EPISODE SUMMARY

In this essential episode (with Jeremy flying solo as Kathryn welcomes their third child!), we tackle the critical third territory on the RCM Game Board: Eligibility and Benefits Verification. Think of E&B as your practice's scouting phase. We break down exactly what E&B means, why it’s a non-negotiable step before any claim is mentioned , and how mastering this repeatable five-step workflow is the key to preventing those costly, frustrating surprises for both you and your patients. We’ll dive deep into:

The two crucial parts of E&B: checking eligibility (is the policy active with me?) and benefits (what does the patient owe?).

The nightmare of Prior Authorization (PA) and why correctly checking for this requirement is the punchline to avoiding guaranteed denials.

The non-negotiable conversation with your patient about their financial responsibility—the game-changer that builds trust and prevents billing surprises.

A real-world case study of a group practice that lost over $20,000 in two months because they missed this crucial step (and how they recovered).

This is all part of a sound practice management strategy, ultimately letting you claim victory for your bottom line. It's time to stop the claim denials and turn them into deposits.

KEYWORDS

Revenue Cycle Management, RCM, Insurance Billing, Private Practice, Practice Management, Eligibility and Benefits, Prior Authorization,  Claim Denials, Patient Care, Cash Flow

TAKEAWAYS

E&B is the Cornerstone: Eligibility and Benefits verification is the third step and a cornerstone of the entire front-end RCM process. It must happen before there is even mention of a claim.

The Two Checks: Eligibility is scouting to confirm the policy is active and you are In-Network. 

Benefits is determining the cost-sharing responsibilities (deductible, copay, coinsurance, out-of-pocket maximum).

PA is the Payment Key: A required Prior Authorization that is not handled correctly guarantees a denied claim. Getting that pre-approval is like getting a special key that unlocks payment.

Non-Negotiable Communication: You must clearly explain the patient's financial responsibility before the appointment. This transparency shifts the dynamic from "Why am I getting this bill?" to "Thank you for letting me know what to expect".

Repeat the Process: Benefits change all the time! This is not a one-and-done process. Continuously update benefits and benefit verification for accuracy and patient satisfaction.

CHAPTERS

00:00 Introduction to Revenue Cycle Management

01:59 Understanding Eligibility and Benefits Verification

05:15 The Workflow of Eligibility and Benefits

09:58 Prior Authorization: A Critical Step

11:24 Communicating with Patients Effectively

13:45 Tools for Managing Eligibility and Benefits

16:02 Case Study: The Importance of Verification

18:28 Conclusion: Turning Process into Practice

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Images: Eligibility & Benefits, Insurance Contact Reference List, E&B Template, Benefit Summary Email Template, KPI Dashboard

EPISODE SUMMARY

You’ve mastered the day-to-day tasks of patient registration, but how do you know if your processes are actually winning? In this episode, Jeremy and Kathryn Zug zoom in on the Key Performance Indicators (KPIs) space within the Patient Registration territory of The RCM Game Board. They break down how practice owners can stop being reactive and start being proactive by moving beyond the day-to-day desk tasks and tracking essential data.

This deep dive into measuring your practice's success reveals the vital metrics that transform patient frustrations into a smooth, positive first impression and ensure your practice's financial health is aligned with your goals. Learn why the patient intake process, if not optimized, can create costly bottlenecks, delay cash flow, and put your practice at risk. It's time to put your data to work and turn those claim denials into deposits.

In this episode, we cover the critical KPIs for Patient Registration:

Provider Utilization: This goal-setting metric measures the percentage of a provider's desired available time filled with appointments and tells you how effectively your scheduling and flow processes are working. A low rate is a huge red flag for untapped revenue.

Missed or Canceled Appointments: Learn how to measure this rate and what a high number indicates about poor patient communication, unclear expectations, or an inconvenient scheduling process.

Form Handling Audit Pass Rate: This crucial HIPAA compliance metric directly impacts your revenue cycle! Learn why intake errors are a leading cause of rejections and denials and how to track the accuracy of your patient data and forms.

Patient Satisfaction Survey Analysis: Turn subjective patient feedback into actionable data to identify friction points that cause patients to drop out of care and ensure your first impression is a powerful one.

