Care Beyond Code

About Care Beyond Code

Welcome to Care Beyond Code, a new show from VBA where we explore the strategies and decisions that bring humanity into the healthcare system, creating better experiences for members, patients, and businesses alike. In each episode, we cover stories of human impact, thanks to administrators going above and beyond the call of duty, as well as deeper-dive, narrower discussions on cutting-edge technology making waves across our industry. Learn more about VBA here: https://vbasoftware.com/

Publisher

VBA

Category

business

Language

en

Explicit

No

First episode

12 Nov 2025

Latest episode

23 Oct 2026

Latest episodes

9 episodes in the feed.

1. 

   23 Oct 2026

   How Logistics Return Agency to Patients | David Berg, Redirect Health

   "Whoever controls logistics controls the flow of time and energy and data and money." Dave Berg, Co-Founder & CEO of Redirect Health, explains how claiming this control redefines the member experience. In this episode of Care Beyond Code, Dave explores why health insurance should be the final step (not the first) in a patient's journey. By separating the act of receiving care from the act of financing it, he reveals how a dedicated logistics platform democratizes the insider advantage. This approach shifts power away from legacy systems and gives individuals true agency over their medical decisions, urgency, and out-of-pocket costs. Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech.

2. 

   5 Aug 2026

   The Five Mountains of Healthcare Payments | Jessica Gerow, Zelis

   Getting a payment digitally from point A to point B in healthcare is table stakes. But what happens in between? In this episode of Care Beyond Code, Adam sits down with Jessica Gerow, SVP & GM of Payments at Zelis, to explore how modernizing the financial healthcare experience is clearing up the fragmented "messy hair clump" of claims, payer portals, and paper checks. What you’ll learn: -- How a large health system handled a 40% growth in claims backlog with zero headcount increase. -- Why digitizing $500 million in paper checks saved an Integrated Delivery Network (IDN) $400,000 a year. -- The "five mountains" of healthcare payments: cybersecurity, banking, technology, legislative affairs, and customer service. -- How tools like ZAPP Edge and Claims Insights are moving the industry beyond just "digital paper". 00:00 Introduction 00:56 Where Zelis fits in the healthcare ecosystem 02:13 The "five mountains" of provider payments 03:18 Story 1: Tackling a 40% claim backlog growth 05:32 Aggregating data and dollars with ZAPP Edge 11:14 How to build trust when procuring new tech 13:28 Story 2: Digitizing $500M in paper checks 17:09 The future of healthcare modernization 19:11 Will the industry ever lose the paper aspect? Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech.

3. 

   3 Aug 2026

   We Overturned a Specialty Drug Denial (here's how) | Darci Roskelley, Direct Care Administrators

   Imagine receiving a rapid cancer diagnosis, only to be told your critical specialty drug treatment isn't covered. In this episode of Care Beyond Code, we explore how one team turned a devastating denial into a fully covered path to recovery. Darci Roskelley, Director of Operations at Direct Care Administrators, joins the show to share a high-stakes impact story about navigating the complex healthcare administration system. She explains how a simple misclassification between pharmacy benefits and medical benefits almost cost a patient everything, and how her team intervened. By leveraging international sourcing and removing the patient from the confusing middleman process, they secured the necessary care without the upfront costs. What you’ll learn: -- How miscommunication between PBMs and medical benefits causes denials -- The steps to investigate and overturn a specialty drug denial -- How international sourcing can significantly reduce medication costs -- Why looking at the "whole picture" of a patient's health journey matters Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech.

4. 

   17 Jun 2026

   Closing the Benefits Education Gap | Jerame Dellapenta, Nova Healthcare

   What happens when critical care is blocked by administrative red tape? In this episode of Care Beyond Code, we sit down with Jerame Dellapenta, Director of Service Delivery and Engagement. He shares a powerful story of navigating the complexities of healthcare administration to help a family afford essential autism spectrum testing. What you’ll learn: -- How a dependent care account (FSA) provided an unexpected financial lifeline -- The critical need for better member education regarding elected benefit accounts -- Strategies for building a servant-leadership culture in customer service 00:00 Introduction to Care Beyond Code 01:23 A Patient's Autism Diagnosis Story 03:33 The Coverage Roadblock 07:45 Finding an Out-of-the-Box Solution 11:06 The Power of FSA and DCA Accounts 13:46 Closing the Benefits Education Gap 17:03 Instilling a Culture of Empathy 22:53 Final Thoughts and VBA's Mission Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech. MLI2AZFHRFJMKRI3

5. 

