle. Listen in, as I unpack the complexities of denials and their impact on healthcare organizations. I'll share insights from recent industry events and personal experiences, …
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Live Denials Q&A 6/18/24- telehealth billing guidelines, claim rejection challenges, & denial resources
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In this episode, we dive into effective strategies for preventing and resolving denials in healthcare billing. Our speakers cover essential tips like checking the place of service, sharing experiences, and networking with other professionals. We explore various types of rejections in healthcare claims, emphasizing the need to understand their origi…
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Live Denials Q&A 6/6/24 - timely filing, authorizations & credentialing
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During today's live Q&A we had some great discussion about important denials that you and your organization are probably experiencing. We had some great interaction with 28 attendees. Check out the conversation!
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Extra Episode: Reducing the Denial Headache with Corey Feldman, founder of Covered Health
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Corey started Covered Health to automate the most challenging element of appealing denied medical claims by streamlining the access to diverse databases and sources to pinpoint denial root causes. I decided to partner with Covered because we share the same vision: preventing patients from getting stuck with bills that should be covered by their ins…
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*Special Episode - Stop Revenue Leakage
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Dive into the world of healthcare industry in our special episode of PM Symposium where we uncover the many facets of the revenue cycle. Hosted along with Jennifer McNamara, we discuss the impact of practice managers, the importance of understanding the revenue cycle, and how to combat revenue leakage. We explore some of the major challenges includ…
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Ep. 29 Season 3 Kickoff + Big Announcement
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Hello Friends! Welcome to the kickoff of season 3! I am overwhelmed to still be running this podcast after 2 years. Thank you as always for your support. In this episode, I share what the topic of season 3 will be and share a big announcement. Speaking of the big announcement, here is the link that I reference. https://fortheloveofrevenuecycle.aweb…
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Hello friends and welcome to episode 28 of For the Love of Revenue Cycle. Thank you so much for tuning in today! A big welcome back to my loyal listeners and a special shout out if today is your first episode. This season is part of the going back to the basics from season 2. I know that it has been about 5 months since Episode 27 was posted. As yo…
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6/5/23 Live Q&A - End of PHE; State of the industry; Operational challenges & more
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Hello Rev Cycle Lovers! This episode is a recording of our live Q&A session today. It is raw and unedited, but that does not diminish the great conversation. We discussed some challenges with the end of PHE, operational challeges that cause denials and also different options for assigning individuals within the revenue cycle. We also spent some tim…
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Ep. 27: Prior Auth, Referrals, Precertification, etc.
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In today's episode, we go back to the "Language of Revenue Cycle" to discuss the differences between the concepts of prior auth, referrals, precertification and predeterminations.
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Technical Difficulties - no episode 4/3/23
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In this short episode I thank the listeners for their patience while I took some time off and announce the new podcast schedule with new episodes.
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Partnering for Change: The Benefits of Value-Based Care Models
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VP and Head of Solutions at Nuna, Parag Patel, chats about how the Prometheus Episode Grouper from Change Healthcare has helped Nuna better serve all. Learn More Follow Serrah Linares, vice president of partnerships at Change Healthcare Follow Parag Patel, VP and Head of Solutions at Nuna nuna.com changehealthcare.com/value-based-care/prometheus-an…
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Patient Experience: Social Determinants of Health in Cancer Care
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Thyme Care Co-Founder, President, and CMO, Dr. Bobby Green, joins host Yousuf Zafar, MD, to discuss how his team at Thyme Care are working to provide personalized care guidance to help cancer patients through their journey. Dr. Green also shares the importance of combining a human touch with technology to help improve lives and reduce care costs. L…
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Partnering for Change: Improving Access to Care Through Transportation
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Safr Care CEO, Syed Gilani, joins host Serrah Linares to discuss how Safr Care approaches the unique challenges they face, and how Change Healthcare helps Safr Care achieve its mission. Learn More Follow Serrah Linares, vice president of partnerships at Change Healthcare Follow Syed Gilani, President and CEO of Safr Care safrcare.com marketplace.ch…
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This is an announcement regarding upcoming changes to the podcast schedule.
