For The Love of Revenue Cycle

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 insurance, and helping to empower revenue cycle management experts to resolve those denials with greater efficiency.

We discussed Corey’s motivations for starting Covered - his brother Russell's experience with unfair insurance denials during his struggle with Ulcerative Colitis. Corey’s family was hit with massive bills, and at a time when they wanted to focus on Russell’s health, instead they were focused on denied claims. Covered intervenes to help providers overturn denials, and prevent bills from becoming patient responsibility.

Corey discussed his journey through the Special Forces, Parachute Health, and running sales for healthcare companies, eventually selling into insurance plans prior to starting Covered.

We discussed my career as well, and turning down Harvard undergraduate in pursuit of a life and career that aligned with my values of giving back and sharing what I've learned with others, which is why I started this podcast.

Corey and I met because he was looking for a podcast on denials and he found mine! We connected over a shared passion to create a denial resolution tool with the goal of harnessing the multitude of databases & sources of truth that a biller has to access in order to identify the root cause of a denial and create an appeal.

We are not only reducing the clicks required to gather the information, but creating a smart tool that will guide RCM professionals through the decisions required to compile the body of the appeal, and eventually generate it for them.

We addressed Covered’s competitive differentiation within the denial management space, and the rapid advancement of AI and LLMs, which have given an advantage to new companies. We touched on the slow moving nature of incumbents, and why they often don’t succeed in building product lines that are as innovative as their original core offering.

If Covered’s mission to fight back against incorrect denials resonates with you, we want to connect! Especially (but not exclusively) if you are an independent specialty provider group, an RCM company fighting denials, an, or a regional/community hospital/health system. If you are struggling to address denials as a result of staffing shortages/payer policies/behavior, or you are just passionate about denials, please reach out!

Today, Covered acts as a software enabled services company, utilizing technology to overturn denials (they’ve returned tens of thousands of dollars to physicians). In addition to helping Covered build out their product, I am helping Covered to actually fight denials as an extension of customer RCM teams. If you're struggling with denials, we can immediately step in and help you, and help identify trends and root causes. In special cases, we also provide consulting services.

One of the advantages of fighting denials on behalf of our customers is that we enter their world, and get to see their problems firsthand. That, in turn, allows us to tweak our product for each customer based on their specific pain points.

You can learn more about Covered on their website, and you can find Corey on Linkedin. As you discover more about Corey and his mission with Covered, I encourage you to check out his podcast Healthcare Reimagined (Apple or Spotify).

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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 including staffing shortages, the lack of standardization and the crucial role of both management and line workers. Tune in to gain invaluable insights, understand the power of community teamwork and informed decision-making. See you at the practice management symposium on February 16th!

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 you may recall, me and my production team were experience technical difficulties. But here we are back again!

In this final episode of Season 2, I’m going to share with you my experience with using reporting and analytics in revenue cycle management. This will include discussing why I believe analytics is so vital, what my favorite reports are and how I use them to run a clean revenue cycle.

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.page/p/7d25c7b7-9c16-490c-95cd-7bd2052fd396

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 time talking about the current state of affairs in our industry related to payer guidelines and staffing shortages.  I hope that you enjoy this conversation.

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.

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.

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.