The Edge of Healthcare: Avoiding Costly Mistakes: The Critical Role of Revenue Cycle Management

Martin Cody: Welcome to The Edge of Healthcare, where the pulse of innovation meets the heartbeat of leadership. I’m Martin Cody, your guide through riveting conversations with the trailblazers of healthcare. Tune in to gain exclusive access to strategies, experiences, and groundbreaking solutions from influential payer and health system leaders. This isn’t just a podcast, it’s your VIP ticket to the minds shaping the future of healthcare right now. Buckle up, subscribe, and get ready to ride to The Edge of Healthcare, where lessons from leaders are ready for you to use today.

Martin Cody: Hello, again, everybody, and welcome to another episode of The Edge of Healthcare: Lessons from Leaders to Use and Learn Today. I can hear the music in the background even though I can’t, but it’s in my head because it’s just part of my DNA. Now, after a year of podcasts covering tough topics, covering things that are important from a financial standpoint. And today is going to be no different because we are going to tackle what the subject matter expert in revenue cycle management and value-based care. The complex topic of RCM of rev cycle management. Everybody thinks they know a little bit about it, but after today’s episode, you’re going to know a lot more. So, I’d like you to say hello to our special guest, Sarah Cevallos, who is our subject matter expert on all things RCM and VBC. Sarah, welcome.

Sarah Cevallos: Thank you so much for having me.

Martin Cody: I’m excited to discuss revenue cycle management. And please, people, do not turn the channel just because it’s revenue cycle management. This is not a boring topic. I would like everyone to stay awake. This is financially probably one of the most impactful topics for any healthcare organization, be it hospital, be IT provider, group. And so Sarah, it is a complex 9 to 10-step process of revenue cycle management, but in a half hour or so, explain to people: what is RCM?

Sarah Cevallos: Yeah, great question. And I laugh because I sometimes wonder how the heck I got into this, because it’s so complicated and often puts people to sleep, but also keeps people fascinated by explaining what I do. Just a quick joke. When my husband and I met, he said to me, you really need to get a job that I can explain to my friends so I can appreciate that. Yeah. Just to give you a little sense of it. Yeah. So revenue cycle in as quick of a nutshell as I can make it. And then we can get into some more questions, and you can elaborate on what I missed because, you know, no revenue cycle as well. I bucket it in three categories pre-service all the stuff in the middle, and post-service. So, I think of it as starting with the payer negotiations. So, the health plans need contracts with the providers or the hospital systems, whoever is actually contracting. And then you have to go through the enrollment and the credentialing process, making sure that your providers are connected to all of your contracts and making sure that your locations are connected. And so that is a critical part in the service hasn’t even started. You haven’t even started seeing patients yet, and you’re already doing work. And then, the patient actually comes in the door and sees the provider. But even before that, you have to make sure that their benefits are reviewed. Does the patient have adequate coverage? What is their out-of-pocket responsibility? Are prior authorizations required for the services that you’re performing or referrals?

Martin Cody: Currently, my least favorite phrase in healthcare, prior authorization. But please.

Sarah Cevallos: But please continue. It is a thankless task, that is for sure. So prior authorizations, obviously a critical part of making sure that you’re going to get paid for the services that your clinicians have provided, and then after that is making sure all your charges are entered. So, have you coded the procedures accordingly? And with the right modifiers, the right diagnosis codes, all of the background that goes in it. So that’s all before the patient even really comes in, right? And then once you have that claim and your billing system, now that’s all the stuff in the middle. That’s the stuff that you are submitting to the payer. You are making sure the payer has gotten it through the clearinghouse, because the clearinghouse is another checkpoint for you. And then making sure that all of that stuff has been adjudicated back. Sometimes, payers don’t even respond, and you don’t even know until your team follows up with it. And so all that stuff on that last leg is if they did respond, was it denied, or was it paid? Did you have to follow up with the insurance company? That’s another huge part of it. Our follow-up. And then obviously sometimes they don’t pay correctly. I know, believe it or not, sometimes insurance shocking.

Martin Cody: I find that very difficult to believe.