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Ep. 26: Revenue Cycle Management with 2022 challenges
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The topic I have today kind of covers several topics. I had a hard time coming up with the title of this episode because it isn’t about just one thing. But let’s just say that if you are struggling with most of the country to run your revenue cycle with staff shortages, crazy payer expectations and the patient as a consumer, then you have come to t…
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Health Care Mandates: Implementing a DSNP
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Quartz Health Solutions director of accreditation and quality insurance, Amy Bachhuber and senior director of Medicare operations, Mark Kirchberg join host Shelley Stevenson to discuss how they implement dual eligible special needs plans. Learn More Follow Shelley Stevenson, director government programs practice at Change Healthcare Consulting Foll…
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Ep. 25: Institutional vs. Professional Billing
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Today, we are going to talk about some of the differences between institutional vs. professional billing or hospital vs. physician billing. I want to remind you this is very high level and basic. But I think it’s a good introductory into those differences.
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Today, we are going to talk about the various part of Medicare: A, B, C, and D. I’ll share with you what each part is and then share some of the payment or reimbursement models for Medicare.
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Today, we are going to discuss appeals. What are they? What is their purpose? What makes a great appeal?
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Live Q&A 10/4/22 - Free CEUs, accessing payer policies, and more
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During today's live Q&A, we talked about billing emergency visits with procedures in the inpatient setting, options for free CEUs, how to access payer policies and how we can integrate the topic of specialties into the podcast. Great conversation!
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Capitol Connection: Marching to the Midterms
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Sirona Strategies Partner Kristen Ratcliff McGovern joins host Deanne Kasim to discuss policy and legislative trends leading up to the midterm elections. McGovern shares the key issues Congress needs to focus on before the end of the year, as well as some pre- and post-election considerations. Learn More Follow Deanne Kasim, vice president of healt…
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Today, we are going to discuss five KPIs. Common key performance indicators in physician revenue cycle. We’ll discuss how the KPIs are formulated and how they can be used to maintain an efficient and effective revenue cycle.
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Ep. 21: Edits, Rejections, Status and Denials
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Today, we are going to discuss edits, rejections, claim statuses and denials. We’ll be taking a look at each concept to understand their differences and how it is so easy to confuse them.
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Ep. 20: Quick Hit Acronyms HIS, HIM, HIE, HIT
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If you have been in healthcare for more than 10 seconds you know that we love our acronyms. I’ll be sporadically talking about acronyms over the coming weeks. Today’s episode is about the acronyms HIS, HIT, HIE and HIM (and we are throwing a few others in there). Let’s jump in.
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Zoom Live Q&A 9/20/22 - Welcome back
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This is a recording of our Live Q&A from 9/20/22. We are back after several months off. This is an open forum time to discuss anything with me or between those who attend. Today's discussion was some catching up and getting to know you and discussing some of the challenges of billing. Please send me your email address if you would like to be added …
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Ep. 19: Credentialing, Contracting, Enrollment
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Welcome to the first episode of Season 2! Today’s episode is about credentialing, contracting, and enrollment. These are very different concepts, but often get confused. Hopefully, I’ll be able to sort out some of the confusion.
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I am thrilled to be back! Thank you for your patience and support. As the title would indicate, this episode is a teader of what is coming up in Season 2. First episode of the season will be streaming on September 12th!
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Patient Experience: An Evolved Approach to Digital Engagement
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Luma Health Co-Founder and CEO Adnan Iqbal joins host Patrick Drewry to discuss how and why his company created a digital patient engagement platform and why Luma Health chose to partner with Change Healthcare to create a singular patient journey across healthcare. Learn More Follow Patrick Drewry, VP of product RCM at Change Healthcare Follow Adna…
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Partnering for Change: Wedding Health Technology with Indigenous Wisdom
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Sustain Hawaii Founder and Executive Director Kevin Vaccarello joins host Serrah Linares to discuss the work being done to support vulnerable Hawaiians using both technology and indigenous wisdom. Vaccarello shares how Sustain Hawaii was able to use technology to expand its operation and support its mission of transforming the islands’ capacity for…
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Ep. 18: Day in the Life of a Medical Biller
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Today is the second episode in our Day in the Life Series. I’ve been really looking forward to bringing you this series. In the next few episodes, we will be talking about the various roles within the revenue cycle. I believe that it is important for all of us to understand the responsibilities, pressures and expectations involved in these roles. U…
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Ep. 17: Boost Your Career with Emily Hawkins
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Are you stuck in a job that you are desperate to get out of? Do you feel like your loyalty is holding you back? Have you been searching for a job and just not getting anywhere? Today's episode is the one for you. Emily Hawkins mission is empowering the unfulfilled and unrecognized to amplify their job search and career to make a salary they deserve…
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Important podcast announcement.