KEYWORDS

Revenue Cycle Management, RCM, Patient Registration, KPIs, Provider Utilization, Practice Management, Medical Billing, Insurance Billing, Healthcare Business, Form Handling Audit, HIPAA Compliance, Practice Growth

TAKEAWAYS

Move Beyond the Day-to-Day: Get a clear picture of your practice's health by conducting a monthly data pull on key metrics to identify bottlenecks, improve patient retention, and increase revenue.

Utilization is Goal-Driven: Provider Utilization is a goal-setting activity that measures your scheduling's effectiveness against the provider's desired hours, not just their physical availability. Low utilization can be a sign of a bad patient intake process, a provider with overly specific preferences, or ineffective scheduling.

Cancellations Are a Red Flag: A high rate of missed or canceled appointments is a big red flag that you must look at weekly. To correct this, run a test of your patient registration process (a "ghost shopper" test) and implement a solid wait list.

HIPAA & Claim Accuracy Are Linked: The Form Handling Audit Pass Rate is vital because intake errors and incomplete forms are a leading cause of rejections and denials—which delays cash flow and puts your practice at risk of HIPAA violations.

Ask Actionable Questions: When designing patient satisfaction surveys, the more granular the questions, the better. Ask questions directly linked to changes you are willing to make to find patterns and focus your improvements.

KPIs Create a Predictive System: A comprehensive KPI dashboard aggregates your metrics for a bird's eye view, helping you move from a chaotic, reactive process into a predictable, proactive system that ensures your practice is running the thing, not the other way around.

CHAPTERS

00:00 Introduction: Mastering the Patient Registration Metrics

02:09 From Tasks to Insights: Evaluating Patient Registration

04:28 Provider Utilization and Practice Health

06:42 Pulling and Analyzing Utilization Metrics

08:43 When Utilization Drops: Finding the Root Cause

14:09 Tracking Missed and Canceled Appointments

20:08 Form Handling Audit: Protecting Compliance and Cash Flow

25:05 Turning Feedback into Action: Patient Satisfaction Surveys

30:03 Dashboard Overview: Turning Metrics into Insight

32:09 Case Study: Using KPIs to Improve Patient Registration

33:59 Conclusion: Moving Forward with Data-Driven Decisions

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Images: Patient Registration KPI Dashboard

EPISODE SUMMARY

This week on The Claim Game, Jeremy and Kathryn Zug make the final move in the Patient Registration territory of the RCM Game Board: 

Checkout. It’s easy to think the work is done when a session is over, but this final step is absolutely critical for a practice’s revenue cycle and reputation.

We break down the key elements of a solid checkout process—from physically guiding the patient to the checkout person and ensuring payment authorization works, to the essential practice of scheduling the next appointment on the spot. We discuss the tactical process for handling outstanding patient balances, including setting up payment plans for past due debt before the patient leaves the desk. Most importantly, we cover how to talk about money without damaging your relationship with the client, proving that clear, well-trained communication is the ultimate tool for diffusing emotion.

Plus, hear a fascinating case study about a practice that revolutionized its efficiency by measuring a single, unexpected KPI at checkout.

KEYWORDS

Private Practice, Revenue Cycle Management, Medical Billing, Insurance Billing, Mental Health Billing, Patient Checkout, Cash Flow, Patient Collections, Practice Growth, RCM Best Practices

TAKEAWAYS

Checkout Closes the Loop: A patient’s registration isn't complete until the first checkout has successfully happened, and this process is a major reputation-building activity.

The Three Key Actions at Checkout: A solid checkout process focuses on three tactical elements: 1) Collecting payment (and verifying the payment authorization works); 2) Scheduling the next appointment ; and 3) Offering to answer any questions.

Resolve Past Due Balances Now: Do not allow patients to leave the desk if they have past due balances without setting up a clear payment plan. Practice Solutions’ policy is to collect the current balance in full and set up a plan for the historical debt; you don't want to add to the debt.

Communication is the Key to Customer Service: Make sure your checkout person is extremely well-trained and good with people. Information is so good at diffusing emotion. They need to be able to clearly read an ERA or claims notes to explain why a balance exists in layman's terms—turning a potential confrontation into a transparent discussion.

