Jon Jaroska

Prompt Triangulation RCM logic is high stakes. One wrong interpretation of a complex payer rule and your clean claim rate plummets. We’ve all seen AI get a little too "creative" with facts. That’s why I don’t rely on just one model when the revenue is on the line. I call it Prompt Triangulation. If I’m wrestling with a tricky denial pattern or a dense new policy, I don’t just ask ChatGPT. I take that same prompt to Claude and Co-pilot, too. Think of it like getting a second and third opinion from specialists. If all three models land on the same logic? I feel confident. If one of them flags a nuance the others missed? That’s where the real work begins. AI is a powerful tool, but it’s not a "set it and forget it" solution for healthcare leaders. It’s an assistant that needs a peer review process. Trust the tech, but verify the output. Your bottom line will thank you. #HealthcareInnovation #RCM #Leadership #AI #RevenueCycle

6

KPI Spotlight Series #4: Charge & Payment Posting Timelines Today’s spotlight is on two KPIs that keep your revenue cycle moving: Charge Posting Timeliness and Payment Posting Timeliness. Charge Posting Timeliness What it measures: How quickly charges are entered into the PM system after the date of service. Why it matters: Claims can’t be submitted until charges exist. Slow posting delays cash flow and clouds provider productivity reporting. Timely charges support accurate month-end performance. Industry expectation: Most high-performing groups post within 48–72 hours of service. How to improve: Use encounter reconciliation to prevent missed charges. Monitor provider documentation lag. Automate charge capture through EHR tools and coding workflows. Payment Posting Timeliness What it measures: How quickly payments are posted into the system after they are received (ERA/EOB). How long it took to get paid from the original date of service. This highlights payer responsiveness, delays, and trends in claims turnaround time. Why it matters: Denial workflows cannot begin until payments are posted. Payment lags distort AR and delay financial reporting. Helps identify slow-paying payers and operational bottlenecks. Industry expectation: ERAs posted within 24–48 hours; paper EOBs within 72 hours. How to improve: Enroll all possible payers in ERA/EDI. Apply auto-posting rules for clean remittances. Maintain daily deposit and posting queues to prevent backlog. Every Date in the Claim Lifecycle Is Measurable Every point along the claim journey creates its own measurable timeline. Each one highlights where delays or inefficiencies may be hiding. You can track the number of days between: Date of Service → Charge Entry (charge lag) Charge Entry → Claim Submission (coding/charge review lag) Submission → Payer Acceptance (clearinghouse or payer intake delays) Acceptance → Payer Received Date (payer internal routing) Received Date → Payment Date (payer processing time) Date of Service → Payment Date (total days to collect) Together, these metrics help you pinpoint exactly where slowdowns are happening—whether inside your organization, at the clearinghouse, or with a specific payer. Each step shows where delays occur—provider lag, charge capture issues, clearinghouse delays, payer processing times, or posting backlogs. Together, these metrics tell the true story of your revenue cycle’s speed and health.

11

6 Comments

Growth Doesn’t Break Practices. Bad RCM Does. Every scaling practice believes growth will solve financial stress. More locations. More providers. More volume. Then cash tightens. From the sales side, I’ve seen it repeatedly: growth exposes weak RCM faster than anything else. Multi-location groups without standardized revenue workflows experience: • Inconsistent cash flow • Location-level denial spikes • Leadership blind spots • Delayed profitability This isn’t a scale problem. It’s an infrastructure problem. Medeye RCM LLC is built for growth-stage practices that want control before chaos. We standardize revenue operations while preserving payer and specialty nuance. Questions I urge buyers to ask: • Can your RCM model scale without adding headcount? • Are all locations benchmarked equally? • Does leadership see revenue in real time? My belief: Growth without revenue control is risk disguised as success. #HealthcareGrowth #RCMScaling #SalesInsights #MultiLocationCare #RevenueOperations

11

EHRs weren’t built to think. They were built to document. PointClickCare. MatrixCare. All of them. They’re glorified filing cabinets with a user interface. They store what already happened. They organize what already went wrong. They make it easier to find problems… after the fact. But they don’t prevent anything. And that’s the gap. #Vyxyntra #ComplyX #LongTermHealthcare #Reform #2035OSInitiative

