The Hospital Finance Podcast

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Aug 2026

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If you’re concerned about revenue at your hospital, then The Hospital Finance podcast is your go-to source for information and insights that can help you protect and enhance the revenue your hospital has earned. From regulatory changes to revenue cycle optimization, readmissions to bundled payments, you’ll get important perspectives, news and strategies from leading experts in healthcare finance. For show notes and additional resources from Besler Holdings, visit https://www.besler.holdings/podcasts.

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September 9, 20267 min

Modern Identity Defense for Healthcare Series—Passkeys in Practice

← Back to All Podcasts Modern Identity Defense for Healthcare Series—Passkeys in Practice In this episode, Eric Englebretson, Besler Holdings’ VP of Information Technology, provides us with a glimpse into our next Hospital Finance Academy Webinar, the second in the Modern Identity Defense for Healthcare series, Passkeys in Practice , live on Wednesday, September 16, at 1 PM ET. Highlights of this episode include: What we can expect in this second installment in this series? Why passkeys specifically? How MFA isn’t solving the identity security problem What actually is a passkey? What makes passkeys phishing-resistant? HIPAA and compliance rules What’s next? Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back Eric Englebretson , Besler Holdings’ Vice President of Information Technology. In this episode, Eric will provide us with a glimpse into our next Hospital Finance Academy Webinar, the second in its Modern Identity Defense for Healthcare series, Passkeys in Practice , live on Wednesday, September 16th, at 1 PM Eastern Time. Welcome back, and thank you for joining us, Eric. Eric Englebretson: Thank you for having me yet again. Kelly: All right. Let’s go ahead and jump in. So, Eric, the last time you talked about identity attacks in healthcare. What can we expect in this second installment in this series? And why passkeys specifically? Eric: Well, Kelly, because if part one was about why attackers go after identities, part two is going to be about the single biggest fix we’ve seen in at least 15 years. Passwords are, and I can say this without hyperbole, one of the worst security tools we have for protecting a digital identity. And honestly, passkeys are the industry’s answer. Google, Microsoft, Apple, Amazon, PayPal, if you’ve logged into any of those lately, you’ve probably already been nudged to create one. And this session is going to take the mystery out of what’s actually happening when you do. Kelly: Yeah, no, I’ve seen a lot more passkeys myself lately, so this will be interesting for me too. So, we already have MFA. Isn’t that solving the identity security problem already? Eric: So, it does help, but it doesn’t solve it. SMS codes can get intercepted via either SIM swapping and just general insecurities in the protocols behind text messages. The one-time codes you get from apps like Google Authenticator, those can still be phished and replayed if someone tricks you into typing your password and code into a fake site. And then, of course, push-based MFA has what we call and what we identified in the last session as MFA fatigue where people just approve prompts to make them stop. That’s literally how Uber got breached, in fact. Passkeys sidestep all three because they’re inherently multi-factor: something you have, the device, plus something you are or know, like a biometric or a PIN. So, it’s one seamless step, nothing to fatigue approve and nothing to get intercepted and replayed. Kelly: Very, very interesting. So, Eric, in plain English, what actually is a passkey? Eric: And this is so fun because at its core, it’s really complicated, but it’s a pair of cryptographic keys. Don’t let your eyes glaze over when I say that. I’ll explain a little bit more in the session. And ultimately, of those keys, one lives on the website server and one lives on your device, and they never trade that secret part back and forth. So, think of it like a locked suggestion box. Anyone can drop a message in using the public key portion, but only the person holding the private key can open that message box and, in this case, sign something to prove that it’s really them. The signature is what gets checked, not a password, not your private key. So, the important bits don’t go back and forth where they could be intercepted. Kelly: I mean, it sounds easy enough. So, what actually makes passkeys phishing-resistant? I mean, it sounds like a big claim given how easily we can be tricked into giving away passwords and authenticator codes. Eric: It actually is a big claim, but I think it holds up. So, each passkey you create is bound to a specific domain, and that’s one of the important bits. So, if somebody builds a pixel-perfect clone of Microsoft.com at, let’s say, micronsoft.com and you don’t notice, your device actually won’t even offer the passkey. It actually simply won’t even respond. When implemented properly, there’s no password to type, so there’s nothing to divulge and put in the wrong place. And that one property right there basically neutralizes phishing and the adversary-in-the-middle attacks, which we talked about and were the star villains of our last session. Kelly: Very interesting. So, healthcare has HIPAA and compliance rules around all of this. Do passkeys actually check that box? Eric: So, this is great. They don’t actually just check it. They exceed it. So, HIPAA Security Rule requires verifying that a person accessing e-PHI is who they claim to be, but they don’t mandate a specific technology. So, passkeys deliver cryptographic proof of identity, and that eliminates the number one credential theft vector. And that also aligns with, and I’ll explain this as well in this session, something called NIST SP 800-63B. Again, don’t let your eyes glaze over. And basically, they have what are called authenticator levels. And these meet or even go up to the next level depending on whether or not you’re using hardware keys. And then for HHS’s own 405(d) program, they’ve been recommending FIDO2 and passkeys as a priority mitigation for healthcare specifically for quite a while now. So yes, definitely, this far exceeds the things that we need for HIPAA. Kelly: Well, that is great news. And I’m looking forward to learning more about that. So, this all sounds almost too good. What’s the catch? Eric: That’s a really fair question. I get it a lot. So, in this case, we’ve got– we’re building a front door that is genuinely rock solid, made out of metal. The catch is actually a backdoor here, account recovery. So as an example, let’s say you’re storing all your passkeys on your phone. If your phone dies and you lose your passkeys, what’s guarding your way back in? Because you’ve got to have one, right? Well, usually it’s a password reset email plus an SMS code. Well, that’s the absolute weakest link protecting the strongest lock we’ve ever built. We’ll dig into exactly how to close that gap in the full session, but that’s really the only downside.</...