Pitfalls to Avoid: The biggest pitfalls are failing to collect payment at the time of service, which leads to patient aging, and surprising patients with unexpected bills months or years later. Your patient aging shouldn't exist.

Essential Tools: Two key tools are the Payment Authorization Form (a legally binding document giving permission to charge a card) and the Checkout Checklist (a procedural guide for staff). These ensure consistent and correct application of your financial policies and empower your staff to have clear conversations about money.

CHAPTERS

00:00 Introduction: Completing the Registration Journey

03:48 Turning Checkouts into Cash Flow

08:14 Money Conversations that Build Trust

13:05 Avoiding Checkout Pitfalls

16:30 Power Tools for the Front Desk

20:26 Case Study: When Checkout Data Changes Everything

24:46 Conclusion: Checkouts that Build Reputation

26:21 Resources and Educational Opportunities

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Images: Checkout Checklist, Payment Authorization Form

EPISODE SUMMARY

Welcome back to The Claim Game! In this round of mastering Revenue Cycle Management, we're taking a magnifying glass to the crucial territory of Patient Registration and zooming in on the seemingly "riveting" world of HIPAA Compliance. We know that when practice owners hear "HIPAA," their first instinct might be to "run for the hills", but understanding this federal law is absolutely vital for your practice's bottom line and your peace of mind.

Kathryn and Jeremy break down the three core rules—Privacy, Security, and Breach Notification —and why patient registration is ground zero for proper handling of Protected Health Information (PHI). We also dive into a candid discussion about the risks of offshoring patient data, noting that HIPAA is an American law and the lack of data safety guarantees and potential legal complications overseas should be a huge consideration when choosing a vendor.

This episode is packed with specific, actionable protocols, including the non-negotiable need for staff training, the importance of two-factor authentication (especially after the Change Healthcare breach) , secure digital storage (no downloads to your desktop!), and the process for handling everything from physical records to a breach notification. We end the episode with a real-world case study card that shows the costly pitfalls of discussing PHI in public spaces, like a waiting room.

It's time to turn those claim denials into deposits and ensure your practice is not only compliant but confident.

KEYWORDS

HIPAACompliance, RCM, Patient Registration, PHI, Protected Health Information, EHR, Security Rule, Privacy Rule, Breach Notification, Practice Solutions, The Claim Game

TAKEAWAYS

​​HIPAA is Your Law, Not a Suggestion: HIPAA stands for the Health Insurance Portability and Accountability Act and is a federal law establishing standards to protect sensitive Patient Health Information (PHI).

Registration is Ground Zero: Patient registration is the first step where you collect, store, and transmit PHI (Name, DOB, Insurance ID, even IP addresses), making this a critical area for compliance.

Offshoring PHI is a Risk: Companies outside the US are not held to the same HIPAA standards, creating a data safety risk for your practice and your patients. We choose to keep all of our staff stateside for this reason. If you are working with vendors, always ask for a Business Associates Agreement (BAA).

The 3 Rules: Privacy, Security, & Breach Notification: You must be mindful of how you govern PHI (Privacy Rule) , how you protect electronic PHI (Security Rule) , and your protocol for notifying affected individuals/HHS if a breach occurs (Breach Notification Rule).

The Compliance Officer is NOT the Intern: Assign a stable, organized compliance officer to maintain documentation, monitor legislation, train staff, and handle breach notifications.

Security Must Be Multi-Layered:

Digital: Utilize HIPAA-compliant systems (like a secure EHR), encrypted emails/portals, and two-factor authentication for all software access.

Physical: Limit physical access (locks, key cards) , position screens to prevent unauthorized viewing (privacy screens!) , and securely dispose of paper PHI (shredding or burning, not s'mores).

Oops is Not an Option: Red flags include leaving documents visible, storing digital PHI on personal, unencrypted devices, discussing patient information in public spaces (like the waiting room), or improperly disposing of paper records.