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Healthcare Mandates: Consent and Data Segmentation
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Cambridge Health Alliance Chief Medical Information Officer Hannah Galvin and OneRecord Co-Founder and CEO Jennifer Blumenthal join host Genevieve Morris to discuss how technology can support consent capture and revocation, consent sharing, and the standardization of segment-sensitive data. Learn More Follow Genevieve Morris, senior director of int…
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Ep. 16: Day in the Life of a Revenue Cycle Manager
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Today is the first episode in our Day in the Life Series. I’ve been really looking forward to bringing you this series. In the next few episodes, we will be talking about the various roles within the revenue cycle. I believe that it is important for all of us to understand the responsibilities, pressures and expectations involved in these roles. Un…
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Ep. 15.3: Common Modifiers, Part 3
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Today’s episode is the final part in our 3-part series on modifiers in the clinical or office setting. As many of you know, modifiers are an essential part of the revenue cycle. They have a direct effect on the revenue flow of the organization. Decisions on appending the correct modifier starts with the provider’s documentation, then it’s in the ha…
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Capitol Connection: Post-Pandemic Healthcare Policy
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Alliance of Community Health Plans President and CEO Ceci Connolly joins host Deanne Kasim and colleagues to chat about the current status of Medicaid and possible safeguards for vulnerable populations. Learn More Follow Ceci Connolly, president and CEO at Alliance of Community Health Plans Follow Deanne Kasim, VP of health policy at Change Healthc…
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Ep. 15.2: Common Modifiers Part 2
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Today’s episode is part 2 in our 3-part series on modifiers in the clinical or office setting. As many of you know, modifiers are an essential part of the revenue cycle. They have a direct effect on the revenue flow of the organization. Decisions on appending the correct modifier starts with the provider’s documentation, then it’s in the hands of t…
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Zoom Live Q&A 4/5/22 Breaking Down Billing for New Drugs with Stephanie Thebarge
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In this live Q&A, Stephanie Thebarge CPC, CPMA, CPPM, CPB, CEMC, CHONC, PESC shares with us her extensive knowledge of drug billing. If you have any further questions or would like a copy of the presentation, please reach out to her at sthebarge@gmail.com.
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Ep. 15.1: Common Modifiers Part 1
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Today’s episode is part 1 in our 3-part series on modifiers in the clinical or office setting. As many of you know, modifiers are an essential part of the revenue cycle. They have a direct effect on the revenue flow of the organization. Decisions on appending the correct modifier starts with the provider’s documentation, then it’s in the hands of t…
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Zoom Live Q&A 3/22/22 - Modifier intro
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In this live Q&A we have a sneak peek into the modifier series. We discuss modifiers 24, 25 and 79. If you love it, check out the next 3 episodes as we dive into common modifiers.
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3/17/22 No Surprises Act Live Q&A Panel
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The No Surprises Act has definitely been a surprise to many of us! Do you still struggle with details in the policy and how to be compliant when applying them to operations? This is a recording of the Live Q&A Panel we held today with our subject matter experts. I have no doubt that you will find helpful information within this great conversation.…
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Ep. 14: AAPC and Careers with Rae Jimenez
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I am so excited to introduce the guest in this episode. I have to admit that I was fangirling a little bit. If you are involved with AAPC or have taken advantage of their educational opportunities, you have probably heard of her. So without further ado, my guest today is Rae Jimenez. In our conversation you will learn that her current role at AAPC …
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Ep. 13.2: Marketing a Billing Company with Quiana Craig
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Today’s episode is part 2 in a series in which Quiana Craig shares with us her journey in growing her company. If you didn’t catch part 1, press pause on this one and go back to listen. If you have been thinking about starting your own company or are looking for ways to freshen up your current one, stay tuned and get some great tips from a pro.…
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