September 2, 202616 min

The Money is in the Note, Not the Claim

← Back to All Podcasts The Money is in the Note, Not the Claim In this episode, VerifyMedCodes Co-Founders Nathan Turock and Angelo Selitto, discuss why the money is in the clinical note, not the claim. Highlights of this episode include: What it means when they say “the money is in the note, not the claim” What problem VerifyMedCodes solves How the deterministic approach is different “You can’t defend a code. You can’t reproduce.” How to catch issues before the claim goes out, missing modifiers, unsupported codes, and linkage problems How hospital finance leaders should be thinking about readiness How to process a clinical note without patient data ever leaving the building Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Nathan Turock and Angelo Selitto . Nathan is CEO and co-founder of VerifyMedCodes. He leads strategy, partnerships, and go-to market, focused on helping hospitals and RCM teams turn clinical documentation into defensible, denial-resistant revenue. He founded Verify Med Codes to close the gap between what clinicians document and what actually gets paid. We have Angelo, who’s co-founder and chief architect of VerifyMedCodes. He’s a healthcare integration architect with 13-plus years’ experience across Epic, FHIR, HL7, Identity, and Clinical AI. And he’s delivered production CDS hooks and FHIR for value – based care and led ambient AI documentation rollouts across 33, 000 providers. He designed the VerifyMedCodes deterministic PHI-safe coding engine. In this episode, we’re discussing the money is in the note, not the claim. Welcome, and thank you both for joining us, Nathan and Angelo. Nathan Turock: Thank you for having us. Angelo Selitto: Thank you for having us. Thank you for the intro, and wonderful to be here. Kelly: All right. Well, let’s go ahead and jump in. So, VerifyMedCodes started as a coding engine. What problem did you set out to solve, and why do you say the money is in the note, not the claim? And Nathan, I’m going to toss this one over to you. Nathan: Okay, that’s great. The money is in the note. The way it all works, if we’re going to make it easier for the audience, the progress note that the doctor writes is actually what gets paid by the insurance companies. The way it’s set up in the United States healthcare system is the doctor writes the note, then it goes to a coding or billing agency, and they have to put in all the codes that have been created since the ’50s and ’60s by the insurance industry to make sure it’s accurate so they get paid. The problem with that is the insurance companies have made it so convoluted and so difficult to find all the proper codes. And I won’t get too into the weeds, but you have your ICD-10 codes, your EM codes, your RAF scores, your HCCs, etc. And it gets very difficult for the physician, hospital, provider to get paid what they’re owed. We created this to make it transparent. So, it goes right from the doctor’s note, we code that the English language, then we code it into the medical nomenclature of actually the entire globe, and then we code it into the coding system that has been created by the insurance companies in the United States to maybe not pay exactly what they should. So, we’re going for clear transparency because I believe that the healthcare provider should get paid what they’re worth, and they shouldn’t be convoluted or changed up by the insurance company just because they want to put all this coding into play. Kelly: Right. No, I love that y’all made that transparent. I know there’s a lot of complexities in the coding world. So, a lot of AI coding tools make compliance teams nervous because they can hallucinate a code. How is a deterministic approach different, and why does