Welcome to “Revenue Cycle Optimized,” where you will find exclusive insights and practical advice to optimize and transform your healthcare practice’s financial health and operations.

Stuart Newsome, CPCO, hosts a lineup of industry leaders – healthcare executives, frontline professionals, tech innovators, and more – to unpack key strategies for optimizing every aspect of the revenue cycle. Think everything from patient access improvements and workflow enhancements to advanced coding practices and effective claims management strategy. We also highlight the impact of AI and automation in transforming these processes.

This podcast is brought to you by Infinx. Visit https://www.infinx.com for more information about their services and resources.

To learn more visit the show page: https://www.healthcarenowradio.com/programs/revenue-cycle-optimized/

Revenue Cycle Optimized

Lab Revolution In The Age Of AI And Access

How do today’s diagnostic laboratories grow, stay compliant, and remain profitable while facing staffing shortages, payer complexity, and soaring demand for advanced testing? On this special episode, they sit down with Ashish Dua, President and Co-Founder of Glidian, a company recently welcomed into the Infinx family. With deep expertise in laboratory workflows and prior authorization automation, Ashish shares how Glidian is helping labs—from scrappy startups to academic medical centers—scale faster, reduce overhead, and win physician loyalty by solving access barriers. The conversation explores how AI is transforming lab revenue cycle operations, not just by removing administrative burden, but by enabling entirely new workflows—such as acting as prior auth agents for physicians and training algorithms to interpret analog responses from payers. We’ll also discuss how shifting the burden of prior authorization from providers to labs is creating a new dynamic where labs can move from being cost centers to true revenue drivers. Ashish brings perspective from working with labs that perform high-volume molecular diagnostics, including non-invasive prenatal testing (NIPT) and hereditary cancer screenings like BRCA1/2, offering a timely view into what it really takes to operate a modern, financially sustainable lab in 2025.

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Revenue Cycle Optimized: Lab Revolution in the Age of AI and Access

Staying Ahead In The AI Arms Race With Payors

As artificial intelligence takes a front seat in revenue cycle operations, providers are confronting a fast-changing landscape shaped by payor-driven automation. Denials are being issued in seconds. Post-payment reviews are ramping up. And compliance, once a back-office function, is now a strategic necessity. In this special Office Hours session, Stuart Newsome distills the most important insights from his AAPC HEALTHCON presentation and a prior HFMA segment—delivering a clear-eyed look at the AI arms race between payors and providers. The session will examine how payors are deploying AI to control costs, how providers can avoid costly compliance missteps, and what governance structures are needed to keep automation accountable. Attendees will leave with a practical understanding of the risks and remedies surrounding AI in healthcare RCM, plus actionable steps to build resilient compliance programs that evolve with the technology.

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Revenue Cycle Optimized: Staying Ahead in the AI Arms Race with Payors

Six Shifts Shaping RCM Influenced by AI Agents

In 2025, revenue cycle management is being reshaped by the rapid advancement of automation and the emergence of intelligent AI agents. This session explores six major shifts that are redefining how healthcare providers manage claims, denials, eligibility, and financial performance — all through the lens of AI-enabled transformation. Built from real conversations with revenue cycle leaders, clinical teams, and healthcare finance professionals, this session offers a strategic breakdown of where RCM is headed and what’s holding organizations back. From the transition to platform-first strategies, to the increasing need for secure and resilient infrastructure, to the rethinking of workforce models around digital assistance — we’ll dive into the practical realities shaping today’s automation landscape. With AI agents now acting as collaborators, not just tools, healthcare organizations are beginning to realize new efficiencies, enhanced compliance, and measurable ROI. This session goes beyond hype and gets into how automation is truly impacting day-to-day revenue operations.

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Revenue Cycle Optimized: Six Shifts Shaping RCM Influenced by AI Agents

The Hidden Hazards of Surgical Prior Auth

Prior authorization for surgical procedures continues to be one of the most frustrating and costly hurdles in the revenue cycle. In this episode, Bo Bowman and Stuart Newsome unpack the hidden hazards that routinely derail authorizations—before a procedure is even scheduled. Drawing on firsthand experience and fresh examples from real-world surgical workflows, they explore the most common pitfalls, including failure to prove medical necessity, inaccurate procedural coding, insufficient documentation, and timing missteps. They also touch on the role automation and AI can play in supporting human teams—helping to surface missing requirements, flag coding mismatches, and push authorizations forward before deadlines hit. Whether you’re on the clinical side, in operations, or supporting from RCM or technology, this session will give you a clearer path forward and arm you with the awareness needed to avoid denials, delays, and administrative fatigue.

