Best Third Party Claims Management Podcasts (2024)

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Episode #49 - From Army Investigator to Insurance Expert: Insights from Barry Zalma 56:06

3h ago56:06

56:06

Send us a text In this episode, Chantal Roberts and William Auten welcome Barry Zalma, a seasoned insurance industry professional with over 56 years of experience. The trio discusses the changing role of insurance adjusters, their relationship with policyholders, and the current challenges faced by the industry. Barry shares his journey from a mili…

1
Season 7 - Episode 47 - #TerryTuesday - Navigating the Challenges of Telehealth Services and Billing 42:49

4d ago42:49

42:49

In this episode, Sean and Terry discuss the recent incident where Sean accidentally went live with colorful language during a recording. They also dive into the proposed changes to the telehealth services and fee structure for 2025. Terry explains the challenges and limitations of telehealth services, especially when it comes to billing and coding.…

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SEC Suffers Dismissal of Claims in Solarwinds Securities Fraud Case 12:22

3h ago12:22

12:22

A New York federal district judge handed down a significant decision dismissing much of the SEC's securities fraud enforcement action against SolarWinds arising from its claims relating to SolarWinds' cybersecurity policies and disclosure of a significant cyberattack against the SolarWinds' network. In this episode of Corruption, Crime, and Complia…

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Episode #48 - Balancing Obligations: The Art of Ethical Claims Handling 53:43

14d ago53:43

53:43

Send us a text In this episode of The Art of Adjusting®, hosts Chantal and William dive deep into the duties and responsibilities that insurance carriers have towards third-party claimants. They explore the fine line between contractual and moral obligations, emphasizing the importance of maintaining goodwill and treating claimants with respect to …

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Season 7 - Episode 46 - #TerryTuesday - Privilege or No Privilege "That is the Question" 29:50

1h ago29:50

29:50

This is a controversial topic depending on which side of the yellow line you stand on... The question is does all work with a consultant require attorney client privilege... This is a great discussion for those of you looking to engage in coding and billing audits.

1
Season 7 - Episode 45 - Monday Auditing, Coding, and Compliance Roundtable 58:35

1h ago58:35

58:35

This was a great live show! Sean was joined by Terry, Christine, and Paul to discuss Medical Decision-Making for levels of EM service when Rx Management is involved. There was a lot to unpack in this episode so don't miss this one!

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Season 7 - Episode 44 - #TerryTuesday - Words Matter 22:43

1h ago22:43

22:43

Terry and Sean take on the importance of words in the medical record. There is no slowing of the audit trend so providers better buckle up!

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The Boeing Plea Agreement 22:41

1d ago22:41

22:41

Have you heard of the recent controversies around Boeing 737 MAX and its safety? Have you wondered what is being done about the concerns around it? In this episode of Corruption, Crime, and Compliance, Michael Volkov delves into the latest developments in the Boeing 737 MAX case, highlighting the recent plea agreement proposed by the Department of …

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Podcast takeover this week: 10-year-old patient with boundless wisdom, is crashing the airwaves this week! 18:33

17d ago18:33

18:33

I sat down with a returning and special guest here on our podcast and asked my daughter, "What do you think the Doctor's Office will be like when you grow up?" Caption: Editor, Michael Tetreault and daughter on a CMT podcast discussing what's important to the all-star team at home. By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today, Ho…

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Deep Dive into the SEC's Settlement with R&R Donnelly on Cybersecurity Controls 12:15

8d ago12:15

12:15

How does the SEC's recent settlement with R.R. Donnelly & Sons Company impact internal controls for cybersecurity incidents? In this episode of Corruption, Crime, and Compliance, Michael Volkow discusses a significant decision by the SEC involving a $2.1 million settlement with RR Donnelly & Sons Company (RRD) related to a 2021 ransomware attack. T…