same note in, same codes out matter for revenue integrity? And Angelo, I’m going to toss this one to you. Angelo: No, it’s a great question. And a probabilistic AI coder can read the same note twice and give you two different code sets. And for revenue integrity, that’s the whole problem. You can’t defend a claim you can’t reproduce. So, our deterministic core is same note in, same codes out every time. And that’s the type of defensibility that we want to offer, right? Is that we have the history, we have the evidence-based, we are giving you the information because of what the note stated. It’s not a hallucination. It’s there in the documents. So, we’re really just carrying it forward, and you’re going to reproduce the same information because the same defensibility and the same information always surfaces. So, it’s just the AI can do its suggestions. It could offer and flag, basically recover anything that was missed and offer options. But in the end, the AI doesn’t have the final say. And I think that’s the difference between fast and defensible. Kelly: Yeah. No, I love what you said about, “You can’t defend a code. You can’t reproduce.” I actually wrote that down because I really thought that that was very interesting that you said that. I love that. So, Nathan, where are hospitals leaving the most defensible money on the table today? Is it risk adjustment capture, denials, or is it somewhere else? Nathan: It’s in all those, to be perfectly honest with you. The denials is your holy grail, capturing the right amount of money for the service that you provided. The reason being is the insurance companies like to deny a lot. I know everybody out there in podcast land has never heard of an insurance company denying anything. Kelly: Right. Nathan: Exactly. So, with that being said, I’m going to sort of piggyback off of what Angelo said and to make this very digestible. Angelo loves when I say it’s an incredibly complex tool that we’ve created, but it’s an A plus B equals C or A plus B plus C equals money. Coding system A is the progress note, which is written in the English language. B is the medical terminology that we’ve also coded into a large LLM. C is all the codes from the insurance companies that we utilize their language against them so they can’t deny. So, we have A plus B plus C equals the correct dollar amount. It’s deterministic. It’s accurate. It’s to the point. So, where they’re leaving money on the table is a couple of different sectors. The first one is first pass rate, which means that the note goes through cleanly and insurance says, “Yep, it’s good to go. We’re going to pay you for it.” The second one is– the big one is denials, which when an insurance company says, “Nope, you don’t have enough data on that. We are denying this for XYZ reason,” it costs money to reprocess that note again. ...

August 26, 202625 min

Impact of ‘Failure to Progress’ in Value-Based Care on Healthcare System and Patients

In this episode, Theresa Hush, CEO at Roji Health Intelligence, discusses the impact of value-based care's failure to progress in achieving the economic sustainability of the healthcare system and if or what can change the course.

August 19, 202616 min

The Revenue Walking Out Your Door--Capturing Wellness Spend at the Point of Care

In this episode, Kevin Torf, Co-Founder & Managing Partner at T2 Group discusses the revenue walking out your door, capturing wellness spend at the point of care.

August 12, 202625 min

Why Hospital CFOs are Leaving Millions on the Table and What the Best-Run Health Systems are Doing Differently

In this episode, James Jacobi VP of Employee Benefits at Hilb Group discusses something that hits every CFO and finance leader in healthcare directly, the runaway cost of employee benefits.

