Episode 15 - How to sharpen your inpatient auditing program with better chart selection

From the Trenches: A Healthcare Analytics Podcast

#Tech #Health Plans #Cotiviti

1:15:36

In this episode, we welcome back David French, columnist for The New York Times , former constitutional attorney, and author of Divided We Fall . We discuss the current state of American democracy, the challenges of political division, and how we can engage in civil discourse despite deep ideological differences. David also shares a personal update on his family and reflects on the profound trials and growth that come with adversity. 📌 What We Discuss: ✔️ How David and his family navigated the challenges of a serious health crisis. ✔️ The rise of political polarization and the factors driving it. ✔️ Why distinguishing between “unwise, unethical, and unlawful” is crucial in analyzing political actions. ✔️ How consuming different perspectives (even opposing ones) helps in understanding political dynamics. ✔️ The role of Christian values in politics and how they are being redefined. ⏳ Episode Highlights 📍 [00:01:00] – David French’s background and his journey from litigation to journalism. 📍 [00:02:30] – Personal update: David shares his wife Nancy’s battle with cancer and their journey as a family. 📍 [00:06:00] – How to navigate personal trials while maintaining faith and resilience. 📍 [00:10:00] – The danger of political paranoia and the pitfalls of extreme polarization. 📍 [00:18:00] – The "friend-enemy" paradigm in American politics and its influence in Christian fundamentalism. 📍 [00:24:00] – Revisiting Divided We Fall : How America’s divisions have devolved since 2020. 📍 [00:40:00] – The categories and differences of unwise, unethical, and unlawful political actions. 📍 [00:55:00] – The balance between justice, kindness, and humility in political engagement. 📍 [01:00:00] – The After Party initiative: A Christian approach to politics focused on values rather than policy. 💬 Featured Quotes 🔹 "You don't know who you truly are until your values are tested." – David French 🔹 "If we focus on the relational, we can have better conversations even across deep differences." – Corey Nathan 🔹 "Justice, kindness, and humility—if you're missing one, you're doing it wrong." – David French 🔹 "The United States has a history of shifting without repenting. We just move on." – David French 📚 Resources Mentioned David French’s Writing: New York Times David’s Book: Divided We Fall The After Party Initiative – More Info Advisory Opinions Podcast (with Sarah Isgur & David French) – Listen Here 📣 Call to Action If you found this conversation insightful, please: ✅ Subscribe to Talkin' Politics & Religion Without Killin' Each Other on your favorite podcast platform. ✅ Leave a review on Apple Podcasts, Spotify, or wherever you listen: ratethispodcast.com/goodfaithpolitics ✅ Support the show on Patreon: patreon.com/politicsandreligion ✅ Watch the full conversation and subscribe on YouTube: youtube.com/@politicsandreligion 🔗 Connect With Us on Social Media @coreysnathan: Bluesky LinkedIn Instagram Threads Facebook Substack David French: 🔗 Twitter | BlueSky | New York Times Our Sponsors Meza Wealth Management: www.mezawealth.com Prolux Autogroup: www.proluxautogroup.com or www.granadahillsairporttransportation.com Let’s keep talking politics and religion—with gentleness and respect. 🎙️💡…

hace 6 años 7:42

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Although the cost of inpatient hospital stays continues to rise, health plans are finding that their inpatient claim auditing programs are returning less value. They’re also facing challenges such as provider abrasion resulting from requesting too many medical charts to validate those claims, which makes it more difficult to successfully retrieve medical records. We talk with Cotiviti product director Jena Reilly about how health plans be more selective and focus on pursuing medical records that will actually return value back to the plan.

18 episodios

Episode 15 - How to sharpen your inpatient auditing program with better chart selection

From the Trenches: A Healthcare Analytics Podcast

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published hace 6 años

MP3•Episodio en casa

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18 episodios

#Tech #Health Plans #Cotiviti

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Episode 18 - The insider's guide to clinical appropriateness 18:37

hace 6 years18:37

18:37

When a health plan is deciding whether to pay a claim, there’s no shortage of information to consider and reviews that must be performed, including medical coding and documentation. And perhaps the most challenging question to answer is this: is the information on the claim clinically appropriate? On episode 18 of “From the Trenches” podcast, we speak with Marla Wilson, Cotiviti vice president of clinical and coding operations, and Ken Sabulsky, vice president of audit operations. Listen as they dive into how Cotiviti reviews member claim history and medical charts to ensure clinical appropriateness.…

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Episode 17 - How to step up claim overpayment recovery results 11:09

hace 6 years11:09

11:09

Payment accuracy programs are critical to delivering value to health plan members. Some plans excel at recovery management while others struggle—and the difference in financial results is significant. But regardless of size, any health plan can improve its recovery results by pulling a few key levers. Cotiviti's Chris Mastro, vice president of operations, once again joins Jeremy Bamford, senior product director for payment accuracy, to look at what drives success in recovering claim overpayments.…

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Episode 16 - The keys to successful claim overpayment recovery 7:38

hace 6 years7:38