1
US Physician shortage & the importance of clinical experiences for medical students & graduates 59:36

20d ago59:36

59:36

Our next guest is Kyle Swinsky, CEO of AMOpportunities. Kyle leads a company that helps medical trainees, students, and international graduates secure rotations in the US. Kyle's company mission is to help improve the US health system by unveiling the importance of foreign-trained physicians and the impact of US clinical experiences for internation…

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Tax Plan Your Way to Wealth with the Team at My Financial Coach 47:52

12d ago47:52

47:52

Sponsored Webinar Founded in 2018, My Financial Coach has focused on providing financial planning and wellness through the use of technology and financial experts. Our leadership and operations team ranges from world-renowned economists to leading financial planners from famous fintech startups. We hope to shape the financial services industry towa…

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Ethics and Professionalism in Claims Handling: Lessons from Quentin Brogdon 50:01

29d ago50:01

50:01

Send us a text In this episode of The Art of Adjusting® Podcast, host Chantal Roberts welcomes Quentin Brogdon, an experienced trial lawyer and former insurance defense attorney, recommended by Nancy Germond. Quentin shares invaluable insights from his extensive career, offering a unique perspective on the relationship between insurers, adjusters, …

1
Season 7 - Episode 43 - #TerryTuesday - Flat-lining! 29:09

14d ago29:09

29:09

In this episode Terry and Sean take on what it means to flat-line with your coding and how to avoid unnecessary scrutiny!

1
NAVEX State of Risk and Compliance Programs 13:32

18d ago13:32

13:32

Is your HR department rolling their eyes at compliance? Does your company have a non-retaliation policy? The report, based on over 1,000 global responses, reveals growing maturity in compliance programs but notable gaps, such as only 61% having a hotline and 55% having a non-retaliation policy. Join us on this week’s Corruption Crime and Compliance…

1
Season 7 - Episode 42 - Defending Your Claims Action 29:21

21d ago29:21

29:21

This one is a head-scratcher for The Compliance Guy for so many reasons... Not going to give it away but this is a really good episode you are gonna want to catch!

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Season 7 - Episode 41 - Monday Auditing, Coding and Compliance Roundtable 52:50

21d ago52:50

52:50

We had a great program on Monday with Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM Christine Hall Stephanie Allard, CPC, CEMA, RHIT Scott Kraft and John Paul Spencer and their take on some hard-hitting issues: 1. Practices wanting to use RNs or MAs to do post of visits after 90-global surgery 2. Medical necessity for E/M servic…

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Leaving your 🥼 job on a high note [and with gratitude!] 10:49

22d ago10:49

10:49

You can’t control how they left you. You can control how you leave them. Consider sending a thank you note. By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today/Host, Concierge Medicine Forum Hear me out … Experts say finishing well requires expressing gratitude — even to those you’ve worked next to, for, and around for the past few year…

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Halyna Senyk, from the CEELI on Anti-Corruption Progress in Ukraine 31:29

24d ago31:29

31:29

Is the progress itself enough to consider the battle won? Are the ongoing scandals casting a shadow over the hard work against corruption? Despite challenges (such as limited resources due to the ongoing war) and recent scandals (such as overpriced eggs for the military), Ukraine maintains multiple institutions committed to transparency and integri…

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Level Up: Your Guide to Becoming an Expert Adjuster 1:00:38

1M ago1:00:38

1:00:38

Send us a text Join Chantal and William on this episode of The Art of Adjusting® Podcast as they dive deep into the journey of becoming an expert claims adjuster. They break down the career path from novice to seasoned professional, emphasizing the value of experience, continuous learning, and self-education. You'll hear them discuss the importance…

1
One task only you can do, not on A.I.'s to-do list. 7:06

27d ago7:06

7:06

A concierge medicine doctor recently called me out of the blue on my cell phone. She followed up with a phone call a few weeks later with another text with a helpful link to something we had discussed earlier. As you might imagine, it made my day! Can the Physician do something like this FOR everyone or every patient? No, but as author A.S. says, “…