August 7, 20267 min

Modern Identity Defense for Healthcare Series--Defending Against Identity Attacks - When MFA Isn’t Enough Webinar

← Back to All Podcasts Modern Identity Defense for Healthcare Series: Defending Against Identity Attacks – When MFA Isn’t Enough Webinar In this episode, Eric Englebretson, Besler Holdings’ Vice President of Information Technology, provides us with a glimpse into Webinar, the first in its Modern Identity Defense for Healthcare Series: Defending Against Identity Attacks – When MFA Isn’t Enough live on Wednesday, August 12, at 1 PM ET. Highlights of this episode include: What is this webinar about? MFA still effective? How the attacks are evolving What session tokens are and why you should care about them Why healthcare is a frequent target Warning signs that an account may be compromised Next evolution beyond traditional MFA Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness.We’re pleased to welcome back Eric Englebretson , Besler Holdings’ Vice President of Information Technology. In this episode, Eric will provide us with a glimpse into Besler Holdings’ next Webinar, the first in its Modern Identity Defense for Healthcare Series– Defending Against Identity Attacks – When MFA Isn’t Enough live on Wednesday, August 12, at 1 PM Eastern Time. Welcome back and thank you for joining us, Eric. Eric Englebretson: Thank you so much. I’m happy to be here. Kelly: Well, great. Well, let’s go ahead and jump in. So can you provide a quick overview of what you’re going to be reviewing during this webinar? Eric: Absolutely. So, the thing that I think is very important for us to cover is that identity has become one of the most targeted areas in all of cybersecurity right now. It used to be that attackers focused on servers or the corporation’s network, and once they’d gotten in from there, they would pivot to get at the thing they’re really after, which is often a company’s data. In the age of cloud computing and remote work, defenses have generally gotten better because traditional defensive methods of defending the network give way to security practices like something called Zero Trust, whereby any interaction with an organization’s resources must be authenticated no matter where a location request might come from. And so, the next logical step is identity attacks. And why is that? Like I said, since attackers focus used to be on breaking into networks and servers, the payoff might be limited. A compromised web server hosting a hospital website might not have any access to any data at all, really, but in today’s integrated environments, one compromised user account. Now that can give an attacker access to email, collaboration tools, patient systems, financial applications, and cloud services, depending on your role. In most organizations, your identity becomes the new perimeter, and that’s why attackers increasingly target people and accounts instead of infrastructure. This is going to be a two-part series covering modern identity security, why attackers have moved to trying to capture identities as a first attack rather than compromised servers, what we can do about it. And in part two, one of the biggest new advancements you’re probably already using in a few places, passkeys. Kelly: Awesome. Sounds like you’re going to cover a lot during this webinar. I’m really looking forward to it. So, we hear a lot about MFA and how attackers try to bypass it. So is MFA still effective? Eric: Absolutely. So, MFA really remains one of the most important security controls that has come to us in the past 10 or so years, and it really does stop the vast majority of common attacks, including password reuse, credential stuffing, and other attacks similar to those. The key message here is that MFA is definitely not broken. The message is that attackers have evolved and they’re now looking for ways to get around it. It is just that effective. They’ve got to work around it now rather than just simply trying to use a username and password. And that means organizations need additional layers of protection alongside of MFA. Kelly: Yeah, so we know that MFA is still effective. So how are attacks evolving to work around it? Eric: Modern attackers often focus on stealing authenticated sessions rather than stealing passwords. In some phishing attacks, victims enter their credentials and complete MFA successfully, but the attacker captures the resulting session that’s created. Think about it this way. Is it easier for a thief to steal your hotel room key or to try to convince the front desk to issue a new one? In most cases, it’s easier for the thief to steal your room key. After that, they can just come and go as they please, usually without so much as a second glance. We’ve put so many guardrails around the authentication process that attackers are now moving on and looking at what’s behind that, something called sessions and tokens. Kelly: So, what are session tokens and why should people care about them? Eric: So, session tokens and they are kind of background… so this is kind of we enter that realm of nerdy a little bit, but stick with me. Session tokens are what keep you log in after you’ve authenticated. They’re the reason that you don’t have to enter your password and MFA code every single time you open an email or click a new page. They’re incredibly useful, but that makes them also incredibly valuable to attackers. If an attacker does steal a valid session token, they may be able to act as though they’re already authenticated without having to have your password again. And that is what makes them so important, and that is why people should care. Kelly: Yeah, no, that makes a lot of sense. Why is healthcare such a frequent target for identity attacks? I mean, we’ve been hearing so much about this lately. Eric: Absolutely. So, the main reason for that is that healthcare combines highly valuable data with extremely time-sensitive workflows. Clinicians and staff are constantly dealing with alerts, messages, urgent requests, and attackers understand that environment, and they design their hacking and phishing campaigns specifically to exploit human pressure and urgency. Healthcare isn’t targeted because it’s careless. That’s actually quite the opposite. It’s targeted because its mission creates very unique opportunities attackers can try to exploit. Kelly: Yeah. I guess having that– always having that sense of urgency probably doesn’t help us in that way, right? Eric: Absolutely. Kelly: Yeah. So, what are some warning signs that an account may be compromised? <p class="has-text-co...

