Welcome to RCM ReFramed, the podcast dedicated to reshaping traditional views and approaches to Revenue Cycle Management (RCM) through innovative frameworks and strategic insights. Join us for the latest innovations, expert interviews, and discussions that will help enhance your RCM processes and shape the future of healthcare finance.
RCM ReFramed
Claim This Podcastby GetixHealth
8 episodes
Updated Weekly
Accepts GuestsHas SponsorsLocation 🇺🇸
Podcast Overview
Welcome to RCM ReFramed, the podcast dedicated to reshaping traditional views and approaches to Revenue Cycle Management (RCM) through innovative frameworks and strategic insights. Join us for the latest innovations, expert interviews, and discussions that will help enhance your RCM processes and shape the future of healthcare finance.
Language
🇺🇲
Publishing Since
10/3/2024
1 verified contact email on file for RCM ReFramed
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Recent Episodes
June 26, 2026
Turning Coding Needs into Coding Success with AI-RCM Reframed
<p>Autonomous coding doesn't fail because of the AI. It fails because of weak documentation, undocumented logic decisions, and missing physician engagement. Kelly Pearson, Director of Coding and CDI at MercyHealth, joins RCM Reframed to share the operator playbook behind their autonomous coding rollout, including what she would do differently with a second chance. </p><p>Kelly walks through the operational pain points that drove MercyHealth to AI (coder shortages, pre-AR delays, backlog pressure), how the team assessed AI readiness through documentation quality, and why a layered audit model with 100% review at go-live was non-negotiable. She also explains the four-month implementation moment that prompted MercyHealth to create a dedicated coding project manager role, and how provider trending data is now driving targeted physician education. </p><p>What you will take away: </p><p>* Why documentation readiness, not AI capability, determines success </p><p>* How to structure a layered audit model that scales without removing oversight</p><p> * Why a dedicated coding project manager is essential from day one * How to engage physician advocates early and use AI trend data for targeted education </p><p>* The future of the coder role: validation, analytics, education, and AI governance</p><p> Subscribe for more conversations with revenue cycle operators who've actually done the work.</p><p>Learn more about GetixHealth: getixhealth.com </p><p>Connect with Kelly Pierson: https://www.linkedin.com/in/kelly-pierson-cpc-crc-499848145/</p>
May 29, 2026
Beyond Bots: What Rev Cycle Leaders Need to Rethink about AI.
<p>What does an actual RCM automation roadmap look like when it's built by operators, not vendors? Michael Laukaitis, Director of Revenue Cycle, Analytics, Accounting, and Quality Assurance at UT Southwestern, walks through the sequence his team followed over eight years: reporting first, then workflow analysis, then RPA, then AI, then agents. </p><p>The result: roughly $4.5 million in FTE-equivalent savings over six years, including $1.5 million in the last year alone. The team built an AI agent named Sophie that surfaces SOPs, answers workflow questions, and compares Epic upgrade documents against existing procedures to flag what needs review. Their first agents handling Epic functionality and denials management are coming online in the next month and a half. </p><p>Michael's warning to providers: he points to a 2016 Microsoft presentation that convinced him payers were already using automation and AI. Many provider RCM teams are still appealing those denials manually. As he put it: "The one thing I've seen organizations that have failed do is to just put bots in just to have bots." </p><p><br></p><p>What you'll get from this conversation: </p><p>* The reporting → analysis → RPA → AI → agents sequence, and why skipping steps creates "emotional support bots" </p><p>* How Lean Six Sigma, Gemba walks, and the five whys come before any UiPath build </p><p>* Why the SOP library is operational infrastructure, not a documentation chore — and how it became the foundation for an AI agent </p><p>* A Medicaid coverage retrieval example: four staff handling roughly 16,000 accounts every three months versus a bot that could do the same workload every 16 days, with implications for timely filing and self-pay conversion </p><p>* How to drive AI adoption with skeptical staff by anchoring on their three biggest weekly frustrations, not strategy slides </p><p>* The case for embedding analytics in operations while strictly following IT governance </p><p>* How to safely build AI literacy on a personal GPT when your security team hasn't approved enterprise access </p><p>A practical playbook for anyone who owns denial rate, AR days, or net revenue yield. </p><p><br></p><p>🎙 Subscribe to RCM Reframed for more conversations with RCM operators. </p><p>🔗 Learn more: https://insights.getixhealth.com/podcast/beyond-bots 💼 Connect with Michael Laukaitis: https://www.linkedin.com/in/mikelaukaitis/</p>
April 24, 2026
The Impact of Experience Across the RCM Landscape-EP 7
<p>In this insightful conversation, host Shawn Gretz, President, Sales and Marketing for GetixHealth, sits down with Sandra Gubbine, Assistant Vice President, Revenue Cycle at AtlantiCare and discusses a wide variety of topics that touch on leadership in revenue cycle and more.</p><p><br>Discussing everything from how Sandra found her way into healthcare, system conversions, and managing people in diverse areas of healthcare, to mentoring the next generation of leaders and volunteering, Shawn and Sandra explore issues that impact the healthcare revenue cycle and beyond.</p><p></p>
8 total episodes available
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Frequently asked questions
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- What is RCM ReFramed?
- How often does this podcast release new episodes?
This podcast updates weekly.
- Where can I listen to this podcast?
This podcast is available on 4 platforms including Apple Podcasts, Spotify, and more. You can also use the RSS feed directly.
- Does this podcast accept guests?
No, this podcast does not typically feature guests.
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