   7 Apr 2026

   Preventing the Train Wrecks of Tomorrow | Alberta Manga and Miranda Buder, Custom Design Benefits

   In this episode of Care Beyond Code, we're joined by Alberta Manga (https://www.linkedin.com/in/alberta-manga/)and Miranda Buder (https://www.linkedin.com/in/miranda-buder-92b73bb0/) from Custom Design Benefits (https://www.customdesignbenefits.com/). They discuss how their unique in-house medical management and patient advocacy teams use data to predict and prevent high-risk hospital admissions. Listen as they share two high-impact stories of real people navigating difficult diagnoses. Learn how Custom Design Benefits secured a single case agreement for out-of-network cancer care in just three hours to avoid surprise billing. Then, hear how they guided a patient through post-discharge financial anxiety by securing community resources and setting up a hospital payment plan. What you will learn: -- How in-house case management eliminates lagging data transfers to assist members immediately. -- Why looking at the social determinants of health is crucial for a successful patient recovery. -- How three-way calls can help laymen navigate complex hospital financial conversations. 00:00 Welcome to Care Beyond Code 00:46 Introduction to Custom Design Benefits 01:45 The Advantage of In-House Medical Management 03:21 Predicting and Preventing Future Health Crises 05:04 Addressing Social Determinants of Health 06:44 Story 1: A Testicular Cancer Diagnosis 08:28 Securing an Out-of-Network Single Case Agreement 11:15 Resolving Patient Frustration in Just Three Hours 15:04 Building Long-Term Trust with Patients 16:25 Story 2: Recovering from a Ruptured Appendix 17:27 Providing Community Resources for Financial Anxiety 20:44 Navigating Hospital Payment Plans via Three-Way Calls 22:24 The Importance of Compassionate Healthcare Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com. Don't forget to subscribe for more insights into the future of healthcare tech.

6. 

   24 Mar 2026

   How We Erased an $80,000 Medical Bill | Todd Archer, Concierge TPA

   In this episode of Care Beyond Code, we sit down with Todd Archer (https://www.linkedin.com/in/todd-e-archer-a311588/), President of Concierge TPA (https://ctpa.com/) (CTPA), to discuss how technology is injecting more humanity into healthcare administration. We explore how his team leverages hospital bill reviews and the 501(r) tax code to assist vulnerable members on limited benefit plans. What you’ll learn: -- How a life-changing wrist surgery bill was successfully reduced to zero. -- The unique financial challenges faced by workers with limited or no benefits. -- How modern technology connects electronic medical records to hidden financial assistance. -- The future of on-demand communication and AI in the health insurance space. If you found this story inspiring, be sure to subscribe to our channel for more examples of care above and beyond the code! 00:00 Introduction to Care Beyond Code 01:19 Meet Todd Archer and Concierge 02:10 Serving the Underserved 04:08 Traditional TPA Practices 06:26 Setting the Stage for an $80k Bill 08:20 Understanding Hospital Bill Reviews 09:15 The Power of Section 501(r) 11:54 Erasing an $80,000 Debt 13:08 Automating Patient Outreach 15:27 Leveraging Electronic Medical Records 19:08 The Human Impact of Zero Debt 20:56 Navigating Hospital Relationships 23:51 The Future of AI in Insurance 26:07 Keeping the Human Touch Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com (https://vbasoftware.com/). Don't forget to subscribe for more insights into the future of healthcare tech.

7. 

   10 Dec 2025

   Why is the "Old School" Healthcare Approach Still Winning? | Mike Castleberry, CRO of Consociate

