43 mins #6 Mar 18, 26 Patient referrals with Dr. Will Morris Dr. Will Morris is Chief Medical Officer at Tennr. He's also a practicing hospitalist, a former hospital CIO, and former Chief Medical Officer at Google.In this episode, Will explains how Tennr manages the full referral lifecycle from the receiving provider's perspective, why most referrals end up in a black hole for patients, and how intelligent triage and closed-loop communication can match patients to the right provider at the right time.00:00 Introduction01:47 What does Tennr do?02:42 What is the self-pay referral experience like?05:48 Is waiting for "Dr. Famous" always the right move?06:24 What's the difference between a formal and informal referral?11:13 Why do referrals disappear into a black hole?13:34 How does closing the referral loop benefit everyone?17:41 Can Tennr solve the Dr. Famous wait time problem?24:44 What is "The Goal" and why does it apply to healthcare?34:01 What does a Tennr implementation actually look like?36:44 Do health systems that use Epic already have this solved?40:11 If you could change one thing about RCM, what would it be?Learn more about Tennr: https://tennr.comConnect with Dr. Morris on LinkedIn: https://www.linkedin.com/in/mowilliam/
45 mins #5 Mar 05, 26 Credentialing explained with Varun Krishnamurthy Varun Krishnamurthy is the co‑founder and CEO of Assured Health, an AI-powered provider credentialing and enrollment platform.In this episode, Zack and Varun talk about credentialing – how insurers check that a healthcare provider is qualified to practice. They cover how provider credentialing works, the bottlenecks it can cause, and how to improve it.0:00 - Intro0:44 - How Varun started Assured Health1:57 - How long does it take for a provider to take insurance?3:26 - Does provider experience speed up onboarding?4:20 - How Dawn Health led to Assured Health7:31 - What must a provider do to accept insurance?9:11 - Is there a single application for credentialing?12:15 - How complex is credentialing, really?15:29 - What else besides credentialing do you need to accept insurance?18:02 - How do you keep provider data current?19:51 - Is credentialing a major bottleneck for providers?22:18 - Credentialing vs. provider enrollment vs. transaction enrollment25:17 - What are closed panels and why do they matter?26:30 - When does a credentialing service make sense?31:05 - What are the steps for credentialing?34:32 - How can you tell if a provider is already enrolled for insurance?38:13 - Has anyone tried to standardize credentialing?40:03 - What Varun would change about RCMLearn more about Assured Health: https://www.withassured.com/Connect with Varun on LinkedIn: https://www.linkedin.com/in/varunakrishnamurthy/Referenced in this episode: - "Reality has a surprising amount of detail" by John Salvatier: http://johnsalvatier.org/blog/2017/reality-has-a-surprising-amount-of-detail- "Estonia, the Digital Republic" by Nathan Heller: https://www.newyorker.com/magazine/2017/12/18/estonia-the-digital-republic- Aadhaar (India's National ID system): https://en.wikipedia.org/wiki/Aadhaar
55 mins #4 Feb 05, 26 Payer enrollment with Megan Struxness Megan Struxness is Head of Payer Operations and Revenue Cycle Management at Bridge, a healthcare platform that helps telehealth providers accept insurance nationwide.In this episode, Megan and Zack discuss payer enrollment – the industry term for what healthcare providers need to do to accept insurance.They cover payer contracting, credentialing, what superbills are, how out-of-network claims work, and how small operational details – like enrollment and eligibility checks – determine what providers actually get paid.Watch on YouTube: ---Learn more about Bridge: https://www.usebridge.com/Connect with Megan on LinkedIn: https://www.linkedin.com/in/megan-struxness-79962866/Referenced in the episode: - "Reality has a surprising amount of detail" by John Salvatier: http://johnsalvatier.org/blog/2017/reality-has-a-surprising-amount-of-detail---Listen and subscribe to the Understanding Healthcare with Zack Kanter podcast:YouTube: https://www.youtube.com/playlist?list=PLZ4o7H5Som0Zlo2dGH4jMJy0nlL1oqxDoSpotify: https://open.spotify.com/show/6cyz5JaAoG3R995QokLR2dApple Podcasts: https://podcasts.apple.com/podcast/understanding-healthcare-with-zack-kanter/id1860618431RSS feed: https://feeds.transistor.fm/understanding-healthcare-with-zack-kanter
48 mins #3 Jan 22, 26 Healthcare finance with Dr. Eric Bricker Dr. Eric Bricker is an internal medicine physician and Chief Medical Officer at AHealthcareZ, a popular healthcare finance YouTube channel.In this episode, Eric and Zack break down revenue cycle management (RCM), the flow of money in U.S. healthcare.They cover how healthcare plans are funded, how Medicare Advantage differs from traditional Medicare, how eligibility checks work, medical coding, and why what doctors bill insurers isn't what they're paid.--- AHealthcareZ videos related to this episode:Revenue Cycle Management in Healthcare Explained: https://www.youtube.com/watch?v=rqdWr9ynZ_oDo Insurance Carriers Want Healthcare Costs Up or Down? https://www.youtube.com/watch?v=ELyvOLkxADUTraditional Medicare vs Medicare Advantage vs Medicare Part D vs Medicare Supplement Explained: https://www.youtube.com/watch?v=KRzBxPj-eQkHealthcare Uncovered Ep 2: Denied Requests: Medicare Advantage and the Rise of Prior Authorizations: https://www.youtube.com/watch?v=5hwCF1HPjOIMedical Coding Overview: https://www.youtube.com/watch?v=fqNBNE_YSroHealth Insurance Claims Adjudication: https://www.youtube.com/watch?v=bM9e2EPUg0gHealth Insurance Claim Repricing: https://www.youtube.com/watch?v=u8upoDe0nwIHospital Chargemaster Explained: https://www.youtube.com/watch?v=2PUwLXW2-swInsurance Float Explained: https://www.youtube.com/watch?v=WBOYDnPfkUUPatient Out-of-Pocket Healthcare Costs Explained: https://www.youtube.com/watch?v=ilfgZiJNwyMHospital Finance Explained: https://www.youtube.com/watch?v=O1CGDi50Nys
53 mins #2 Jan 14, 26 Healthcare interoperability with Brendan Keeler Brendan Keeler is Interoperability Practice Lead at HTD Health and author of the Health API Guy Substack.In this episode, Brendan explains why healthcare standards are actually a good thing, how HIPAA and X12 enable interoperability, the history of FHIR (Fast Healthcare Interoperability Resources), how information blocking and related laws are changing health tech, and how AI may reshape the healthcare standards and regulation.