The Claim Game

The Claim Game podcast, hosted by Jeremy and Kathryn Zug, is designed to help healthcare providers navigate the complexities of revenue cycle management (RCM). Each episode aims to cut through confusion by breaking down complex billing processes and sharing real-world solutions. The podcast uses a "game board" metaphor to simplify the RCM landscape, offering strategies and practical tips to help practices "win" at revenue cycle management. Jeremy and Kathryn draw on their extensive experience to empower providers to take control of their revenue, turning claim denials into deposits and allowing them to focus more on patient care. The podcast covers key territories of billing, such as credentialing, patient registration, eligibility & benefits, payment posting, aging follow-up, and claim submission, with the ultimate goal of providing clarity in a confusing, frustrating, and outdated industry. <a href="https://jeremyzug.substack.com?utm_medium=podcast" rel="noopener noreferr

The Claim Game is a business podcast hosted by Jeremy and Kathryn Zug, with 59 episodes on record and a Required Pod Score of 80. PitchCentric scores this show on Booking Probability, Listen Score, and live audience signals refreshed every 24 hours.

Jeremy and Kathryn Zug hosts The Claim Game, a business show with 59 episodes published.

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  Episode #58

  Anne Neal on How Availity Is Reducing Claim Denials and Administrative Waste

  Aug 13, 202643 minS1

  EPISODE SUMMARY In this episode of The Claim Game , Jeremy Zug sits down with Anne Neal, Vice President of Product Management & Payment Integrity at Availity , to discuss the future of revenue cycle management. Together, they explore Availity's Abrasion Index, payment integrity, AI, prior authorization, and preventing claim errors before submission.. They also discuss fraud prevention, responsible AI, and the future of touchless claims processing. KEYWORDS Availity, Revenue Cycle Management, Payment Integrity, Claims Management, Claim Denials, Prior Authorization, Healthcare AI, Payment Accuracy, Abrasion Index TAKEAWAYS Prevention Beats Correction: Preventing claim errors before submission reduces denials, appeals, administrative work and payment accuracy. Shared Challenges: Providers and payers face many of the same pain points, creating opportunities to collaborate. Payment Integrity Starts Early: Helping providers submit clean claims before submission improves reimbursement. Responsible AI: AI can streamline claims management and prior authorization when combined with transparency, governance, and human oversight. Touchless Claims: Automation, AI, and better data sharing are moving healthcare toward faster, more accurate reimbursement. CHAPTERS 00:00 Introduction to Availity and Anne Neal's Journey 04:50 Availity's $4.5T Network Healthcare Network 09:37 Preventing Claim Errors 15:56 Prevention Over Clawbacks 22:40 What the Abrasion Index Reveals 26:40 What Is Payment Integrity? 29:50 Responsible AI in Healthcare 34:55 The Future of Touchless Claims 38:49 Innovation at the Speed of AI 40:43 Building a Better System Together RESOURCES Today Sponsors: Visit practicesol.com Visit availity.com Availity’s Payment Integrity , Availity Extend , and Abrasion Index Anne Neal on LinkedIn The Claim Game Podcast The Hourglass Learning Hub . Practice Solutions Blog . Book : Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance .

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  Episode #57

  Hemant Gupta on AI, Insurance, and the Future of Healthcare

  Aug 6, 202645 minS1

  EPISODE SUMMARY In this episode of The Claim Game , Jeremy Zug sits down with Hemant Gupta , physician advisor and former Chief Medical Officer at UnitedHealthcare, to explore the intersection of clinical care, insurance, and healthcare innovation. Together, they discuss why claim denials happen, how better documentation supports medical necessity, the structural challenges of value-based care, and how AI can reduce administrative burden while improving patient outcomes. Whether you're a provider, practice owner, or healthcare leader, this episode offers practical insights into building a more transparent, efficient healthcare system. KEYWORDS Revenue Cycle Management, Medical Necessity, Claim Denials, Physician Advisor, AI in Healthcare, Clinical Documentation, Prior Authorization, Value-Based Care, Healthcare Transparency, Utilization Management, Healthcare Innovation, Insurance Billing TAKEAWAYS Bridge the Provider-Payer Gap: Strong documentation helps demonstrate medical necessity and supports appropriate reimbursement. Claim Denials Aren't One-Size-Fits-All: Different denial types require different prevention and resolution strategies. Better Documentation Matters: Clear, complete records reduce audits, strengthen claims, and support better patient care. Value-Based Care Needs Alignment: Lasting change depends on aligning providers, payers, data, and incentives. AI Should Reduce Friction: Used responsibly, AI can streamline documentation, speed approvals, and improve healthcare efficiency. CHAPTERS 00:00 Introduction to Hemant Gupta's Journey 08:47 Closing the Gap Between Physicians and Payers 16:07 The Biggest Misconceptions About Insurance Denials 21:23 The Structural Barriers to Value-Based Care 35:45 Can AI Reduce Healthcare Friction? 42:53 Connect with Hemant Gupta RESOURCES Today Sponsors: Visit practicesol.com Connect with Hemant on LinkedIn 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 .