Sarah Cevallos: I always call them little gremlins in the health insurance is like somebody just messed up that fee schedule, didn’t they? Sometimes it’s overpayments, sometimes it’s underpayments. And so that’s a whole other procedure that has to happen. And obviously reconciling with your accounting and finance team is a whole other element of it. So often, people get finance and accounting mixed up with revenue cycle management. While they sound and feel very familiar, they’re actually very different processes.

Martin Cody: So I like the categorization into three buckets. And I’ve always seen the circle of revenue cycle tasks, if you will, from start to finish. That has probably those nine or more steps now. And I wrote down some of the steps that I remember pre-registration, registration, which it seems like you’ve preregistered, then you register, which is interesting. Why that extra step is there? Charge capture, utilization review, we haven’t talked about that yet. Coding, claim submission, remittance process, insurance follow-up, and then patient collections. Now, that’s just a basic rev cycle. Let’s call it a journey. And 15 years or so ago, there was very little automation per se in the tracking, in the management, in the completion of forms, and stuff like that, like there is today. There was claim submission and adjudication. The coding really took some leaps forward with electronic medical records and ICD-9, and now ICD-10 and Pix codes and ENM scores and those sorts of things. It’s a lot to do. And I’m curious, is there a threshold of a physician organization based upon the number of physicians that they try to do this in-house? Almost always when they start out. So if they do this with five docs or 10 or 15 docs, it can be done okay and managed potentially. Okay. You could be solvent, but is there a threshold based on your experience where if you get over X number of providers, you need to either outsource this or have another firm come in and help you do it?

Sarah Cevallos: Yeah, that’s a really great question. I’ve worked with firms all shapes and sizes, so some of them could be 1 to 2 doctors with one specialty. Some are multi-specialty, so one, it really depends on what services they’re providing. It could be very complicated services like oncology, which is a specialty. I’ve worked in a ton as well as neurology, but some can be more basic, right, primary care, telehealth, things like that, where you’re just having ENM services that are billed, which are just physician-level services. So sometimes, those can actually be scaled a little slower in terms of outsourcing. You can handle it a little bit more in-house because you have more simplification of codes that you’re actually billing. So, really, like I said, depends on how complex the services are being provided. I would say that if you have a specialty that is has really high risk as far as like what you’re billing like high dollar drugs as an example or high dollar procedures, really making sure that you have a specialized person who understands what it’s like to request prior authorizations as an example, because that makes or breaks your practice, whether or not that is what is.

Martin Cody: A specialized person. What is it? And let’s stick with oncology, because I think that checks all the boxes for highly specialized, very expensive drugs. So this specialized person is what a VP of.

Sarah Cevallos: It’s somebody who understands medical terminology. Somebody who understands and really wants to be a detective. Payer policies and things that are required from the health insurance company to unlock that payment. Very complicated and sometimes hidden. So I call, I always call revenue cycle people detectives because the information isn’t available very easily on purpose, which is why I’m driving home to specialized. So it’s just not okay to have your nurse do it as an example. Nurses understand medical terminology. They understand patient care. They understand that stuff. But this is very paperwork-heavy. So that individual, sometimes they ask, do you have to have a certified coder? Not all the time. I don’t believe so. I think if you’re having coders code your charges, absolutely. Or have someone check those, but not somebody for like a prior authorization or benefits investigate or even a biller. But I do believe that you really need somebody who is experienced with medical terminology because of the fact that you have to go through those records and really translate the services into what the health insurance company may or may not cover.

Martin Cody: It just seems like it’s a never-ending cat-and-mouse game of we know you think you’re entitled to this payment, but we’re going to make it really, really difficult for you to actually get reimbursed for a procedure that you already did two months ago.

Sarah Cevallos: Yeah, it’s really interesting, right? It’s one of the only industries where you have to justify what you did. If you think about a plumber coming over to your house to fix your sink, you don’t say, well, can you show me the steps that you took and code those into the invoice so that I can see exactly what I’m paying you for? No, you’re like. He fixed the sink. Here’s your money. Sometimes, you pay in advance, right? So, it’s a super interesting and complicated process to have to go through. And really something that why revenue cycle exists, why people like myself are in business.