3

Most medical billing companies believe positioning themselves as "experts" will win deals, but here's what's really happening... After analyzing positioning strategies across the industry, I keep seeing the same costly mistake: companies default to highlighting their years of experience and specialty knowledge, thinking this will resonate with prospects. The reality? This approach actually works against you. **Why "Expertise" Positioning Falls Flat** When prospects evaluate vendors, they encounter multiple providers making identical claims. Your "20 years of anesthesia billing experience" becomes meaningless when every competitor says the same thing. Worse yet, as you pursue larger contracts ($100K, $250K, $500K+ annually), expertise-based positioning becomes increasingly inadequate. Bigger prospects have sophisticated evaluation criteria that go way beyond basic competency. **The Features vs. Benefits Problem** Most companies focus on what they HAVE instead of what clients GET: ❌ "20 years of anesthesia billing experience" ✅ "Reduced claim denials and faster payments" ❌ "Certified coding specialists" ✅ "Maximized reimbursements and compliance protection" ❌ "Specialty-focused team" ✅ "Streamlined workflows and improved efficiency" **What Actually Works: Outcome-Based Positioning** I recently saw a perfect example of this transformation. One company repositioned from "experienced anesthesia billing specialists with 15 years in the field" to focusing on their "Revenue Recovery Guarantee" program. Instead of highlighting experience, they emphasized: • 90-day cash flow improvement guarantee • Proprietary denial prevention methodology • Risk-free trial with performance benchmarks The result? A 300% increase in qualified leads and significantly higher close rates on larger accounts. **The 5-Point Differentiation Framework** Before finalizing your positioning, evaluate it against these criteria: 1. **Uniqueness** - Can competitors easily make the same claim? 2. **Relevance** - Does it address critical client pain points? 3. **Credibility** - Can you substantiate it with evidence? 4. **Clarity** - Is the value immediately understandable? 5. **Measurability** - Can clients verify the promised outcomes? **Key Takeaway:** While expertise matters, it can't be your primary differentiator. The most successful medical billing companies focus on specific, measurable outcomes rather than generic capabilities. Moving from what you know to what clients gain is the difference between competing on price and commanding premium rates. What's been your experience with positioning your services - are you emphasizing expertise or outcomes? Read my Blog Post: https://lnkd.in/gtp2StgP

9

1 Comment

Legacy DME software frozen again?… It’s time to let it go ❄️ This isn’t just a clever image. It’s a real risk. In healthcare, downtime isn’t inconvenient… it’s dangerous and when systems go down: • Patients wait • Orders stop • Cash stalls Stop getting left out in the cold and future-proof your DME today.

66

9 Comments

The biggest HIPAA update in 20 years is happening right now. And most small clinics have no idea. The final rule is expected in May 2026. Your compliance deadline: late 2026. Here are 7 things changing and what your clinic needs to do about each one: 1️⃣ MFA is now MANDATORY Multi-factor authentication is no longer optional or "addressable." Every login to every system touching patient data requires a second verification step. No exceptions for small practices. 2️⃣ Encryption closes its loophole The old flexibility that let clinics opt out of encryption with a documented reason is gone. All ePHI at rest and in transit must be encrypted: every device, every database, every backup. 3️⃣ You need a technology asset inventory A comprehensive written list of every device, software, and system that touches patient data, updated annually and mapped to your network. Most clinics have never built one. 4️⃣ Vulnerability scanning every 6 months Automated security scans required twice a year. Annual penetration testing required. Results documented and gaps addressed. For most small clinics, this means engaging a security professional for the first time. 5️⃣ Network segmentation required Clinical systems must be separated from administrative and guest networks. If someone compromises your front desk computer, they should not be able to reach your EHR. Most modern routers support this, but most clinics have never configured it. 6️⃣ Breach notification compressed to 72 hours The current 60-day notification window is dramatically shortened for many scenarios. Your breach response procedure needs a complete rewrite and an annual drill to prove it works at that speed. 7️⃣ Business associate oversight goes deeper Signing a BAA is no longer enough. You must verify your vendors are actually implementing required controls. That means annual security questionnaires for every vendor touching your patient data. The math is simple: ✗ Average cost of a ransomware attack in healthcare: $10.9M ✗ OCR fines for willful neglect: up to $1.9M per violation ✓ Cost of getting compliant now: a fraction of either Organisation size no longer exempts you from any of this. A 3-provider clinic faces the same requirements as a 500-bed hospital. The clinics that start preparing now will have a smooth transition. The ones that wait will be scrambling and exposed. Where does your clinic actually stand right now? We built a free 15-point HIPAA assessment that gives you your compliance score, shows your breach cost exposure, and delivers step-by-step fix guides in under 10 minutes. Link in comments 👇 #HIPAA #HealthcareCompliance #MedicalPractice #HealthIT #CyberSecurity #SmallClinic #HIPAAUpdate2026 #HealthcareAI #OCR #ElevareHealthAI