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  Episode #56

  Daniel Fava: The New SEO Strategy for Private Practice Websites

  Jul 30, 202648 minS1

  EPISODE SUMMARY In this episode of The Claim Game , Jeremy Zug sits down with Daniel Fava, founder of Private Practice Elevation, to discuss how your website can become an extension of your administrative team. Daniel shares how building his wife's therapy practice website led to an agency specializing in web design, SEO, copywriting, and digital strategy for private practices. Together, they explore how AI is changing SEO, why Google holds healthcare websites to a higher standard, and practical ways to improve your website. From creating helpful FAQ pages and clearly explaining insurance participation to building topic-focused content that attracts the right clients, this episode is packed with actionable advice for building trust, reducing confusion, and converting more website visitors into clients. KEYWORDS Private Practice SEO, Website Redesign, Revenue Cycle Management, Therapist Marketing, Insurance Clarity, AI Search Optimization TAKEAWAYS Directories Get You Found; Your Website Gets You Chosen: Directories help prospective clients discover your practice, but your website is what builds trust and turns visitors into clients. Google Expects Expertise: Therapy websites fall under Google's YMYL (Your Money or Your Life) category, making trustworthy, high-quality content essential for SEO. Focus on Topic Depth: Create content that answers specific client questions instead of relying on keyword repetition. Reduce Intake Questions: FAQ pages, insurance information, and billing expectations eliminate confusion before a client reaches out. Clarity Improves Lead Quality: Listing pricing, insurance networks, and coverage details upfront attracts better-qualified leads. Invest in Strategic Copywriting: Strong messaging paired with SEO helps visitors feel understood and encourages them to schedule. CHAPTERS 00:00 Meet Daniel Fava: From WordPress to Private Practice Websites 05:41 Is SEO Dead? How AI Is Changing Therapist Websites 12:01 Why Clear Website Messaging Wins More Clients 19:31 Why Therapist Bios Matter More Than You Think 23:45 The SEO Strategy Every Therapy Practice Needs 27:13 Directories Get You Found. Your Website Gets You Chosen. 30:37 How Therapist Websites Build Trust Before the First Session 35:31 How to Structure a Therapy Website That Converts 44:46 Final Advice for Building a Better Therapy Website RESOURCES Today Sponsors: Visit practicesol.com Learn More About Private Practice Elevation: Visit privatepracticeelevation.com Check out the Private Practice Elevation Podcast The Claim Game Podcast The Hourglass Learning Hub : Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates. Practice Solutions Blog .

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  Episode #55

  The AI Social Worker: Marina Badillo-Diaz on AI, Ethics & Mental Health

  Jul 23, 202650 minS1

  EPISODE SUMMARY In this episode of The Claim Game , Jeremy Zug sits down with Dr. Marina Badillo-Diaz, LCSW, founder of The AI Social Worker, to explore how artificial intelligence is transforming mental health and human services. Dr. Badillo-Diaz shares practical guidance on using AI ethically, protecting client privacy, and maintaining clinical judgment while embracing new technology. Together, they discuss AI documentation tools, HIPAA compliance, AI companions, and how therapists can confidently integrate AI into their practice without losing the human connection. TAKEAWAYS AI Should Support, Not Replace, Clinicians: Dr. Badillo-Diaz's "Co-Star" framework emphasizes that providers must review, edit, and guide AI outputs to preserve clinical judgment. Always Verify AI Documentation: AI scribes can save significant time, but every note should be carefully reviewed before becoming part of the client's record. Know the Risks of AI Companions: AI can improve administrative workflows, but relying on AI for emotional support raises important ethical concerns, especially for younger users. Use AI Transparently: The AI Assessment Scale encourages thoughtful, transparent AI use while recognizing when human expertise is essential. Choose Secure AI Tools: Paid, HIPAA-compliant platforms with Business Associate Agreements (BAAs) provide stronger privacy protections than free consumer AI tools. CHAPTERS 00:00 Dr. Marina Badillo-Diaz's Background and Journey 10:38 Using AI in Therapy Without Losing the Human Touch 13:03 Beyond ChatGPT: Smarter Ways to Use AI 19:54 Choosing the Right AI Tool for the Job 27:11 The Risks of AI Becoming a Companion 39:09 Why AI Needs Human Oversight 40:50 Helping Therapists Embrace AI 46:43 Connect With Dr. Marina Badillo-Diaz RESOURCES Today Sponsors: Visit practicesol.com Learn more About The AI Social Worker: Visit theaisocialworker.com Connect with Dr. Marina on LinkedIn 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 .

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  Episode #48

  Practice Audit: How Nicole Brewer Built a High-Performing Insurance-Based Group Practice

  Jun 4, 202649 minS1

  <p>EPISODE SUMMARY</p><p>In this episode of The Claim Game, Jeremy sits down with Nicole Brewer, owner of reTHINK Your Practice and reTHINK Therapy in Henderson, Nevada. Celebrating a massive 10-year milestone this year, Nicole has managed to scale an insurance-based group practice to 23 therapists while keeping her sanity intact.</p><p>Even better? Nicole officially holds the highest score out of all the practice audit episodes recorded to date!</p><p>Jeremy and Nicole look under the hood of her exceptionally high-scoring practice. They break down how a robust task management system eliminates mental fatigue , the rigorous...

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