Martin Cody: You listed out, and we kind of highlighted, you know, nine or more steps. And each one of those steps when wrong or when done incorrectly, everything unfolds. Yep. So, who is managing the process? And let’s say it’s a 100-organization provider organization. And they have this outsourced. And there’s any number of people because they’re submitting claims. And the claims have to be filed in a timely manner by definition, from a timely filing perspective. And every one of these things that can go wrong adds time to the process.

Sarah Cevallos: Yep. Yeah.

Martin Cody: So, in bucket number one and with the pre-registration, registration, and stuff like that, what are some of the errors that occur in that scenario? And then, what are some of the downstream negative manifestations of those errors?

Sarah Cevallos: Yeah. So, you talked a little bit about pre-registration and registration. That is a huge part of the revenue cycle process that is really vital to make sure you get it right. One of the biggest errors I find is that the person who’s asking the patient, you come into the doctor’s office, have you had any updates to your insurance? That’s not the question to ask. The question to ask is, is your insurance still Blue Cross / Blue Shield? Because the patient may say yes, but you don’t have the information on the other end. You don’t know what the patient already had, right? So it’s really about how to frame the question to the patient. And each time a patient comes in, you ask that question. I’ve seen a lot of practices make the mistake of, oh, I’ll verify that insurance, or I’ll ask that patient if they had any updates annually. People switch jobs. People have life changes, life events, marriage, divorce. All of that happens, where you can switch your insurance at any time. So I always tell any practice or anywhere I work, make sure you’re asking that patient every time. It feels very it’s very annoying. But it is financial protection for your group. The other thing is that real-time eligibility checks are critical. You can check on ability on the provider or the payer portal each time the patient comes in. Is their coverage still active? There are events where someone goes on Cobra, and let’s just say they don’t pay their premium that month. For whatever reason, you have a 30-day window to pay the premium. So, at any point during that 30 days, the patient could say they’re eligible, or the portal can say it, but actually, in retrospect, their insurance gets terminated. So it’s very risky and very critical for that registration process to get checked and downstream. You may not get paid because perhaps you didn’t get that patient’s card in order to file the right claim to the right carrier, you miss timely filing, or you miss a prior authorization because you didn’t know that you needed one, because it’s a completely different insurance carrier that the patient had.

Martin Cody: So, two things explain pre-registration to registration.

Sarah Cevallos: So pre-registration, they’re used pretty interchangeably. But pre-registration is the basic kind of like I have Blue Cross my first and last name. Maybe my date of birth, right? Do you have that basic fundamental information of the patient? Registration is when you’re coming in and you’re scanning the card, you’re getting more details on the patient. Those two things should all really be done at the same time again for the better patient experience. So you don’t have to register or pre-register before your appointment, you can come in, and the doctor already has all of your information. That should be the best practice. Unfortunately, that doesn’t always happen just because of the way that the workflow may have unfolded.

Martin Cody: I think that this person at a physician’s office could be the single most point person and customer-facing person involved, other than perhaps the provider, because you mentioned that, yes, it’s frustrating that we have to answer these exact same questions every single time we go to the doctor. Oftentimes, we answer even more questions. You know, if I had an appendicitis in 2006, you don’t have to ask me again about my medical surgical history. I still had the appendicitis. So that sort of stuff is extremely infuriating for the patient. But you hit upon a very good, articulate point with regards to how you phrase this question can either frustrate the patient or endear the patient to the practice. And I think that is immensely overlooked at medical practices today. And I’m curious, how do you resolve that? How do you actually empower that person to ask really intelligent questions so the patient feels as if they’re valued?

Sarah Cevallos: Yeah, that’s a really great question. Really invest in customer service. Educate that front desk or that financial individual at the practice. Why it’s important to ask the question the right way and to know why they’re asking the question. That was the biggest takeaway that I had when I was talking or training. Anybody at the front desk is like, I’ll ask this question, but why am I asking the question? And once you explain to that individual why, then it’s like a light bulb, right? Then they’re there supporting you as the person who’s trying to get the bills paid. As to why, you know, I explained to them all the time, it’s like you guys are the door that opens up our bank account. You allow the service to happen. So I need you to be able to be equipped with the tools to be able to make it and make it unlock, right? And it’s the same thing. Why I asked the clinicians, hey, please tell me if you add a service at any point in this time. Because if you add the service and you don’t tell somebody within the revenue cycle, or the front desk, or anybody in the office, we may miss an opportunity to get paid on that as well. So it’s really around education, enabling them with the why and being able to really just bring them part of the journey with you.