4

1 Comment

“Can you recommend a good AI tech vendor?” 🤔 It’s a question I hear all the time—and it sounds like a simple ask. But here’s the truth: A tech referral alone doesn’t solve a business problem. ❌💡 Even when your DSO client is asking for one, that request is often a symptom— not the strategy. If you're a dental CPA, business consultant, or fractional CFO, you already know your client’s numbers. 📊 💸 You’re reviewing financials together. You’ve seen where their labor or supply costs run high. 📉 You’ve tracked unapplied credits or AR over 90. 🎯 You understand their long-term business goals. That’s exactly where a real conversation about technology should begin. 🧩 Before recommending software—whether it's for RCM, AI, or patient billing—we need to ask: 👉 Tell me about your current state and long term goals? 👉 What problem are you actually solving? 👉 Which KPIs are you focused on? Because a tech strategy that’s disconnected from business strategy risks becoming a distraction. Or worse, a costly misstep. ⚠️ When your client is chasing AI because “everyone else is doing it,” 🤖 or asking for a vendor list before they’ve defined success metrics— this is your moment to lead. 🧭 ✅ Start with the business strategy ✅ Use the numbers ✅ Then explore where technology can make an impact If you’re a financial or operational consultant supporting DSOs and you’d like to explore how Optimize Dental Consulting can partner with you to bring this kind of thoughtful tech strategy to your clients, I’d be glad to connect. 🤝 Let’s raise the bar on what true partnership looks like in dental consulting. 🦷📈 #dsotech #dentalconsulting #dentalcpa #dso #fractionalcfo #digitaltransformation

66

15 Comments

The biggest winners of 2027 CMS real-time prior-auth requirements? Medical billing companies. Here’s why no one is saying it out loud: As Centers for Medicare & Medicaid Services pushes speedy prior auth + stricter compliance… The revenue cycle becomes: 1. More technical 2. More automated 3. Less forgiving Which sounds like progress. Until you realize: Most providers are not built to operate that way So what happens? They don’t transform. They outsource. And suddenly: Billing companies aren’t just back-office vendors. They become: • API operators • Compliance engines • Gatekeepers of cash flow That’s a massive shift. Because whoever controls billing… Controls when and if you get paid. Here’s the twist: Automation doesn’t eliminate middlemen. It upgrades them. The old billing company: Manual, labor-heavy, reactive The new one: Tech-enabled, embedded, indispensable So yes — CMS is modernizing healthcare. But it’s also quietly deciding: 👉 Who owns the revenue layer And it’s not the providers.

