Revenue Cycle Optimized: Inside Look at a Prior Auth Turnaround with AI Enabled Services

Episode 53 - Federal Rule to State Reality & National Impact: How MHDC Is Shaping Prior Authorization On this episode host Tony Schueth, CEO of Point-of-Care Partners (POCP), and co-host Ross Martin, MD, Senior Consultant with POCP are joined by guest, Denny Brennan, Executive Director of the Massachusetts Health Data Consortium (MHDC). Together, they examine how MHDC is translating national interoperability policy into practical, statewide action, specifically around the CMS 0057 rule. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

On this episode, host Carol Flagg closes out 2025 and welcomes in 2026 with a discussion on short form video for B2B healthcare marketing. Her guest is Jared Johnson, founder of the popular podcast, Healthcare Rap. Jared has been leveraging short form video for both his show and his clients and he joins Carol to talk about his experience as well as share some stats that will help paint the picture for why short form video is a content play must for 2026. Learn more about Jared Johnson at: https://healthcarerap.com To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Inside Look at a Prior Auth Turnaround with Enabled Services Health systems continue to face growing prior authorization volume, staffing strain, and payer complexity—challenges that stretch even further across multiple service lines and rural environments. Rayne Premo, Quality & Prior Authorization Manager at Iowa Specialty Hospital, discusses how her organization strengthened its prior authorization workflows using a centralized model supported by AI-enabled services. We’ll explore how teams can streamline processes, reduce administrative burden, and prepare documentation to meet payer expectations while positioning themselves for future expansion. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

On this episode Fred Goldstein invites Dr. Iltefat Hamzavi, MD, FADD to explore vitiligo as a complex autoimmune disease with significant psychosocial and clinical implications. They discuss the burden of delayed diagnosis, the societal and emotional challenges patients face, and the importance of early, individualized treatment. He outlines current therapeutic approaches—including topical agents, phototherapy, systemic options, and surgical interventions—and highlights the condition’s associations with other autoimmune diseases. The conversation underscores how education, support, and emerging medical advances are reshaping outcomes and quality of life for people living with vitiligo. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Host Matt Fisher talks to Edmund Jackson, Founding CEO, UnityAI, about the evolution of AI and how advancements enable agentic AI; challenges of building AI for healthcare; tackling discrete issues with AI to enable success; importance of voice as part of agentic AI and responding with personal touch; how AI can be catalyst for healthcare change. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

This episode turns the microphone toward Gil Bashe, host of Health UnaBASHEd, to discuss Gil's soon to be released (est. December 2025) book titled ""Healing the Sick Care System: Why People Matter - Gil Bashe on Restoring Humanity, Trust, and Mission to American Healthcare"". Executive producer and occasional co-host Gregg Masters interviews Gil in a deeply personal conversation about the state of American healthcare, the importance of human-centered care, and what we can learn from Gil’s lifelong journey in medicine, policy, advocacy, and spiritual leadership. KEY TOPICS: • Why the U.S. healthcare system struggles • Hyper-specialization and loss of whole-person care • Innovation without access • Patients caught in systemic gaps • Gil’s life journey — combat medic, advocate, CEO, rabbi To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

On this episode of Talking the Walk, host Tom Testa sits down with serial entrepreneur and League CEO Mike Serbinis to break down what the next generation of healthcare consumer experience will look like. From the industry’s shift away from point solutions to the arrival of agentic AI, Mike shares how the right platform can finally deliver the simple, personalized, always-on experience consumers have been waiting for. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Blood Pressure Control Crisis in Primary Care: New AI Study Reveals What's Going Wrong Join us as Dr. Andrew M. Davis and Amy Wainwright from University of Chicago Medicine reveals how AI-powered analysis of 37,000+ patients exposed a crisis hiding in plain sight: nearly 30% of hypertensive patients have dangerously uncontrolled blood pressure despite regular primary care visits. Using cloud-based machine learning across 112 providers, Dr. Davis's team identified critical gaps traditional metrics miss—underutilized medications, missed referrals, and troubling disparities in care. More importantly, they developed interventions that work. Discover how to leverage advanced analytics for measurable ROI, implement real-time clinical intelligence at scale, and empower providers with data-driven feedback that reduces cardiovascular risk at the point of care. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

On this episode of Voices of Self-Funding, host Tom Testa speaks with MIT-trained AI researcher and ClarityCare AI co-founder Hermine Tranie about how artificial intelligence is delivering measurable wins in utilization management (UM) and prior authorization (PA). Hermine explains how AI agents convert unstructured records into structured insights, drive real-time approvals at the point of care, and free up nurses for higher-value tasks – boosting accuracy, efficiency, and compliance. As a preview to her interactive “AI Mini-Hackathon” session at HCAA’s 2026 Executive Forum, Hermine shares a practical roadmap for adoption and what TPAs and self-funded employers can do today to start seeing ROI. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Payers are increasingly using AI to scan claims, flag anomalies, and trigger denials or audits automatically—often without transparency and long before anyone on the hospital side understands what happened. As these systems accelerate, hospitals face growing exposure, especially when documentation, data flow, and internal AI tools aren’t aligned with how payer models interpret clinical and financial information. This session unpacks the mechanics behind automated decision-making, why even accurate claims can be flagged, and how missing audit trails or inconsistent documentation can undermine appeals. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/