Martin Cody: Yeah. And it just, it really goes to the point of hiring high-quality caliber of individuals to basically. And if you look at businesses, whether it’s restaurants or higher-end hotels, I’ll use that as an example. They’re the face of the company. They want that first interaction to be pristine. They want it to be memorable. They will look up from their computer and make eye contact with you. A lot of the old-fashioned skills with regards to people skills are invested in that person at the front desk because they can make or break the practice, and especially when it comes to the rev cycle side. You mentioned something about real-time eligibility. Does every carrier have that capability?

Sarah Cevallos: Not every carrier. Some of the smaller ones do not. But we’re talking about 90% of them do. So it’s the small ones that maybe don’t maybe hold retirement plans or something that just haven’t invested in them. But the majority of health plans absolutely do.

Martin Cody: Perfect. And then from a charge capture standpoint, that is obviously not the front desk person. That’s another whole different unit that’s doing that, correct?

Sarah Cevallos: Correct. Yep.

Martin Cody: And they’re making certain that whatever the provider documented is accurate and that they have the appropriate charges on the sheet.

Sarah Cevallos: Yep, absolutely. So in some practices, most practices, let me say, and there’s an electronic medical record that has an HL7 interface that goes into their billing system, or it’s a combined system where the billing and the EMR are together, but there are still some practices out there that have somebody who is looking at the medical record, and there’s a paper charge sheet that goes to the it’s a paper super bill that goes into the charge. The person who’s doing the charge capture and is looking at what has been checked off, right? And then actually hand keying it into the system at that time. So that actually does happen in 2025 today.

Martin Cody: Where I would run from that practice if I was a patient. I mean, that’s a, I think that’s cute adorable. But are you kidding me? Someone’s going to. And I remember looking at those super bills and what was it, the 1500 form or.

Sarah Cevallos: No, yeah. So.

Martin Cody: This is coming back to me, and it’s all still painful.

Sarah Cevallos: So, the CMS 1500 form is actually called the super bill. But there is these charge entry sheets that emulate. Oh, that’s right bill so that it’s more easily accessible for the clinical team to just check what was what happened. So yes.

Martin Cody: So you’re right. Fully integrated EMR practice management systems. All that’s kind of built into the back end. And it’s got exponentially more difficult with the advancement from ICD-9 to ICD-10 and the explosion of codes that gets then completed and then submitted to the insurance company.

Sarah Cevallos: That is correct. Yep. Within these systems, there should be some type of edit software that’s looking and checking for any errors within the claim before it goes to the clearinghouse. So it is really, really critical for anyone who’s investing in a technology like a billing system to know, is there some type of platform built in that you can build rules in? Because those CMS 1500 forms, as you mentioned, and have PTSD from, as do we all have very specific boxes that need all the check marks. And I always say like a pretty little bow. It has to go out perfectly to the payer, so that there’s no excuses as to why they can’t paint. They’re going to find their excuses, but it has to be perfect. So examples being if there’s a data entry error where you have a pound sign in the member ID that will reject, right, because it doesn’t know that system doesn’t read it that way. Or if there’s a modifier on there that’s out of order, something in the system will definitely trigger it. So because sometimes we have fat fingers, we make mistakes. Those systems and those checks and balances should also always be in place within the software, even before it gets to the payer. So once it’s submitted through the payer, the clearinghouse also has another set of edits that will check it too. And those are more just like general ones, more like CCI, very high-level edits. Then, once it gets to the payer, that’s when you hope, okay, one, that they got it, and two, that they process it in a timely manner.