1
Season 7 - Episode 40 - #TerryTuesday - G2211 and Some Payors Refusal to Pay 27:49

1M ago27:49

27:49

Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM and #TheComplianceGuy, addressed critical issues in the latest #TerryTuesday episode. In this episode, we delved into current events affecting our country, marking a significant departure from our usual content. Listeners can fast forward to the 15-minute mark for an insightful discu…

1
Bryn Sedlacek, Vice President at Aravo, on Holistic Third-Party Risk Management and Unitary Visibility 28:05

2M ago28:05

28:05

Bryn Sedlacek, Vice President and Product Manager at Aravo, joins us on the podcast to discuss third-party risk management focusing on holistic risks and unified visibility. In a wide-ranging discussion, Mike Volkov and Bryn Sedlacek discuss the challenges in implementing a third-party risk management program that captures holistic risks and mainta…

1
Transforming Doctors Compensation for a Fairer and More Rewarding Life 1:11:47

1M ago1:11:47

1:11:47

Meet Ethan A. Nkana, the visionary behind Rocky Mountain Physician Agency (RMPA), and a potential disruptor for The DocPreneur Leadership Podcast. Back in 2019, he saw that doctors were getting paid unfairly based on factors like where they went to school or their race and gender. TO LEARN MORE OR CONNECT WITH ETHAN, visit: https://rmpa.co/ Amidst …

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Season 7 - Episode 39 - Dana McMahon Chief Compliance Officer / Stryker 34:39

2M ago34:39

34:39

Sean sat down with Dana McMahon, Chief Compliance Officer for Stryker to discuss all the great things she and her team are doing to ensure a culture of compliance and to lead Stryker into the future. Beyond that Dana is the Global President for Stryker Women's Network (see bio below)! This is one great discussion you do not want to miss! Bio Dana s…

1
Season 7 - Episode 38 - #TerryTuesday 32:37

1M ago32:37

32:37

Terry and Sean sat down to discuss credentialing vs contracting. What are the main differences, how do you handle various aspects of each and the pitfalls to avoid.

1
Season 7 - Episode 37 - Monday Auditing, Coding and Compliance Roundtable 1:02:12

2M ago1:02:12

1:02:12

The full panel was back this week taking on an array of topics impacting healthcare organizations across the country! Join Stephanie, Paul, Scott, Christine and Terry as they discuss and debate HCC Coding Issues, No Charging Physicians and others who refer to the practice and so much more...

1
Sanctions Enforcement Risks 15:47

2M ago15:47

15:47

In this episode of Corruption, Crime and Compliance, we delve into the complex world of sanctions compliance and enforcement. In this new era of aggressive sanctions enforcement, companies have to understand the red lines that define where criminal and civil enforcement risk increases. In contrast to the history of FCPA enforcement, DOJ and OFAC ha…

1
7 Qualities Happy Doctors Have 30:22

1M ago30:22

30:22

By Editor, Concierge Medicine Today I have a unique seat on the bus in our healthcare culture to speak to Physicians from all walks of life. From early startups to late retirements, it's a fun job for the most part, pouring into Physicians' lives and sharing their thoughts on running a successful practice with you. Once a quarter, we write a letter…

1
Episode #45 - On Two Wheels: The Insurance Dynamics of E-Bikes 59:27

2M ago59:27

59:27

Send us a text Happy Independence Day! We think you will find this to be an educational episode. William and Chantal discuss several challenging subjects related to motor vehicles and homeowner policies. They explore car classifications, modernizing policies, and the roles of claims adjusters. They analyze how changing policyholder needs and new te…

1
Season 7 - Episode 36 - #TerryTuesday 35:13

2M ago35:13

35:13

This episode Terry and Sean take on adding services to your revenue mix and the costs for doing so if "Medical Necessity" is not met. There is a ton to unpack in the episode. Sean also blogged about this topic on LinkedIn Monday, July 1, 2024... take a look at that blog!