CHAPTERS

00:00 Introduction: Navigating HIPAA in Patient Registration

03:53 The Hidden Risks of Offshoring Patient Data

07:54 Privacy, Security, and PHI: The Rules Every Practice Must Follow

18:09 Building HIPAA Protocols That Actually Work

22:03 HIPAA Security Rule: Systems, Safeguards, and Access Control

24:36 Common HIPAA Mistakes (and How to Avoid Them)

25:17 When a Breach Happens: What to Do Next

27:21 Your HIPAA Toolkit: Templates, Logs, and Lifesavers

29:24 Case Study: A Real HIPAA Violation in the Waiting Room

32:12 Conclusion: Putting HIPAA Compliance Into Practice

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Images: HIPAA Compliance Guide

EPISODE SUMMARY

Are you tired of grappling with insurance denials due to a simple mismatch in credentialing? Patient registration is more than just a clerical task—it's a key part of your RCM strategy, and this episode zooms in on the next critical step: 

Provider Assignment and Scheduling. Matching the patient to a provider with the right credentials and specialty is crucial for ensuring a smooth eligibility match, preventing costly blunders, and guaranteeing you get paid. This process, which ideally begins on the intake call, requires collecting both patient information (insurance, presenting problem, preferences like language and availability) and using your provider’s preferences and utilization limits to find the best possible fit. Once assigned, getting the patient on the calendar requires granular availability checks and clear 

Appointment Scheduling Guidelines that detail protocols for new patients, handling reschedules, tracking session limits, and managing insurance changes. Finally, managing your wait list is essential; treat it as a powerful tool for converting hot leads, filling cancellation slots, and ensuring optimal provider utilization to protect your revenue and reputation.

KEYWORDS

Scheduling, Intake Process, Eligibility Match, Credentialed Provider, Insurance Denials, EOBs, Provider Utilization, No Shows, Cancellations, Wait List, Patient Preferences, Provider Availability, Appointment Scheduling Guidelines, Out of Network, Medicaid Carve Out

TAKEAWAYS

Assignment is Strategy, Not Clerical: Integrate provider assignment into your RCM strategy, recognizing that matching the patient's needs and insurance to the provider’s credentials and specialty is crucial for getting paid.

Gather Both Sets of Preferences: Don't just collect patient availability and presenting problems. You must also know the provider’s preferences for utilization (caseload capacity), language, and patient type to ensure a good fit and prevent provider burnout.

Address Carve-Outs Early: Be vigilant for specific carve-outs or plans that may not match your provider’s credentialing, even if they appear "in-network" with the general payer. A mismatch can result in a significant loss of revenue.

Document Your Procedures: Create a comprehensive set of Appointment Scheduling Guidelines that includes protocols for booking, tracking session limits/authorizations, handling patient rescheduling, and managing insurance changes or benefit stage changes.

Treat Your Wait List as Revenue: Organize your wait list by key patient and provider match criteria and check it regularly to move patients into open cancellation slots or newly available appointments. Use it to manage provider under-utilization.

CHAPTERS

00:00 Introduction: Setting the Stage for Patient Registration

01:52 From Intake to Calendar: Matching Patients with Providers

04:00 Strategy Behind Provider Assignment

07:24 Managing Provider Utilization

10:30 From Reschedules to No-Shows: Building Strong Scheduling Policies

12:53 The Power of a Well-Managed Waitlist

17:06 The Four Essential Tools for Provider Assignment & Scheduling

21:30 Case Study: From Revenue Loss to Patient Dissatisfaction

24:51 Conclusion

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Images:  Appointment Scheduling Guidelines, Waitlist, Provider Assignment Tool, Provider Availability and Preference Form

EPISODE SUMMARY

In this episode of The Claim Game, Jeremy sits down with Joe Murphy, the CEO and Co-founder of Checkpoint EHR. Joe shares his unique journey from the high-paced world of telecommunications to the mission-driven sphere of behavioral health technology, focusing on Checkpoint's core value: "Simply, period".

Joe discusses how Checkpoint is working to move EHR systems into the background by eliminating "the tool that everybody hates" and making the process so subtle and simple that providers don't have to think about it. The conversation dives deep into the strategic use of technology to solve the biggest friction points for practices, including "hands-free billing" , the importance of intuitive design, and how customization reduces noise and error opportunities.

Crucially, Joe provides a forward-looking perspective on the rapid pace of change in the healthcare technology landscape. He explains how Checkpoint is becoming an "AI first focused company" , the incredible productivity gains AI offers (including tenfold increases for developers) , and the critical need to treat AI as a thought partner, not a thought leader, to avoid the risk of "hallucination". Finally, Joe details Checkpoint's unwavering commitment to HIPAA compliance, why US-based data centers are non-negotiable, and his advice to practice owners: don't be afraid to "fail forward".