Martin Cody: And I’m thinking now from the patient lens. Because there’s a huge challenge with inaccurate provider information that is either on the doctor’s website or the hospital website. And the level of inaccuracy is causing significant access to care because a lot of mental health patients, the providers listed, and they aren’t accepting new patients, even though the website says they are accepting new patients. So from the patient lens, what can the patient do to verify that this information that they’re viewing is accurate so that if they do make an appointment, they aren’t going to get a surprise bill? It’s not going to be an out-of-network bill. Is there anything they can do to safeguard their time, energy, and effort in seeking medical care?

Sarah Cevallos: Yeah. The person who has likely the most accurate information is the actual provider. So calling the provider’s office and saying, I have this insurance company, are you in network? Is this doctor in network? They know their contracts the best. Likely, sometimes, when you call the health plan. They may or may not, like have the accurate information, right? Because you’re referencing somebody going to the payer website. It says this doctor’s in-network and accepting new patients and they’re not. So, my recommendation would be for the patient to call the provider office and double-check that. That’s my best practice for myself, personally. I’ve had doctor’s offices tell me that they won’t do that. Which talk about customer service is fascinating to me. I typically pick another doctor, but that’s me.

Martin Cody: No, I don’t think you’re alone there, and the data is growing. With regards to the amount of core experiences a patient has at a physician’s office or hospital is now a digital experience, by the way. As they have a poor experience on the hospital website or the provider organization’s website, they do find other providers. That wasn’t the case ten years ago. And I think it’s interesting how people are starting to vote for care access and care provider with their feet based upon their experience with the office, with the website. I think it’s fascinating. And you hit upon a point that you just referenced with regards to inconsistencies and mistakes. We see it all the time at Medicaid, unfortunately, and the great magazines out there, Becker’s Modern Healthcare and some of those, they’re now starting to highlight a lot of the major health systems that are having significant directory accuracy issues. And insurers from that standpoint, because you think of these big giant insurers, whether it’s Aetna, Humana, United, and stuff like that, their data is sometimes below 50% accurate, and CMS is starting to take away their Medicare stars, and that sort of stuff. That’s all preventing care access by the patient. And it’s amazing to me, to your point much earlier about this is 2025. A lot of these problems are solvable. So why, in your expertise on value-based care and rev cycle, don’t you think organizations are solving these?

Sarah Cevallos: Providers or health plans or both?

Martin Cody: Let’s go with provider organizations first.

Sarah Cevallos: Why aren’t they solving the accuracy?

Martin Cody: Accuracy problems?

Sarah Cevallos: I think it’s a matter of investment, and I think it could be also just a matter of being naive and not being a priority. These providers have so much to do. There’s just so much happening in their office. They have panels of patients that are just astronomical. There’s supply and demand issues, right? There’s just so much for them to just run their practices on a day-to-day basis. There’s just so much work to do. And so they just might not even know, right, that there is a problem until somebody is like, it’s the squeaky wheel gets the grease until it becomes a major problem. So I think a lot of them don’t because of that, just because maybe they just don’t know. And there’s other priorities. And the other is it’s an investment. Like you have to have people who are like making this stuff a priority. And I think once it gets thinner where people are moving locations, it’s more consumer forward, less health plan driven where the patient goes, then I think that’s when the providers are the academic centers or whoever. The hospital systems will say, okay, this has to change.

Martin Cody: And I think, and I’m going to touch upon another area of your expertise now, because from a rev cycle standpoint, I look at the transition from fee-for-service to value-based care.

Sarah Cevallos: Yep.

Martin Cody: And value-based care. Long overdue. I think it’s fantastic that we’re actually going to be paying physicians on the quality of care they provide, versus the volume of care they provide. I’m curious how the revenue cycle side of things impacts value-based care contracting, and an organization taking on more risk, because in my layperson’s eyes, you really have to have your RCM buttoned up and tip-top impeccable shape to then be able to negotiate more risk-based contracts so that you aren’t having things fall through the cracks. Accurate statement or not?

