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For The Love of Revenue CycleAuthor: Vanessa Moldovan
Did you ever wish that you had a physician revenue cycle expert and mentor with over 20 years of experience whispering success secrets in your ear? Thats exactly what you will get when you tune into For the Love of Revenue Cycle hosted by me, Vanessa Moldovan. My career and my life have brought me a wealth of knowledge and I cant wait to share with you. My passion is to help others in the industry to reach their full potential and find success in the wonderful, crazy world of physician revenue cycle. Whether you are a beginner, expert, physician, consultant, educator or just plain curious, each episode is designed to immediately apply to your career, business and operations. Join me each week as we tackle the topics, trivia and triumphs of revenue cycle. Lets discover our full potential together. Language: en Genres: Education, Health & Fitness, How To, Medicine Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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FTLORC Live Q&A! 10/14/25
Wednesday, 22 October, 2025
In this episode of 'For the Love of Revenue Cycle,' host Vanessa Moldovan engages the community in a live Q&A session. The discussion covers the pressing issue of denials and reimbursement challenges in the healthcare industry. Key topics include recent policy changes by Cigna on automatic downcoding, the implications of DRG downgrades, and strategies for identifying downcoded claims. The episode also addresses how to measure denial rates, manage medical necessity denials, and successfully overturn denied claims. Expert insights and community contributions make this episode a valuable resource for anyone involved in the revenue cycle. 00:00 Introduction and Welcome 00:12 Open Q&A: Community Challenges 01:10 Discussion on Cigna's Downcoding Policy 03:01 Identifying and Handling Downcoding 07:33 Measuring Denial Rates and Overturns 12:00 Government Shutdown Impact on Telehealth 12:57 Combating Medical Necessity Denials 17:25 Escalating Denial Issues with Payers 22:20 Conclusion and Community Engagement