KEYWORDS

Private Practice, Revenue Cycle Management, EHR,  Electronic Health Records, AI in Healthcare, Medical Billing, Behavioral Health, Checkpoint EHR, Hands Free Billing, Credentialing, HIPAA

TAKEAWAYS

The Mission Moment: Joe's shift from the revenue-focused world of telecom to healthcare was driven by the desire to "make a difference in everybody's community" by helping clinicians address the mental health crisis. Checkpoint EHR's core mission is to "help those who help others".

The EHR that Fades into the Background: Checkpoint's goal is to be so subtle and simple that a provider doesn't have to think about it. They work to reduce the number of choices a user makes to narrow down opportunities for mistakes, which helps reduce claim denials.

Hands-Free Billing is Key to Cash Flow: Checkpoint emphasizes "hands-free billing" where first-time submissions are automatic and quickly go out the door. This frees up billing staff to spend time on more critical issues like denials or rejections, which is where money is truly on the table.

Usage-Based Pricing Reduces Burden: Checkpoint's model compensates the company only when the practice gets paid. This means costs flex with a practice's revenue (e.g., lower cost during seasonal slowdowns) and eliminates extra charges for claim resubmissions.

AI as a "Serious Player": Joe sees AI as the next major leap forward in technology, similar to the internet's impact. Checkpoint is an "AI first focused company" and has seen productivity increase tenfold on its development team since integrating AI tools.

AI Must Be a Thought Partner: When using AI, providers must stay in control and treat it as a thought partner, not a thought leader. This is critical to combat "hallucination," a phenomenon where AI is designed to always give a convincing response, even if it has to make up the answer.

Data Security is Non-Negotiable: Checkpoint ensures patient data protection by requiring all platforms to be HIPAA compliant, maintaining high access controls, using US-based HIPAA-compliant data centers, and avoiding offshoring data.

The Importance of Clinician-Trained AI: Checkpoint's AI-assisted notes are trained by licensed professionals, ensuring responses are reliable and clinically sound, rather than being trained by user data or making responses based on the "popularity of what other users are doing".

Advice to Practice Owners: Fail Forward: Joe's advice is to partner with your EHR vendor, treat them as a partner and not an adversary. Most importantly: "If you're not failing, you're not trying hard enough". Don't be afraid to "fail forward" by learning from mistakes and empowering your team to own their decisions.

CHAPTERS

00:00 Introduction: Joe’s Journey into Health Tech

05:45 A Lifetime of Innovation: Lessons Across Tech Revolutions

07:10 Signal Over Noise: A Different Approach to EHRs

09:52 Automation That Pays: How Checkpoint EHR Boosts Cash Flow

14:26 Eliminating Hidden Fees: A Different EHR Pricing Model

16:42 Simplifying the Patient Experience in EHRs

18:59 How AI is Reshaping Patient and Provider Experiences

27:15 Protecting Patient Data While Innovating with AI

31:00 The Importance of U.S.-Based Data Centers

32:44 Simple Strategies to Learn AI

34:27 A Roadmap for New Tech in Practices

36:44 Checkpoint's Role in Patient Care Ecosystem

38:38 Navigating Policy Shifts: Staying Resilient Amid Change

42:53 Conclusion: Advice for Practice Owners

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

EPISODE SUMMARY

Welcome back to The Claim Game, the podcast that helps you turn claim denials into deposits! In this episode, we're diving into the second territory on our RCM board: patient registration. Jeremy and Kathryn Zug zoom in on the very first stage of this process—intake—and explain why perfecting it is so critical for both your practice's reputation and bottom line.

Kathryn explains that intake is about more than just paperwork; it’s about collecting accurate data to prevent future rejections. A poor process can cause a patient to abandon care before it even begins, while a smooth one sets the tone for the entire patient experience. We dive into the specific information you need to collect during the initial intake call, from demographic and insurance details to the patient's "pickle" or presenting problem. We also cover essential follow-up steps, such as sending appointment confirmations, intake forms, and visit instructions that put your patients at ease.