Sarah Cevallos: 100% accurate. Your RCM team needs to be at the top of their game in order to execute value-based care. And unfortunately, most of our systems just aren’t ready for that because it will be a completely different way of billing. And the dirty little secret here is that one value-based care contract or negotiation is one contract negotiation and fee structure. So fee-for-service, you submit a CPT code, you get paid for the service value-based care. It is a very specific group of patients that are attributed based on some definition that is different between contracts. So you have to think about it like one type of commercial patient is treated not clinically different, but from a financial perspective, they are billed different. Whereas right now, it’s uniform across all patients regardless of their insurance, right? Most of the time there’s always a little asterisk and everything you talk about revenue cycle. Exactly. But value-based contracting is even more complicated. And so it’s really going to take not just a clinical and operational infrastructure change, but a huge revenue cycle, infrastructure change as well, to be able to know how those contracts operate and how the billing procedures are going to be.

Martin Cody: No. And I think that’s a fascinating shift in healthcare, because as you have the growth of ACOs that are managing value-based care contracts and member attribution to those contracts or those pools of members, if you will, if they aren’t able to accurately identify members and primary care physician relationships, then the whole value chain and the whole cycle chain is disrupted.

Sarah Cevallos: Yeah, absolutely. And it’s critical for it’s not just, you have an orchestration of individuals within a clinic in the four walls of a clinic. Now you’re looking outside your four walls, and you’re thinking, what is the primary care specialist doing? Where are they referring the patient to? What lab or what radiology facility, or what emergency room or urgent care center does the patient know to go to? It’s very, very consumer-focused because education is critical for the patients. They have to be part of the story, otherwise it won’t work.

Martin Cody: Yeah, it’s tough to get them to be part of the story because it is such a daunting, overwhelming process and especially with the silver tsunami that’s happening and people aging out. And not everyone grew up with a smartphone to their hip that is currently seeking care. So, they don’t download the insurance company apps to find a provider. So it’s a real challenge to get them educated on this, and certainly from a practice standpoint and outreach to patient, which is why my guess would be you’re seeing a burgeoning growth of that industry of patient-centric care and patient-centered medical homes and those sorts of things to tie in the technology to keep track of the patient.

Sarah Cevallos: Yeah. And typically what I’ve seen and the areas that I’ve stood up is really just the education to the patient is no matter what your issue is, you call this one location first and they will triage. And that’s, I would say, one of the best practices you have in your toolbox. If you’re trying to implement value-based care within your community or within your practice, is pick who’s the quarterback. You got to pick it, and all those other supplemental groups and referral channels, and everything else will come along, but the patient just needs one point of contact in this type of environment. But that point of contact needs to answer the phone. They have to be held accountable. They have to get their patients access and not stop and make sure that this patient is there’s no disruption, there’s no speed bumps, and that’s risky, but I think it’s doable. And I also think that I’m super optimistic that consumers are really tired of healthcare being like it is exhausted. They’re really tired of it. I mean, look at all these B2C companies and digital health coming to, they’re just going to pay out of pocket. They’re going to get better customer service. They’re going to get faster care, and they’re tired of it. So if we don’t do a good job as stewards of insurance-accepted providers, then they’re going to work around us. And that’s why we have to really make these changes.

Martin Cody: Yeah, and I think it’s interesting too, if the business leaders would put themselves in the shoes of the patient. And by the way, if you replicate your own behavior when we call a company for customer support or anything like that, and you’re greeted with a chatbot or a voice message that says, for faster service, please go to our website. And more often than not, you’re calling the number because the website didn’t help you, right? And so, and I don’t want to, you know, have an ageism lawsuit against the podcast. But if you’re looking at someone who’s 75 age or older that may not have navigated the internet, they just want to your point. I want to call one number and I want to get a frickin answer. And if they hear one more time, just go to the portal. They’re going to go ballistic, and with good reason. So, I love the idea of just having one phone number as it gets monitored by a live person. We call those humans, and that way it’s this person can triage and troubleshoot and solve the problem and take care of the patient, which is yeah, the customer. Yeah. Perfect. All right. We’re going to switch gears and we’re going to go to the speed round.

Sarah Cevallos: All right. You ready. I’m ready.

Martin Cody: Okay. This is the old word association game. I’m going to say a phrase or a word. You tell me the first thing that pops into your mind. Unfiltered.