August 5, 202617 min

A Modern CFO Playbook - OPM for AI, 340B and Patient Engagement

In this episode, Jack Risenhoover, healthcare attorney and chair of Velocity Health, discusses a modern CFO playbook for using “other people’s money” to support AI, 340B, and patient engagement initiatives.

July 29, 202622 min

Building Trust in Clinical AI--What Hospital Leaders Need to Know About Evidence‑Based Decision Support

← Back to All Podcasts Building Trust in Clinical AI–What Hospital Leaders Need to Know About Evidence‑Based Decision Support In this episode, Dr. Claudine Lott, Physician Executive for Commercial Transformation and Implementation at Elsevier, discusses building trust and clinical AI, what hospital leaders need to know about evidence-based decision support. Highlights of this episode include: What ClinicalKey AI is How AI enhanced clinical decision support tools can help organizations improve both clinical efficiency and financial performance How AI-powered tools can support clinicians in real time to reduce errors, avoid denials, and strengthen the overall revenue cycle ROI opportunities for health systems adopting AI-powered clinical intelligence How AI-powered tools remain evidence-based, transparent, and aligned with clinical best practices The most common misconceptions hospital leaders have about implementing AI and clinical workflows Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome Dr. Claudine Lott . She is a board-certified family medicine physician who is passionate about developing and implementing tech-based clinical solutions that improve both patient outcomes and provider experience. As physician executive for commercial transformation and implementation at Elsevier, she supports the development and deployment of their reference products for healthcare providers, including ClinicalKey AI . Dr. Lott received her medical degree from the University of Massachusetts Medical School and completed her residency at White Memorial Medical Center. She served as a primary care physician at the federally qualified Santa Cruz Community Health Center, where she was promoted to site medical director. She then joined Healthcare Startup Crossover Health, where she contributed to the development and expansion of their virtual care model, as well as the creation and deployment of their Patient Engagement Technology Platform. Since joining Elsevier in July 2023, Dr. Lott works cross-functionally to support key initiatives, including customer implementations, product development, and change management. In this episode, we’re discussing building trust and clinical AI, what hospital leaders need to know about evidence-based decision support. Welcome, and thank you for joining us, Claudine. Dr. Claudine Lott: Thanks for having me on. Appreciate it. Kelly: Well, it’s great to have you. And let’s go ahead and jump in. So, what is ClinicalKey AI, and how are its new capabilities designed to reduce clinician burden and improve documentation accuracy? Claudine: So ClinicalKey AI is Elsevier’s flagship generative AI tool that’s designed for clinician use to quickly surface the latest evidence at the point of care to support clinical decision-making. And just to take a step back and provide some context, so here at Elsevier, we’re an almost 150-year-old publishing company. So, for almost 150 years, our role has been as a provider of scientific information and clinical evidence that clinicians can use in their decision-making and in their patient care. And as we’ve moved into more and more clinical solutions, that’s always been kind of our guiding North Star. And so with generative AI coming on the scene, we’ve really thought about, okay, how do we use this emerging technology in our role as a provider of clinical evidence, scientific information to really further that goal of getting