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Taking Your Business From Best Kept Secret To Household Name. 1:03:17

1M ago1:03:17

1:03:17

Helping doctors build profitable businesses so they can live life and practice medicine on their terms. Our guest this week is AUTHOR and Physician-Entrepreneur and my friend, DR. UNA! Dr. Nneka Unachukwu is a board-certified pediatrician and the founder and CEO of Ivy League Pediatrics outside of Atlanta, Georgia. She graduated from the University…

1
Another Look at the Importance of Corporate Culture 14:38

2M ago14:38

14:38

LRN has issued another important report. In its latest report, The 2024 Benchmark of Ethical Culture Report, LRN has focused on the critical issue of corporate culture. LRN is a pacesetter and the leader in reliable studies on complex ethics and compliance issues. If not properly promoted or maintained, a defective culture can lead to serious misco…

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Empower Sleep: The world's most personalized sleep care experience. 57:55

1M ago57:55

57:55

There are approximately 70 million Americans suffering from sleep disorders - most of whom are undiagnosed. As sleep providers, we founded Empower Sleep to deliver more personalized care so everyone can benefit from the effects of better sleep. Our guest today is Dr. Sahil Chopra, MD, Harvard Medical School Loma Linda University University of Calif…

1
Season 7 - Episode 35 - #TerryTuesday 29:34

2M ago29:34

29:34

Terry and Sean are back at it once again taking on the big issues impacting healthcare providers! It's all about risk mitigation and creating a culture of compliance!

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Season 7 - Episode 34 - Monday Auditing, Coding and Compliance Roundtable 1:02:47

2M ago1:02:47

1:02:47

The Monday Roundtable is back with all new segments and compliance centered topics. Join Sean, Terry, Christine, Scott, Paul and Stephanie as they tackle the biggest issues in healthcare.

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Dottie Schindlinger on Diligent's Report on Board Oversight of Cybersecurity Risks and Performance 28:46

2M ago28:46

28:46

Dottie Schindlinger is Executive Director of Diligent Institute, the global corporate governance research arm of Diligent - the largest SaaS software company in the Governance, Risk, Compliance (GRC), and ESG space. She co-authored the book Governance in the Digital Age: A Guide for the Modern Corporate Board Director, co-hosts “The Corporate Direc…

1
The ethics of AI in health data management: Balancing innovation and patient privacy 51:21

2M ago51:21

51:21

Our next guest is Dr. CAROLYN WARD, Director Of Clinical Strategy, Particle Health. Dr. Carolyn Ward is a dynamic and driven internal medicine physician with a passion for physician empowerment and data-driven decision making. With over eight years of experience in healthcare, including as Chief Resident at Rutgers Robert Wood Johnson Medical Schoo…

1
Episode #44 - Adjusting to AI: The New Frontier in Claim Management 50:27

2M ago50:27

50:27

Send us a text Hosts Bill and Chantal are joined by special guest Luis Diaz, a thought-provoking entrepreneur with a passion for technology and insurance claims. https://www.linkedin.com/in/luisarturodiaz/ https://www.gobeyondroadmap.com/ In this episode, they explore the transformative impact of artificial intelligence on the insurance claims proc…

1
AI Risks and Emerging Compliance Frameworks 13:32

3M ago13:32

13:32

A new compliance cottage industry surrounds artificial intelligence. We are at such an early stage of AI development, and companies are still figuring out how they can employ the technology. However, some industries, such as financial institutions, have been using AI for fraud detection and other issues. These early adopters will likely set the ton…

1
Considering a Career in Concierge Medicine? 30:22

3M ago30:22

30:22

By Concierge Medicine Today sources, with Contributions From CMT, Editor-in-Chief UPDATED FOR JUNE 2024 | ATLANTA, GA—For almost two decades now, Concierge Medicine Today (CMT) has been reporting, discussing, writing, documenting, observing, and talking directly with you (i.e., Physicians) about all the various nuances the concierge medicine indust…

1
Season 7 - Episode 33 - #TerryTuesday - Employment Requirement of Incident-To 24:31

2M ago24:31

24:31

Don't let the title fool you... this is not just another incident-to podcast. This episode focuses on the employee/employment requirement(s) and how organizations continue to make significant mistakes.