The conversation also highlights the importance of creating a formal, clear process for intake. Just like a McDonald’s burger is made the exact same way every time, a standardized intake process ensures consistency regardless of who is doing it or when. We discuss key resources a practice needs, including an internal administrative intake packet with a scripted logic tree and an external patient intake form. A good EHR can serve as a central hub for all this information, helping to streamline the process, though not all of them are created equal.

Finally, we hear a case study about a practice that assigned a client to a clinician who didn't take their insurance. This is a reminder that simple mistakes in the intake process can be easily prevented with a clear, well-documented system, protecting both your revenue and your patient relationships. It is a big deal to get intake done well because you have to get it right the first time.

KEYWORDS

Intake, Patient Registration, Revenue Cycle Management, RCM, Insurance Billing, Private Practice, Practice Management, Claim Denials, Patient Experience, EHR, Administrative Intake Packet, Patient Intake Form, Practice Health, Credentialing, Patient Portal

TAKEAWAYS

Intake is Your First Impression: A smooth intake process is crucial for setting expectations and preventing patient frustration from the start. A bad process can cause patients to abandon care.

Standardization is Key: Create a clear, formal, and repeatable intake process for your practice. This ensures consistency and prevents mistakes, regardless of who is handling the intake call.

Prevent Rejections at the Source: Intake errors are a leading cause of claim rejections. By collecting accurate demographic and insurance information up front, you can save significant time and headaches down the road.

Clarity is Kindness: Define the flow of communication between your front office and billing department. When the rules are not clearly defined, it causes frustration for everyone, including the patient.

Utilize Intake Resources: Essential tools for a successful intake process include an internal administrative intake packet with a scripted logic tree and a patient intake form for the client.

CHAPTERS

00:00 First Impressions: Perfecting the Intake Process

07:20 Confirm, Remind, Prepare: The Post-Intake Essentials

10:39 From Front Desk to Billing: Defining the Flow

14:59 Consistency Is Key: Why Intake Must Be the Same Every Time

17:08 The Administrative Intake Packet: Your Secret Weapon

23:49 The Patient Packet: Intake from Their Side

25:49 From SOPs to Portals: Building a Repeatable Intake Process

27:22 How Your EHR Can Make or Break Intake

30:24 Case Study: Consequences of Poor Intake Practices

30:45 The Importance of Effective Intake Processes

32:09 Conclusion: Mastering the First Step – Intake Foundations and Tools

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Images: We mentioned several images in today's Episode

Administrative Intake Packet

Patient Intake Packet

EPISODE SUMMARY

In this episode of The Claim Game, Jeremy Zug interviews Maya Topitzer, the founder of Breksey, an AI-powered client relationship management (CRM) tool built to help clinicians run their private practices like thriving businesses. The discussion dives into a critical, often-overlooked pain point for practice owners: patient registration.

Maya explains that patient registration is more than just booking an appointment; it's a broad process that starts with a potential client's first inquiry and ends with their initial visit. The biggest pain points she sees are the endless back-and-forth communication, which can lead to missed opportunities, and the burden on practice owners' personal time. Jeremy and Maya share how AI and technology, when used ethically, can "crack the code" on these challenges.

The conversation covers the hidden costs of outdated registration systems, such as lost revenue from slow response times and the burnout that comes from administrative work encroaching on nights and weekends. Maya explains how Breksey's technology helps by converting more inquiries into booked appointments and streamlining the process to reduce data entry errors that cause billing headaches down the line. They also touch on the importance of patient experience and how AI can provide a more personalized, less "clunky" intake process.

The episode concludes with a look at the future of AI in practice management and Maya's core piece of advice for all healthcare professionals: ask for more money and remember your power.

KEYWORDS

Revenue Cycle Management, RCM, Patient Registration, AI for Healthcare, Practice Management, Mental Health Billing, Credentialing, Claim Denials, EHR, Payer, Private Practice, Breksey

TAKEAWAYS

Patient Registration is Your Top Funnel. Patient registration isn't just about scheduling; it's a critical part of the revenue cycle that starts from the very first inquiry. Optimizing this process can significantly impact your practice's growth and financial health by ensuring you don't miss out on potential clients.