Revenue Cycle Optimized: The Hidden Hazards of Surgical Prior Auth

RCM Leadership That Gets Results in Coding Teams

Managing a coding team in today’s revenue cycle landscape is no small task—especially when that team is remote, the claims are complex, and the pressure is high. In this session, Jessica Watson, Facility Coding Manager at Infinx, joins host Stuart Newsome for an unfiltered look at what makes an RCM coding leader effective. Jessica shares how she balances performance metrics with coder wellbeing, builds a culture of transparency and accountability across remote teams, and addresses common pitfalls like documentation ambiguity, productivity burnout, and denial patterns. Jessica breaks down what it really takes to build trust, accuracy, and efficiency in a modern coding department. Whether you’re leading a coding team or just want to understand what “good” looks like in the world of facility coding and revenue cycle management, this episode delivers real-world tactics and frameworks you can use today.

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Revenue Cycle Optimized: RCM Leadership That Gets Results in Coding Teams

Prior Auth Reform Pledge and What Comes Next

On June 23, 2025, Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz announced a voluntary pledge from major U.S. health insurers to reform prior authorization (PA) processes. This initiative aims to reduce administrative burdens and improve timely access to care for millions of Americans. On this episode, we delve into the specifics of the announcement, examine the historical context of prior authorization reforms, and discuss the real-world implications for healthcare providers and patients. We’ll also explore how these changes align with ongoing conversations we’re having with clients and what steps providers can take to prepare for the evolving landscape.

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Revenue Cycle Optimized: Prior Auth Reform Pledge and What Comes Next

From Fax to Future in Radiology Prior Authorization Workflows

Faxed orders, scanned attachments, and inbox folders shouldn’t be the reason prior authorizations are delayed. Yet for many radiology groups, that’s still the case. Manual document capture creates friction at the front of the process—forcing staff to rename, sort, and route incoming faxes before a prior auth can even begin. In this episode, we explore how automating document capture accelerates the entire prior authorization workflow. From identifying STAT orders to extracting key order details and triggering auth submissions, we’ll walk through how imaging centers are using AI-driven tools to minimize lag, reduce errors, and scale operations without burning out staff. Joining us is Charulata Nevatia, a healthcare product leader with deep experience in workflow automation. She’ll share what high-performing radiology groups are doing differently and what steps you can take to modernize intake and boost auth readiness.

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Revenue Cycle Optimized: From Fax to Future in Radiology Prior Authorization Workflows

Medicare Fee for Service Meets Prior Authorization

CMS is rolling out prior authorization for traditional Medicare. This Office Hours panel breaks down what the WISeR model means for providers, how AI is involved, and what steps to take now—whether you're in a test state or watching for what's next.

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Revenue Cycle Optimized: Medicare Fee for Service Meets Prior Authorization

Why Credentialing Breakdowns Are Costing Radiology Groups Millions

Radiology groups face mounting pressure to maintain payer alignment, grow their footprint, and stay financially viable—but often, one of the most critical operational functions is still stuck in the shadows: credentialing. Join Rebecca Bairnsfather and Peggy Kelly—two industry veterans now part of the Infinx family—for a candid, behind-the-scenes look at why credentialing and enrollment processes are breaking down under the weight of today’s complexity. With experience managing credentialing operations for thousands of providers across multiple states, they’ll share real stories, actionable strategies, and a no-fluff assessment of the tools, tech, and expectations that define this often-overlooked function.

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Revenue Cycle Optimized: Why Credentialing Breakdowns Are Costing Radiology Groups Millions

From Prior Authorization Chaos to Clear AI Orchestration

Prior authorization isn’t just broken — it’s unsynchronized. On this episode, Evan Martin, VP of Revenue Cycle Management at ZoomCare Inc as well as Host and Producer of The Wilshire’s IT RevCast, shares what happens when real-time care delivery meets a fragmented, rule-heavy prior auth system that can’t keep up. With just one authorization specialist covering 50 clinics, Evan paints a clear picture: today’s healthcare moves fast, but prior auth is still stumbling through a maze of plan-specific rules, outdated workflows, and underperforming automation tools. We explore how even routine imaging, meds, and mental health services become tangled in conflicting payer policies and benefit silos. Evan breaks down the bottlenecks, the firefighting, and the policy blind spots — plus why simply layering automation on top won’t fix it. The real opportunity? An orchestrated model powered by agentic AI triages, retrieves, and routes the right information to the right place — so human teams can actually focus on patient care. This isn’t theory. It’s the lived complexity of treating patients while waiting for permission — and what the future could look like if we finally got the process in tune.

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Revenue Cycle Optimized: From Prior Authorization Chaos to Clear AI Orchestration

Closing the Visibility Gap in Patient Access Metrics

Many hospitals lack real-time visibility into front-end revenue cycle metrics like prior auth status and registration accuracy. This episode explores how closing that visibility gap can reduce denials, improve staff performance, and drive better financial outcomes.