10

1 Comment

It’s not the software that breaks during an EMR migration. It’s what happens to your data when meaning gets lost in translation. When I talk to healthcare leaders planning a system switch, the conversation almost always starts with the technology such as downtime, user training, workflows, go-live support. But the part that keeps them up at night isn’t what’s changing on the screen. It’s what’s happening behind it. Because when data moves, meaning often gets lost in translation. I’ve seen it happen countless times: ➡ ️Quality measures defined one way in the old EMR don’t map cleanly to the new one. ➡ Value-set crosswalks (ICD, CPT, HCC) don’t align. ➡ Contract denominators and numerators break when data definitions aren’t standardized before the move. The result? Post-migration reporting that looks completely different even when performance hasn’t changed. That disconnect doesn’t just cause confusion; it can cost practices 𝗺𝗶𝗹𝗹𝗶𝗼𝗻𝘀 𝗶𝗻 𝗶𝗻𝗰𝗲𝗻𝘁𝗶𝘃𝗲𝘀 under risk-based contracts. The solution isn’t more testing. It’s planning ahead of time. Here’s what I recommend before any EMR migration: • 𝗗𝗲𝗳𝗶𝗻𝗲 𝘆𝗼𝘂𝗿 𝗰𝗼𝗻𝘁𝗿𝗮𝗰𝘁 𝗺𝗲𝘁𝗿𝗶𝗰𝘀 𝗳𝗶𝗿𝘀𝘁. Lock down the denominators and numerators that drive value-based reporting. • 𝗕𝘂𝗶𝗹𝗱 𝗰𝗿𝗼𝘀𝘀𝘄𝗮𝗹𝗸𝘀 𝗳𝗼𝗿 𝗸𝗲𝘆 𝘃𝗮𝗹𝘂𝗲 𝘀𝗲𝘁𝘀. Make sure ICD, CPT, and HCC codes align between systems. • 𝗩𝗮𝗹𝗶𝗱𝗮𝘁𝗲 𝘄𝗶𝘁𝗵 𝗱𝘂𝗮𝗹-𝗿𝘂𝗻 𝗿𝗲𝗽𝗼𝗿𝘁𝗶𝗻𝗴. Run both systems in parallel for 6–8 weeks to catch deltas before go-live. • 𝗖𝗿𝗲𝗮𝘁𝗲 𝗮 𝘀𝗶𝗻𝗴𝗹𝗲 𝗱𝗮𝘁𝗮 𝗱𝗶𝗰𝘁𝗶𝗼𝗻𝗮𝗿𝘆. Your teams should speak one language, no matter the system. The truth is, software changes all the time, but 𝗱𝗮𝘁𝗮 𝗱𝗲𝗳𝗶𝗻𝗶𝘁𝗶𝗼𝗻𝘀 𝘀𝗵𝗼𝘂𝗹𝗱𝗻’𝘁. That’s what keeps your organization steady through every system change and ensures your performance story stays intact.

19

The Real ROI of Modern EHR Integration CFOs often ask me: "What's the ROI on EHR integration?" Fair question. Here are the numbers that matter: Revenue Impact: 15-30% improvement in risk adjustment accuracy 20% reduction in claim denials Faster reimbursement cycles improving cash flow Better HEDIS scores driving quality bonuses Operational Efficiency: 40-60% reduction in manual data entry Significant decrease in administrative overhead Faster onboarding of new providers Streamlined vendor management (many-to-one) Clinical Quality: Improved care coordination reducing unnecessary utilization Better medication management preventing adverse events Proactive chronic disease management Enhanced patient satisfaction scores But here's what the spreadsheet doesn't capture: The peace of mind that comes from knowing your organization can adapt quickly as regulations change. The competitive advantage of attracting top clinical talent who want to work with modern tools. The resilience that comes from having scalable infrastructure. The question isn't whether you can afford to invest in modern integration. It's whether you can afford not to. Organizations that treat technology as a cost center rather than strategic asset are making a fundamental mistake in 2025's healthcare landscape. #EHRIntegration #HealthcareROI #HealthITStrategy #DigitalHealth #RevenueCycleManagement #ValueBasedCare #FHIR #HL7

19

14 Comments

I see this pattern constantly. 👇 A practice uses one system for the EMR and another for billing.🚩 Then something goes wrong... Revenue drops. Claims stall. 😱 The EMR says it’s a billing issue. The biller says it’s an EMR issue. Everyone is technically right. And nothing gets fixed. Fragmentation makes accountability blurry. And blurry accountability is expensive.