AI Can Maximize Your Time and Revenue. AI-powered tools can help you reclaim personal time and capture lost revenue by automating the back-and-forth communication and streamlining intake. According to Maya, practices using Breksey can double their conversion rate from inquiry to booked appointment.

"Bad Data In" Equals "Big Headaches Downstream." Errors in patient registration, like data typos or missing information, create a "massive headache" for billers later on and can lead to claim denials. Technology helps reduce this margin for error by capturing accurate data right from the start.

The Future of Tech is Simple and Conversational. Jeremy and Maya agree that the goal for future practice management technology is to move away from cumbersome, repetitive clicks and toward a more conversational interface. This would allow clinicians to focus on patient care, not paperwork.

You Have More Power Than You Think. Maya's final piece of advice is a powerful one: remember your worth and don't be afraid to ask for more money. As a professional, you have the power to negotiate and ensure your services are not undervalued.

CHAPTERS

00:00 Introduction to Breksey and Its Mission

05:26 Reclaiming Time and Revenue in Patient Intake

09:22 AI Myths in Patient Registration

12:35 Doubling Conversion Rates with Breksey

17:21 Reducing Errors, Reducing Friction: A Better Patient Journey

20:08 Addressing Data Privacy Concerns in AI

22:36 Clinicians as Partners, Not Products

24:55 Revenue Cycle Wins Through Better Registration

27:36 From Community Insights to Insurance Leverage

29:54 Choosing the Right AI for Patient Registration

31:50 Regulation, Risk, and Responsible AI

34:34 Reducing Admin, Maximizing Care: The Future of Practice Tech

37:10 Conclusion: Maximizing Your Practice’s Potential

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

Breksey: A comprehensive solution designed to empower therapists in private practice.

EPISODE SUMMARY

In this episode, we're taking a strategic pause to get a behind-the-scenes look at the very game we’re playing by talking to a game changer himself, Uriah Guilford. He's a licensed therapist, group practice owner, and the head nerd at Productive Therapist, a virtual assistant company that serves providers in private practice.

We're diving into the complexities of the patient registration process and uncovering the real costs of inefficiency, including lost revenue, patient dissatisfaction, and staff burnout. Uriah shares a powerful story from his early days that underscores why patient registration and timely callbacks should be a top priority for every practice. We'll also discuss how early adoption of technology and AI, like conversational AI agents, can transform your intake process and provide a level of service that will "surprise and delight" your clients.

Finally, we’ll talk about how to get started on overhauling your intake process and the value of outsourcing your intake to a virtual assistant. You'll learn the single most important thing to do when you're ready to improve your process and discover the one piece of advice Uriah would leave you with if he could only share one thing about patient intake.

KEYWORDS

Revenue Cycle Management (RCM) , The Claim Game , Patient Registration , Patient Intake , AI, Virtual Assistant , Productive Therapist , HIPAA , Private Practice

TAKEAWAYS

The Phone and Calendar are Key: If you want to dominate your market, you have to manage two things: the phone and the calendar. A fast, efficient response to new inquiries is the highest level of service you can offer.

A Bad Intake is Costly: Inefficiencies in the patient intake process can lead to negative client experiences, lost revenue, and practice owner or staff burnout. A solid intake process is the "opening act" to a client's experience with your practice.

Delegate to Grow: Many therapists struggle to delegate and wait too long to get help. Hiring a virtual assistant to handle the intake process can be a game-changer, allowing you to maximize your impact and grow your practice at a much faster rate.

Leverage AI for Intake: AI tools and conversational AI agents can significantly improve the intake process by answering questions and even booking appointments, even when staff are unavailable. This allows practice owners to do more in less time.

Secret Shop Your Own Process: The single best place to start when overhauling your patient intake is to "secret shop" your own process. By going through every step from the client's perspective—from the voicemail message to the client portal login—you will find areas to improve.

Aim for Surprise and Delight: The ultimate goal for your intake process should be to make it "shockingly amazing" and "surprisingly wonderful" for your clients.