clinicians what they need to make decisions and take the best possible care of patients as quickly, accurately, and effectively as possible. And rather than just sort of slapping generative AI on everything because that’s sort of the new thing to do, how do we really leverage this new tool to solve that problem? So ClinicalKey AI is a conversational search tool. The clinician’s able to ask a question in natural language, almost like they might ask a colleague. And then the system goes and searches a curated set of content that we’ve given to it. So that includes much of our Elsevier clinical content, but also some non-Elsevier sources as well, and searches for information and then surfaces that for the clinician. So, it’s not replacing their clinical knowledge or decision-making, but it’s really supporting them by getting the information that they need and we’ve been developing and iterating on this tool for several years now, constantly thinking about how do we make it better and more suited to this clinician use case. So constantly thinking about how we expand our handpicked content sources, thinking about making sure that we always have traceability so clinicians can see where the information is coming from, citation verification, and always thinking about technology upgrades. So, things like privacy, security, and supporting HIPAA compliant use. Kelly: Wow, that ClinicalKey AI technology sounds really fascinating. So how can AI enhanced clinical decision support tools help organizations improve both clinical efficiency and financial performance? Claudine: So clinically, the biggest win is what we might call speed to evidence. So, we’re in a situation now where patients are increasingly more complex. Medical knowledge is expanding exponentially. And so, getting that information that is really tailored to the clinical situation as quickly as possible is going to enhance clinical efficiency so that AI enhanced decision support can really surface the most relevant trusted information. In seconds, really supporting those consistent decisions under time pressure and given all those other complexities. In terms of how that clinical efficiency translates into financial performance, I think this is something that we’re going to see continuing to evolve as more and more organizations are integrating these types of tools. So certainly, it makes sense that improving clinical efficiency, improving the quality of care is going to translate into financial performance, but sometimes that ROI can be a little bit difficult to quantify. So, I think that we’re going to see those benchmarks continuing to evolve as more and more institutions are implementing these tools. Kelly: Yeah, and I love what you said at the beginning, that speed to evidence. I love that. So, what should hospital healthcare system operation leaders look for in the first six to 12 months to know an AI tool is truly delivering clinical value? Claudine: Yeah, I think this is a great question and something that a lot of both vendors and organizational leaders are really thinking about. Because again, these tools are still new. We’re still seeing how they affect healthcare and how they affect the clinical workflows. And so, we’re still really figuring out how we quantify this sort of clinical value. So, thinking about sort of what can you look for at that 6- or 12-month point to know if your tool is delivering that clinical value. For things like time-saving, improvement of quality of care, those things can be hard to really quantify. And also some of the benefits of generative AI tools, as we mentioned, is that helping clinicians provide faster and better care, it leads to a better experience for those clinicians, for that care team, really addressing that sort of fourth leg of the quadruple aim. But again, that’s something that can be ...