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Revenue Cycle Optimized: Closing the Visibility Gap in Patient Access Metrics

How Radiology Teams Modernize Intake Without Disrupting Epic Workflows

Modernizing radiology intake means more than sending documents to Epic—it’s about building accuracy into the process. Learn how AI-powered document capture uses HL7 ORM mapping to handle multi-patient faxes, duplicates, and poor-quality images, with a phased rollout that keeps data clean and workflows running smoothly.

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Revenue Cycle Optimized: How Radiology Teams Modernize Intake Without Disrupting Epic Workflows

RBMA Founders Day: From Bots to Brains – Radiology’s Guide to AI Agents and Automation

Over 70% of imaging centers still depend on manual referral, scheduling, and prior auth processes—slowing care and straining staff. In this episode, Stuart Newsome, CPCO, VP of RCM Insights at Infinx, shows how AI agents powered by generative AI are transforming radiology operations. See how these “invisible coworkers” integrate with RIS, PACS, and EHRs to automate tasks, improve efficiency, and deliver real results.

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Revenue Cycle Optimized: RBMA Founders Day: From Bots to Brains

Hidden Dollars – A Rural Hospital’s Guide to Financial Survival

Rural hospitals don’t need another cost-cutting cliché. They need to reclaim what’s already theirs. On this episode, Taylor Searfoss from Infinx highlights the hidden dollars buried in hospital workflows—and shows you how to find them.

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Revenue Cycle Optimized: Hidden Dollars: A Rural Hospital’s Guide to Financial Survival

Agentic AI in Action, Live Demo of the Document Capture AI Platform

Manual intake workflows are one of the biggest slowdowns in healthcare. Every day, staff spend hours chasing down documents, retyping data, or figuring out what’s missing—before a patient can even be scheduled. On this episode, Stuart Newsome, VP of RCM Insights at Infinx, shows how agentic AI can change that.

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Revenue Cycle Optimized: Agentic AI in Action, Live Demo of the Document Capture AI Platform

The Realities of Reverification and the Future of Intelligent Automation

AI is everywhere in healthcare conversations, but when it comes to reverification, the reality is more complex. Each January, practices are hit with a surge of eligibility and benefits checks, straining staff and creating bottlenecks that risk revenue and patient experience. Traditional fixes like staff augmentation and manual workflows keep the lights on, but they don’t solve the underlying scalability problem. In this Office Hours, Jonathan Aguiar, Senior Solutions Engineer, and Lora Pada, AVP of Customer Success, will break down the real-world challenges of reverification, explore how staff augmentation and partial automation fill today’s gaps, and discuss how intelligent automation and AI agents are being developed to change what’s possible tomorrow.

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Revenue Cycle Optimized: The Realities of Reverification and the Future of Intelligent Automation

Bringing the Human Touch Back to AI Revenue Cycle Transformation

AI may be the buzzword of the decade, but its success depends on something far older—human connection. Join healthcare leader Nio Queiro for a candid discussion on demystifying AI, building trust across teams, and turning innovation into lasting operational change.

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Revenue Cycle Optimized: Bringing the Human Touch Back to AI Revenue Cycle Transformation

Ensuring Quality and Compliance in AI Coding

Explore how today’s AI-powered coding solutions are designed with compliance and quality at their core. This episode will highlight the safeguards built into implementation, the auditing processes that protect accuracy, and how continuous improvement ensures models evolve over time. Join us to learn how organizations can confidently adopt AI while maintaining trust, compliance, and coding excellence.

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Revenue Cycle Optimized: Ensuring Quality and Compliance in AI Coding

Region 9 HFMA: The Anatomy of AI Agents - What They Are, How They Work, and Why They Matter

AI agents don’t come with arms, legs, or eyes—but they do have something even better: the ability to think, reason, and act. As generative AI continues to evolve, so do the capabilities of AI agents—autonomous systems that can interact with applications, extract and apply knowledge, and make decisions based on context.

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Revenue Cycle Optimized: Region 9 HFMA: The Anatomy of AI Agents

Smart PT Reverification Lessons From Mary Free Bed

On this episode, hear from Mary Free Bed’s Daniel Heemstra on overcoming PT reverification challenges, supported by intelligent automation and Epic integration that simplify the process and reduce the burden on staff.

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Revenue Cycle Optimized: Smart PT Reverification Lessons From Mary Free Bed

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Healthcare NOW Radio and Podcast Network offers discussions on the latest developments and trends impacting the industry including: health tech, health IT, healthcare innovation, healthcare policy, healthcare data security, telehealth, interoperability, biotech, med tech, value-based care, pharma, healthcare compliance, and much more. Shows are hosted by industry thought leaders. Guests are a "who's who" across the healthcare spectrum.  The listening audience is predominantly physician and hospital-based, and the healthcare industry at large.

Revenue Cycle Optimized

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