CHAPTERS

00:00 Introducing Uriah Guilford: Nerd, Therapist, Innovator

06:38 How Intake Systems Make or Break a Practice

11:18 Virtual Assistants: The Secret to Scaling Your Practice

16:07 AI, Insurance, and the Future of Intake Systems

23:00 VA or In-House? Finding the Best Fit for Your Practice

24:52 From Structure to Flexibility: Managing Clinician Preferences

28:19 From Chaos to Clarity: Fixing a Broken Intake System

30:21 Claude, ChatGPT, and Intake Hacks

34:54 Accessibility, AI, and the Future of Therapy

37:35 Where to Get Help: ProductiveTherapist.com

38:37 Conclusion: One Guiding Principle

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

EPISODE SUMMARY

Welcome back to The Claim Game! In this episode, Jeremy and Kathryn Zug shift from the "Credentialing" territory of the RCM game board to a new, crucial area: Patient Registration. They explain that while credentialing is about getting your player piece on the board, patient registration is about getting other players—your patients—onto the board so you can actually start playing.

This episode offers a comprehensive overview of the patient registration territory, breaking it down into five key subcategories:

Intake: The process of collecting information. The hosts emphasize that this isn't just "stuffy paperwork" but a critical, dynamic process that sets the stage for a smooth revenue cycle and a great first impression. They share that a poor intake process is directly tied to a high volume of claim rejections and denials.

Provider Assignment & Scheduling: Matching patients to the right provider. This includes considering patient preferences like gender, language needs, and presenting problems to ensure a good match and prevent patient churn.

Checkout: The process isn't complete until the first checkout is done. The hosts explain why this is a critical moment for a practice's reputation and financial health, as it's the best opportunity to collect payments and schedule the next appointment.

HIPAA Compliance: Jeremy outlines the three main HIPAA rules—Privacy, Security, and Breach Notification—and warns that providers should always do more than the bare minimum to hedge against non-compliance, likening it to building a fence 10 feet away from the legal requirement.

Key Performance Indicators (KPIs): The hosts emphasize the importance of tracking KPIs for every territory, including patient registration. They suggest that metrics like provider utilization and patient retention can serve as an early warning system for problems in the patient registration process.

Finally, Jeremy shares a personal story about a triple-booking blunder from his early days, highlighting the importance of having a clear process and humility in place.

KEYWORDS

RCM, Revenue Cycle Management, Credentialing, Patient Registration, Intake, Provider Assignment, Scheduling, Checkout, HIPAA Compliance, KPIs, Claim Denials, Claim Rejections, First Impression, Patient Retention, Patient Care, Revenue

TAKEAWAYS

Patient Registration is Your First Impression: Patient registration is the forward-facing step that sets your practice's reputation. A smooth, clear process directly impacts patient retention and can prevent billing nightmares down the road.

A Clogged Pipeline Leads to Loss: Just like you don't want to wait in credentialing, you don't want to get hung up in patient registration. A well-defined, efficient process helps get patients into the practice and seeing providers as quickly as possible.

Details are a Lifesaver: Collecting correct and complete information at intake—including IDs and insurance cards—is not "stuffy" but a "lifesaver" that prevents a high volume of claim rejections and denials later on.

The First Checkout is a Must: Patient registration isn't complete until after the first checkout. This is your best chance to collect payment and schedule the next appointment, which is "way easier" than trying to do it over the phone later.

Hedge Against HIPAA Breaches: The penalties for HIPAA non-compliance are steep. Instead of doing the bare minimum, build in systems and procedures that keep you "10 feet away" from a potential breach.

CHAPTERS

00:00 Introduction to Credentialing and Its Importance

02:31 Understanding Credentialing KPIs

04:33 Insurance Revenue Target Analysis: Tracking KPIs to Optimize Your Payer Mix

10:59 Time to Contract: Measuring Lead Times for Smarter Credentialing

16:36 Application Completion Accuracy: Pinpointing Errors, Patterns, and Process Gaps

22:11 Credentialing Efficacy: Measuring Success Rates by Payer

25:42 Application Denial Reasons: Uncovering Why Submissions Fail

29:49 Getting Started with Your Credentialing KPI Dashboard

34:12 Case Study: How Credentialing KPIs Turned an Underperformer Into a Key Asset

37:51 Conclusion: Turning Data Into Practice Growth

RESOURCES

Today Sponsors: Blueprint

Learn More About The Claim Game: Visit practicesol.com/podcast

The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub.

Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.