Podcast
The Next Chapter: Faisal Hussain on change, creativity, family, and finding balance
Listen to the episode here. A lot has changed in the world of Faisal Hussain since he last went under the white-hot spotlight of the Off the Record podcast studios. A new career path, with a new company. Growing children, with whom he gets to spend more time. A surprise award, bestowed by his college alma mater. And many new changes in the…
Read MoreMedical Record Maestro: Reimagining CDI in the Age of AI and the Longitudinal Record
Download the episode here. We need a “human in the loop” in mid-revenue cycle work, experts say. What they fail to address is the more interesting question: Precisely where? Back-end AI fact-checker? Front-end query authorizer? Or, maybe something like my current OTR guest Penny Jefferson envisions: Medical record maestro. The end-to-end connectedness of the medical record, evolving API standards, increased use of prior authorization, episode-based reimbursement models, and review of all of this by AI and other tools makes documentation cohesion more important than…
Read MoreThe Downgrade Era: How Payers Are Changing the Game with (My) Richelle Marting
Listen to the podcast here. Payers are constantly shifting tactics to find new and creative ways to do their favorite thing: Not pay claims. And if you can’t deny? Downgrade! We’re seeing a lot of new patterns and tactics on this front, especially on the Medicare Advantage/private payer side of the house. And so it was time to take a look at where we are on the state of denials, with…
Read MoreRisk Adjustment Reality Check: What’s Working—and What Isn’t
Listen to the podcast. This year has been something of a reckoning for Medicare Advantage. Senator Grassley’s scathing report of UHG’s risk adjustment practices, and the Kaiser $556 million settlement to resolve False Claims Act allegations of upcoding, opened eyes, and got many in the industry talking. I wanted to get someone on the show with opinions, unafraid to speak their mind and share their perspective. I’ve found that person. Betty Stump is Senior Solution Consultant…
Read MoreA reckoning for Medicare Advantage: Inside the Kaiser case with Mary Inman and Liz Soltan
Listen to the episode here. Medicare Advantage is undergoing a reckoning … and that reckoning is coming from within. In January Kaiser Permanente affiliates agreed to pay $556 million to resolve allegations that it violated the False Claims Act by submitting invalid diagnosis codes for their MA Plan enrollees in order to receive higher payments…
Read MoreFrom Encephalopathy to Edema: Talking chart review with Dr. Tarman Aziz
Listen to the episode here. I’m consistently surprised at how few CDI or IP coding professionals talk about their most basic job function. The very reason they are hired, and what most do for eight hours a day. I’m talking about chart review. Go on Linkedin or Facebook and it’s rarely discussed. Yet it’s … everything. Nuanced, complex, clinical, critical to the quality of financial health of hospitals. It’s how patient acuity is expressed in coded data, how hospitals get paid, and why CDI and coding professionals are employed. …
Read MoreClosing out 2025 with its biggest story: Artificial intelligence
Listen to the episode here. Here we are, our last episode of Off the Record this year. I hope you’ve had a great 2025. Just my voice today. I’m ending with a solocast, a reading/summary of a paper about the biggest news story of the year: The explosive growth and proliferation of artificial intelligence, or AI. You might recall my poll from a couple weeks ago; you all confirmed it. 44% of respondents chose AI, beating…
Read MoreOutpatient OG: Amy Campbell on Pre-Visit Reviews, Pet Peeves, and People Management
Listen to the episode here. Outpatient CDI is still in its pioneer-”ish” stage. Why do I say that? Per the most recent ACDIS survey data, only 31% of respondents indicated their organization had a dedicated OP CDI program. Progress, but not enough, and still a minority. So when you find an “OG” who has been…
Read MoreFrom Resistance to Results: Provider engagement from the front lines
Listen to the podcast here. No matter how great your CDI program is—its spectacular workflow, outstanding chart review team, on-point KPIs, shiny new AI tools—nothing works if you don’t have engaged physicians. It still all comes down to provider engagement. Without a physician staff who is bought in and willing to participate and document with…
Read MoreCoaching Clinicians, Convincing Crowds: Susanna Baddiel on Delivering Impactful Presentations
Listen to the podcast here. Fans of Off the Record may recall my recent episode with Chris Petrilli, Director of Revenue Cycle of Operations at NYU Langone, who joined me to discuss his experience delivering a TEDx Talk on artificial intelligence. Chris was well prepared and delivered a great lecture, which you should definitely check…
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