9

Pre-AI SaaS EHRs will lose marketshare for the following reasons: 1. Legacy infrastructure is not built to support agentic applications: EHRs can't just add a plug-in and claim agentic automation. Every 3 months the technology advances and this means the infrastructure needs to be AI-native in order to keep up with these product shifts. 2. Shift in user behavior: doctors and other frontline healthcare workers are no longer willing to wait for anyone to give them permission to adopt AI technology. The old moat was on stickiness and EHRs maintained it with health system consolidation. This shift in AI product adoption challenges EVERYTHING we've known about pre-AI EHR SaaS distribution. 3. Custom frontend applications can now be vibe-coded: IDEs are for engineers but ADEs are being built for professionals. This means that vibe-coding development is no longer just creating prototypes with AI slop. These are real production-ready agentic applications that are secure and built using EHR backend data. #LetDoctorsVibe #VibeMedicine *ADE = Agent Development Environment

26

13 Comments

Your Software Didn't Increase Labor Costs. Your Workflow Did. Go-Live Is Not the Finish Line. It’s the Starting Gun. A new EMR system or AI tool does not increase labor costs. Unowned workflows do. During implementation, the energy is almost always focused on: Build milestones Interface testing Training schedules Hitting the go-live date But what often receives far less attention? Governance. Standardization. Workflow ownership. If no one explicitly decides, “This is the single flowsheet for vitals,” clinicians will create workarounds. Every time. Platforms like Epic, Cerner, or MediTech Systems are incredibly powerful because they allow flexibility. But flexibility without guardrails turns into duplication. And duplication turns into: Double documentation Parallel tracking systems Shadow spreadsheets Manual reconciliation Increased labor hours That’s not a system failure. That’s a governance failure. The Most Expensive Phase of Implementation Is the One No One Budgets For Go-live is when the real work begins. After go-live, leadership often asks: “Why is this tool costing us more?” The better question is: “Have we intentionally optimized what we built?” Because ROI doesn’t show up automatically. It shows up when someone owns: Workflow standardization Documentation rationalization Data governance Accountability for eliminating workarounds Continuous improvement cycles Without ownership, teams default to comfort. Comfort creates redundancy. Redundancy drives labor cost. Technology Doesn’t Create Inefficiency. Drift Does. AI tools, EMRs, automation platforms - they amplify what already exists. If your workflows are fragmented, technology will scale fragmentation. If your workflows are standardized and governed, technology will scale efficiency. That’s the difference. The Leadership Question That Actually Matters Instead of asking: “Is the system working?” Ask: “Who owns optimization six months after go-live?” Because systems don’t optimize themselves. Someone has to: Measure adoption Track documentation burden Kill duplicate fields Eliminate shadow processes Retrain when necessary Re-align governance If no one owns that? You don’t have an implementation problem. You have a leadership gap. Technology is powerful. But power without ownership is expensive. And go-live is just the beginning. I support healthcare organizations in translating technology investments into measurable financial and operational results. If helpful, I’m always open to a conversation. Stacy Calvaruso, MBA #HealthcareLeadership #DigitalTransformation #EMRImplementation #AIinHealthcare #OperationalExcellence #RevenueCycle #HealthIT

14

3 Comments

Time and again same questions that AI poses in front of each tech leader. How much and when you can replace which cost through AI. Below post highlights current state of helpers that we have available in market.

9

1 Comment

Sorry Thomman Kuruvilla, due diligence is part of the deal. If you can't do the due, then you get what you deserve. Listening to a salesman, or even knowing less about a potential purchase than the salesman is YOUR fault, not his. S/he has a vested interest in feeding his/her family and will say what needs to be said to get you to do what s/he wants you to do. Personally, I think that anyone who doesn't contribute to the production of a product or a service is a waste of resources, but I the reason for sales types. They work. Here is a problem with doctors. "We are DOCTORS, we know best and we are too important to mess with your crap." Apparently not. This is why you have to put up with Epic and company and doing literally everything wrong that can possibly be done wrong and charging YOU hundreds of millions of dollars, or in at least one case over a billion dollars, to do it. Act like the rest of humanity and do what needs to be done, you aren't that important. I hope this pisses you off and you actually do a little introspections and change. Here is what is possible: https://lnkd.in/gSzn8wez

2