July 22, 202621 min

People Stay Where Their Future is Strongest

← Back to All Podcasts People Stay Where Their Future is Strongest In this episode, David Alemian, Creator of the Alemian Retention System, is discussing how people stay where their future is the strongest. Highlights of this episode include: How aligning an employee’s financial future with their tenure can change long-term retention behavior What distinguishes a short-term incentive from a true long-term retention structure in financial terms How forfeiture-based structures influence decision making compared to traditional benefit plans What financial modeling should hospitals use to project the long-term impact of retention strategies How hospitals can implement retention strategies without increasing net operating costs What separates organizations that successfully retain top talent from those that just continue to struggle Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness . Welcome back to the award-winning Hospital Finance Podcast . We’re pleased to welcome back David Alemian . David is America’s foremost expert on retaining highly skilled professionals and the creator of the Alemian Retention System. His work defines a critical reality for healthcare leaders, People Stay Where Their Future Is Strongest. He is the author of People Stay Where Their Future Is Strongest: How Organizations Retain Highly Skilled Professionals and Build Lasting Advantage. A definitive framework that explains why highly skilled professionals leave and what determines whether they stay long-term. With over 30 years of experience in financial and workforce strategy, David reframes retention as a financial discipline. He shows how workforce instability erodes margin, disrupts operations, and weakens long-term performance. His work has been featured in Medical Economics, MD Magazine, and Physician’s Practice. He has authored more than 300 articles and produced over 400 educational videos on talent retention and organizational performance. In this episode, we’re discussing People Stay Where Their Future Is Strongest. Welcome, and thank you for joining us again, David. David Alemian: Well, hi, Kelly, and thank you for having me. It’s so good to be back. Kelly: Yes, it’s great to have you back. Well, let’s go ahead and jump in. So, David, yeah, you focus on aligning an employee’s financial future with their tenure. How does that change long-term retention behavior? David: Great question. People are wired for the future. From the time we are very young children, we quickly learn to think about the future. It becomes imprinted on our brain. We’re asked, “What do you want to be when you grow up? Where do you want to live? Who are you going to marry?” It’s always looking toward the future. Employment is the same thing. Highly skilled people don’t make career changes on a whim. They think about it, and they think hard. And here’s what they think, “Is my future better here where I am? Or is my future better if I move to another organization?” Most major decisions are based on the future. When an employee considers staying or leaving, they are literally comparing two possible futures. One future is built by staying with their current employer. The other future is built by leaving and going elsewhere for another opportunity. The future that appears stronger usually wins. It’s that simple. For those who are listening to this, think about your own life and the decisions surrounding your career. Did you think about your future? Chances are very high that you did because our brains are wired for the future. What’s really kind of cool is it’s one of the things that we all have in common. Here’s the difference. Traditional retention strategies often focus on the present. They focus on culture, recognition, wellness programs, team-building activities, and workplace perks. Those things are good, and they matter, but they do not fundamentally strengthen an employee’s long-term financial future. When an organization helps employees build a stronger financial future by staying, retention becomes much more stable because the employee has a compelling reason to remain committed for the long term. People stay where their future is strongest. And that’s what I mean by that. Kelly: I love that. I mean, and I wholeheartedly agree with it, and it makes a lot of sense that focus on the future. You’re right. We do all have that in common. So, what distinguishes a short-term incentive from a true long-term retention structure in financial terms? David: Okay. Now, most retention strategies are expenses, higher salaries, bonuses, 401(k) contributions, retention payments, enhanced benefits, and similar programs all have one thing in common. Once the money is spent, it’s gone. The organization incurs the cost, whether your employee stays or leaves. A true long-term retention structure works differently. The employer funds and owns the plan. The employee never owns the asset. The asset remains on the organization’s balance sheet where it continues to grow and compound over time. The employee agrees to remain with the organization until a future date is established in the agreement. It could be 10 years from now. It could be all the way until retirement. It could be anything in between. If the employee fulfills that commitment, the employee receives a substantial financial benefit. If the employee does not fulfill their commitment and leaves early, the benefit is forfeited. The organization keeps the asset. That distinction changes everything. Instead of creating another expense, the organization creates a growing and compounding asset while simultaneously creating a powerful incentive for the employee to remain long-term. Traditional retention strategies spend money. This strategy builds an asset. Kelly: That is truly just so interesting to me, David. Thank you for explaining that. So how do forfeiture-based structures influence decision making compared to traditional benefit plans? David: Oh, but they do. This is where retention becomes truly powerful. Most traditional benefit plans provide value regardless of whether the employee stays for the long term. An employee may receive higher compensation, employee retirement contributions, bonuses, or other benefits, and still leave for another opportunity. There’s nothing holding them in place. And what happens is the organization absorbs the cost and loses the employee anyway. A forfeiture-based structure operates differently. The employer funds the plan. The employer owns the plan. The asset remains on the organization’s balance sheet where it continues to grow and compound. And the power of compound interest is amazing. The employee earns the right to receive the benefit only by fulfilling the long-term commitment established in the agreement. If the employee leaves before that date, the benefit is forfeited. The organization keeps the asset. The employee receives nothing. That creates a completely different decision-making process. Remember when I said that choosing between two futures, one if I stay and one if I leave? Kelly: Right, yes. <p class="has-...