   What happens when a pharmacy system denies a prescription for a sick patient? Or when a member battling a serious illness is buried under a mountain of confusing medical bills? In healthcare administration, code and software can only do so much. Sometimes, you just need a human to pick up the phone. In this episode of Care Beyond Code, we sit down with Mike Castleberry (https://www.linkedin.com/in/mike-castleberry-7644722a/), CRO of Consociate Health (https://consociatehealth.com/), to discuss the critical balance between operational efficiency and human empathy. Mike shares two powerful stories from the front lines of benefits administration that prove why the "old school" method of personal advocacy is still the most effective way to solve complex member problems. In this episode, we cover: The Pharmacy Glitch: Why simple prescriptions get denied and the manual intervention required to fix it. The "Big Stuff": How TPAs can relieve the administrative burden for members facing catastrophic health events. Balance Billing: The specific steps administrators take to reconcile provider bills so members don't pay what they don't owe. AI vs. Humans: Why technology should handle eligibility, but humans must handle the care. 00:00 Introduction: The Spectrum of Life 00:53 Meet Mike Castleberry & Consociate 01:49 Story 1: The Prescription Problem 07:11 Why the System Breaks at the Pharmacy Counter 10:04 The Value of "Old School" Communication 12:08 Story 2: When Medical Bills Stack Up 17:43 Resolving Balance Billing Issues 20:59 The Future of AI in Benefits Administration 24:52 Conclusion: Instituting Care Beyond Code Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com (https://vbasoftware.com/). Don't forget to subscribe for more insights into the future of healthcare tech.

8. 

   12 Nov 2025

   Thankful For A Denial? | Care Beyond Code feat. Jessica Vander Zanden of Network Health

   Can a health insurance denial actually save a life? In this powerful episode of Care Beyond Code, that's exactly what happened. Jessica Vander Zanden, SVP of Operations and Member Experience at Network Health , shares the incredible true story of how a "mission moment" and a culture of human-centric care transformed a routine denial into a life-saving diagnosis. She explains how Network Health's physician-owned foundation empowers its case managers to become true member advocates, going far beyond the transactional lines of code . In this episode, you'll learn: -- The unforgettable story of a denial that led to a critical cancer diagnosis. -- How to operationally scale empathy and achieve high employee retention . -- How Network Health balances AI and new technology with a human-first member experience . -- What the future of best-in-class member experience will look like. 00:00 Welcome to Care Beyond Code 00:47 Network Health's Mission Moments 01:53 Why Focus on the Human Side? 03:02 A Leader Says "Healthcare Sucks" 05:20 Getting the Real Stories Out 06:38 The Story: A Life-Saving Denial 09:24 How Denials Are Usually Handled 10:45 Coaching the Member to Advocate 12:48 The Diagnosis: Metastatic Cancer 14:21 Staying Connected Through Treatment 15:54 The Member's Thank You Letter 19:22 How to Scale Human Empathy 22:43 Marrying Data and AI with Humans 26:11 Future of Member Experience 28:18 Making Healthcare "Suck Less" VBA helps payers, TPAs, and health plans build the flexible solutions needed to create their own moments of "Care Beyond Code." Learn more at vbasoftware.com (https://vbasoftware.com/). #CareBeyondCode #MemberExperience #HealthTech

9. 

   12 Nov 2025

   How TPAs Use AI & APIs to Modernize | Dr. Stephen Tahta of Allegiance with Matt Salerno of VBA

   The TPA world is moving faster than ever. What happens when legacy systems can no longer keep up with the demand for real-time data, complex integrations, and AI? In this episode of Care Beyond Code: VBA's SVP of Engineering Matt Salerno, and Allegiance President & CEO Stephen Tahta, pull back the curtain on the massive tech modernization happening right now. They break down the critical shift from on-prem "Old Faithful" systems to scalable, resilient, and secure cloud platforms that are ready for the future. What you'll learn: -- What is an API? Plus, an "airport" analogy for healthcare data. -- Why APIs are the "connective tissue" for real-time care. -- How AI is actually being used (Hint: It's not replacing humans). -- A look at VBA's new AI tools: Project Oscar & Project Stormbreaker. 00:00 Introduction 01:15 The Modern TPA Landscape 03:56 Stephen's "Airport" Analogy 06:48 The Challenge of "Old Faithful" 08:06 The Drivers for Modernization 09:52 Why Move to the Cloud? 12:14 The Real Speed of the Cloud 15:43 What is an API? (The Restaurant Analogy) 18:42 APIs as "Connective Tissue" 21:51 How VBA Approaches AI 25:30 VBA's AI Projects: Oscar & Stormbreaker 27:12 AI Frees Humans for Human Work 29:51 Predictive Insights with AI 31:50 Conclusion: Complexity vs. Innovation Learn more about VBA's solutions for TPAs and health plans at vbasoftware.com (https://vbasoftware.com/). Don't forget to subscribe for more insights into the future of healthcare tech. #HealthcareTechnology #TPA #DigitalTransformation

Contact Care Beyond Code

Guest appearances

Books guests

Based on episode analysis; this does not confirm that the show is currently accepting guests.