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Season 7 - Episode 32 - Monday Auditing, Coding and Compliance Roundtable 1:03:31

2M ago1:03:31

1:03:31

Terry, Christine, Stephanie, Paul, and Scott were all back for this new episode of the Monday Roundtable. It was quite the discussion on various payor guidelines regarding G2211, The Anatomy of CPT Codes, Split/Shared Services, EMR as a Tool, and so much more...

1
Third-Party Risks and Sanctions Compliance 18:22

3M ago18:22

18:22

With the beginning of the “New FCPA” era coined by DOJ’s Deputy Attorney General Lisa Monaco, we now need to focus on third-party risk and sanctions enforcement. The law, the practice, and the risks are important and not just the same as FCPA legal requirements. As we embark on a new criminal enforcement era surrounding sanctions violations, compan…

1
Revitalizing Growth: Transformative Strategies for Healthcare and Insurance Companies 1:13:38

2M ago1:13:38

1:13:38

My guest today is Mike Murphy, Managing Partner, Sunstone Management Advisors Mike is an experienced growth leader with an impressive track record of building, growing, and improving the financial performance of healthcare and insurance companies across the service, technology, and payer sectors. With more than 30 years of experience as a C-level e…

1
Episode #43 - Balancing Tech and Touch: The Heart of Claims 54:09

3M ago54:09

54:09

Send us a text In this episode, Bill and Chantal explore the human element in claims adjusting. They discuss the importance of empathy, effective communication, and cultural sensitivity in the profession. Bill shares personal stories that highlight the need for adjusters to remember that for many claimants, this is their first and only experience w…

1
Carlos Villagran Discusses Rebuilding a Corporate Culture After a Corporate Crisis 48:24

3M ago48:24

48:24

Carlos Villagrán is the Director of Compliance at CMPC, a 100-year-old Chilean-based holding company, one of the worldwide leading pulp, paper, packaging, personal care, and other forest products manufacturers. With more than 20,000 employees, CMPC has industrial operations in 9 countries (LatAm and the US) and commercial offices in the US, Europe,…

1
Medical A.I. in healthcare and the escalating threats of cyberattacks in healthcare. 42:44

3M ago42:44

42:44

RXNT is a trailblazer in ambulatory medical software and we caught up with Randy Blodyga. Under the leadership of Randy Boldyga, a visionary in the healthcare industry since the 90s, RXNT stands at the forefront of healthcare innovation. RXNT isn't just another name in healthcare; it offers a comprehensive suite of solutions, from practice manageme…

1
Private Equity and Your Practice: Knowing what to do before you start the PE discussions 38:31

3M ago38:31

38:31

"I value my long-term client relationships and always strive to meet and exceed their expectations by being responsive to their requests, listening to their needs, and providing direct access to other Rehmann advisors.” ~The Rehmann Team, Danielle L. Ambrozy, CPA, MBA, CHBC Danielle is responsible for providing accounting and tax services to small …

1
Checking in on the Caremark Cases 12:28

3M ago12:28

12:28

Over the last ten years, we have seen a marked shift from the Delaware Chancery Court chipping away at corporate board member liability claims. In a number of seminal cases involving Boeing airplane crashes (In re the Boeing Co. Derivative Litig., No. 2019-0907 (Del. Ch. Sept 7, 2021)), and deadly listeria outbreaks from tainted ice cream (Marchand…

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Third Party Claims Management Podcasts

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