July 17, 20269 min

Medicare Cost Report Appeals and Reopenings—Best Practices Webinar

← Back to All Podcasts Medicare Cost Report Appeals and Reopenings—Best Practices Webinar In this episode, Kristin DeGroat, Besler Holdings’ Chief Legal Officer, provides us with a glimpse into Webinar, Medicare Cost Report Appeals and Reopenings: Best Practices, presented live on Wednesday, July 22, at 1 PM ET. Highlights of this episode include: What is this webinar about? Key takeaways Recap of the whole series Who can benefit from this webinar Subscribe Today! Kelly Wisness: Hi, this is Kelly Wisness. We’re pleased to welcome back Kristin DeGroat , Besler Holdings’ Chief Legal Officer. In this episode, Kristin will provide us with a glimpse into Besler Holdings’ next and final webinar in its Medicare Cost Report Appeals and Reopening series. This one focused on Best Practices . This will be live on Wednesday, July 22nd at 1 PM Eastern Time. Welcome back and thank you for joining us, Kristin. Kristin DeGroat: Thank you for having me again. Kelly: All right, well, let’s go ahead and jump in. So, this webinar will focus on best practices. Can you give us a quick review of what we can expect in the way of best practices? Kristin: Yes. Navigating a Provider Reimbursement Review Board appeal requires rigorous adherence to strict rules and regulations. And because of that, there are some extremely valuable best practices that you need to think about when you’re filing these appeals. The portal and the deadlines are not just suggestions, they are requirements. So, navigating those in terms of best practices and setting forth how you remember when things are due and that kind of stuff in terms of an appeal is really important. But also important is the reopening process, ensuring that you adhere to the max deadlines, and that’s the Medicare Administrative Contractors deadlines and requirements. They are different. You do things a little bit differently. So, you need to think of how you handle that and getting those filed as well. And then just in general, CMS in general, there’s so many different parts and pieces that lead into appeals and reopenings. So just trying to set yourself up for success in terms of getting these filed and following the protocols, and basically trying not to irritate the board and the MAC are very important in this process. Kelly: Yeah, that sounds like solid advice, Kristin. And we always love best practices, so this is going to be a really great webinar. So, what do you think is going to be some key takeaways from the webinar? Kristin:Kind of what I just said about the being able to categorize or set up maybe calendaring or other avenues to ensure that you’re meeting the deadlines. And also cataloging, keeping your documentation together in a way that somebody else can understand. We all get caught in the, I’ve done it, I’ve looked at it so much, then we forget that people aren’t exactly like us and don’t read things exactly the same. So, cataloging that in a way that others can understand and appreciate, I think, will be the greatest takeaway. Kelly: Yeah, that sounds like a great takeaway too. So, this is the last in our Medicare Cost Report Appeals and Reopening’s webinar series. Can you do a quick recap of the first two, and how does this one fit in? Kristin: So, the first one was a deep dive into the PRRB and the rules and the deadlines, the timeliness, the amount of controversy. Those strict requirements and then we talked a little bit about the reopening requirements. And so, all of that together then led us to, well, what are the most common issues? That was the second webinar. And we did the deep dive into the most common issues, and we gave the status, kind of case law where they were sitting right now, and what we expect, or hope, maybe, is a better word, the outcome will be for those cases. So, the third one will definitely not hit the issues and the updates. So really, if you want to learn about the most common issues, updates, that one you’ll have to go watch if you didn’t join us for the second webinar. Hopefully, you’ll join us for the taped version, so to say. But I think this third one really will kick and tie to the first one where we kind of went through everything, but this will just be a little bit different approach. So maybe the lingo might be repeated, and I might forget to give the definition for my lingo. So, I will do my best. But I invite you to look at the whole series together, because I do think the whole thing together really makes sense. Kelly: Yeah, creates that complete picture, right? Kristin: That’s correct. Kelly: Yeah. So, do you have to watch the first two or watch them in order for this webinar’s content to make sense? I mean, or are they standalones? Kristin: I don’t know that they’re necessarily standalones completely. The first one did go through in detail what we’re going to talk about in best practices. And it gave a little overview of the issues. But really, that second webinar, the diving into those issues and really telling you what the status is, where they are right now, I think really is a standalone. But in order to get there, you had to meet all of the requirements. And you have to have the best practices to ensure that you’re really not irritating your audience. You want to make sure that you’ve complied and have done things showing not to be rude, right? When the board says you have 20 days to file this, don’t do it on the 21st day. It’s just as simple as that. Just following the rules and some best practices to help get you through. The other thing is appeals aren’t new, reopenings aren’t new. So, there is a lot. 30-plus years of going through the process has really, I think, laid out for us a nice, seamless transition from, “Here’s the rules,” to, “Here’s the issues, and here’s how you keep the goodwill going with your issues and your appeals, and even your reopenings.” So we’re going to talk a little bit more about reopenings, probably, in this third series, because I think the max concerns about how we approach issues and appeals, I think it’s something that we really need to take heed of because they are the ones that are going to help you settle your cases and help push these cases through. So, I think I want to do a little bit more focus there. Kelly: Okay, that makes a lot of sense. Looking forward to that one. So, who do you recommend attend this webinar? Who is the target audience? Kristin: Really, anyone in reimbursement. If you are filing a cost report or even thinking about an appeal, and you’re probably filing reopenings, so anyone doing those that has always wondered, “Well, I wonder why I did my reopening this way, and I didn’t get a really good resp...

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