Sarah Cevallos: Oh, boy. Okay, so since we already discussed.

Martin Cody: One, because I love getting people’s perspective. Prior authorization.

Sarah Cevallos: Ouch.

Martin Cody: Oh, ouch. I said unfiltered, that sounded like it was cleaned up a little bit. That could have been profane, but ouch, ouch, ouch is the winner.

Sarah Cevallos: All right. It’s just, it’s a thankless job. And no matter what, someone gets hurt.

Martin Cody: That’s a good point. Fax machines.

Sarah Cevallos: Can I create a visual for this one?

Martin Cody: Please. Like a sledgehammer?

Sarah Cevallos: No, no, the visual is just someone in an office just staring at it. So I have, we had to have fax machines because of some of these insurance companies. And I just every time I walk past it, I always had one of my team members just staring at the fax machine, not knowing what to do. So I’m like, just waiting, you know? And I’m just like, this is what we’re paying people to do is just stare at fax machines. So then…

Martin Cody: It happens a lot. This one might be tougher, but I’ll give you a visual now. You’re walking into a physician’s office, and they hand you a clipboard of paper forms to fill out. That’s the visual.

Sarah Cevallos: I don’t know. Job opportunity. That’s what I think of. I can help you.

Martin Cody: Yes. I think that if they’re doing that in 2025, they don’t care about the patient experience.

Sarah Cevallos: Yeah. I like that too. I just yeah, that’s all I got is I can help you, right?

Martin Cody: Last question. Living or breathing? If there is one person that you would like to sit down in healthcare and have a long extended chat and pick their brain and really get into a discussion with them. Who is it and what are you drinking?

Sarah Cevallos: Oh, I think if I’m having a long extended chat with anyone that I want to like, absorb, and keep the information, it’s going to be like a coffee or a hot tea. Because as much as I love an old-fashioned, I want to be very present for the situation in healthcare. Dr. Vivian Leigh is probably one of my favourite authors. She has this book called The Long Fix, and it talks about value-based care and the transition in healthcare and what it just needs to be. She’s, I believe, a fellow at Harvard. What I love about the book is that it doesn’t just represent the problem and explain it in a very thoughtful way. It also has very concrete, just easy to read steps of what you can do to implement value-based care. And I think it’s just one of these books that anyone can pick up and understand what she’s talking about. And I love books like that. And I think that that is just a profound message that if we can get someone to be able to explain it in layman’s terms and have actual action steps to implement it, then obviously there is a way to get it out there and be able to really, really execute it into the world.

Martin Cody: I love it, I appreciate that. I was unaware of Dr. Leigh, so thank you for educating my knowledge base, which I love, which is why I like talking to very smart people. If someone wants to get ahold of you based upon the subject matter expertise not only described today, but all the other areas that you can cover from value-based care and rev cycle. How do they get Ahold of Sarah?

Sarah Cevallos: LinkedIn. Just look, Sarah Cevallos, I think there’s maybe one other who’s a realtor. I’m not a realtor. I don’t sell houses or my email, just my first and last name at gmail.com.

Martin Cody: Perfect. Sarah, thank you so much. I can tell this process hasn’t changed. Some of the tools have changed over the years and the technology has changed. Made it a little bit faster, but it’s still it’s the same old thing. If you miss one step, it could cost you tens, if not hundreds of thousands of dollars, not to mention the amount of time it is from a delayed standpoint. Then the corrective action also takes more time and expense. So you have to get the rev cycle side of things correct to have a successful practice. So, thank you so much for illuminating that and sharing the ways on how to do that. And thank you so much, everybody, for tuning in to The Edge of Healthcare lessons from leaders to use today. We’ll see you on the next episode. Take care everyone.

Martin Cody: Thanks for diving into The Edge of Healthcare with us today. I hope these insights will fuel your journey in healthcare leadership. For more details, show notes, and ways to stay plugged in to the conversation, head over to MadaketHealth.com. Until next time, stay ahead of the curve with The Edge of Healthcare, where lessons from leaders are always within reach. Take care of yourselves and keep pushing the boundaries of healthcare innovation.