Revenue Cycle Optimized

Medical necessity sits at the intersection of clinical judgment, coverage policy, and payer scrutiny, and in this episode Stuart Newsome, VP of RCM Insights, unpacks what it really means. Joined by Viveka Jagadeesan (Enablement Manager), Lindsey Nelson (Director of Product Marketing), Christina Harkins (Senior Revenue Cycle Manager), and Angie Adams (VP Clinical & Patient Engagement), the group explores Medicare error data, CERT audits, recoupment risk, NCD vs. LCD nuances, and how AI-driven policy intelligence can support medical necessity on both the front and back end of the revenue cycle.

Missed insurance changes and outdated eligibility data trigger a massive amount of unnecessary prior auth volume—most of it preventable with a simple reverification step. In this episode, we break down how proactive reverification keeps PA teams from drowning in duplicate submissions, rework, and avoidable denials.

Listen in as AR and denials management automation comes to life in this live demo of Infinx ARDM. Christina Harkins walks through how AI-driven denial prevention, claim prioritization, and productivity analytics transform how revenue cycle teams work.

Brought to you by www.infinx.com

In this episode, Vishwanath Singh breaks down how Infinx is modernizing quality assurance across both RCM and Patient Access through structured governance, risk-based sampling, and emerging AI copilots that strengthen accuracy and reduce variability. He explains how documentation, SOP creation, and auditing are being transformed into real-time, intelligence-driven processes that protect revenue and accelerate performance.

Missed eligibility and benefit verifications can snowball into prior authorization chaos. Listen and learn to unpack how tighter EVB workflows prevent unnecessary prior auths and downstream denials.

Prior authorization in oncology is notoriously complex, with aggressive payer policies and documentation hurdles that delay care. Join Liz Durkin, Manager of Revenue Cycle from Exact Sciences, as she shares challenges faced before Infinx, improvements since partnering, and how automation and programmatic strategies are reshaping their PA workflows.

Brought to you by www.infinx.com

In this episode, Eric Grone and Jonathan Aguiar walk through how a flexible patient access platform blends AI, automation, and human expertise to handle eligibility, prior authorizations, and patient estimates at scale. They break down how health systems can configure hybrid models by payer and modality, reduce denials, and unlock analytics that finally make payer friction visible and fixable.

Repeat submissions are a silent time thief in revenue cycles — often caused by missing documentation, manual tracking gaps, or payor black holes. In this episode, we explore why they happen and how automation, visibility, and workflow discipline keep you from falling into the trap.

Long hold times and overwhelmed front-office staff have made patient scheduling a pain point across healthcare. In this episode, we explore how Infinx and Voxology are redefining patient access with AI-powered scheduling agents that combine empathy, intelligence, and efficiency to transform the way patients connect with care.

Brought to you by www.infinx.com

Tim Anderson, Executive Vice President of RCM Services at Infinx, shares the unique dynamics, challenges, and opportunities involved in supporting academic medical centers. From multi-specialty billing and grant-funded research to faculty oversight and revenue integrity, he explains how deep expertise and flexibility drive lasting partnerships in this complex sector.