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EmblemHealth issued New York City-based Mount Sinai Health System’s independent practice association a cease-and-desist letter regarding its decision to stop…
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Bring external payer data into a health system and it can look like a one-time integration project — connect, map, deliver, done. It rarely works that way. Teams must track expected files, validate incoming data, interpret payer-specific formats, reconcile claims…
Presented by:
- Rob Pinataro, CEO, Health Data Innovations
- Christopher Ragsdale, Founder and Principal, Towers Advisory
- John Supra, Founder and Managing Member, Better Health Matters
- Jonathan Kaye, Founder and Executive Chairman, Health Data Innovations
In this episode, Boris Pasche, MD, PhD, FACP, President and Chief Executive Officer of Barbara Ann Karmanos Cancer Institute and Oncology Department Chair at Wayne State University, joins the podcast to discuss navigating uncertainty in today’s healthcare environment. He shares…
Hospitals are at an inflection point. Today’s ED boarding, workforce shortages, and rising length-of-stay pressures can’t be solved by yesterday’s tools. Inpatient leaders are expected to deliver safe, predictable care amid bottlenecks that shift by the hour — a challenge…
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In this episode, Robert Corona, DO, CEO of SUNY Upstate University and Community Hospitals, shares lessons from his healthcare leadership journey, including navigating COVID-19, taking career risks, and leading with kindness. He also discusses the importance of preparation, lifelong learning…
In this episode, Amanda Free, Anthem Blue Cross and Blue Shield of Georgia Commercial President, discusses improving healthcare affordability, expanding access in rural communities, strengthening value-based care partnerships and helping members make smarter choices about where and how they receive…
In this episode, Mark D. Sparta, FACHE, President and Chief Operating Officer, Hackensack Meridian Health, discusses expanding ambulatory care, improving throughput and access, and using technology and AI to meet rising demand. He also shares his approach to building the…
At Seattle Children’s, approximately 94% of specialty referrals arrive by fax. That means staff process more than 10,000 referrals each month across 39 specialty clinics. Before a patient can be scheduled or seen, staff must review each referral, identify missing…
Presented by:
- Shannon Degnan, MSN, Clinical Systems Architect, Seattle Children's
- Grant Egerdahl, IT Applications Analyst, Lead with the Departmental Systems team, Seattle Children’s
Federal auditors found that 13 percent of the prior authorization requests Medicare Advantage plans denied met Medicare coverage rules, care that likely should have been approved. The pressure that creates lands on the revenue cycle. This report shows how health…
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Hospital revenue loss rarely begins with a bad claim. It often begins days or weeks earlier, when a service is scheduled before authorization requirements are confirmed, documentation is incomplete or the final service no longer matches what was approved. That…
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In this episode, Mandy Eaton, PhD, President and CEO of Memorial Health, joins the podcast to discuss building a strong workplace culture and the importance of creating a diverse and inclusive workforce. She also shares her perspective on the growing…
Popular in EHRs / Interoperability
Popular in HR
Million-dollar data: Why ‘interoperability’ isn’t solving your records problem — and what will
Presenters: Kaushal Kulkarni, M.D.Alex DanielsNishant ("Nish") Hari
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