Ask a Revenue Cycle Leader is a new series featuring insights from health system and hospital revenue cycle executives nationwide. Becker’s poses questions on the most pressing issues in healthcare finance — from payer relations and automation to workforce and patient experience. We welcome responses from all revenue cycle, finance and reimbursement leaders.
Question: What is one question you wish people asked revenue cycle leaders more often, and how would you answer it?
Editor’s note: Responses have been lightly edited for clarity and length.
Joanna Caballero. Corporate Vice President of Revenue Cycle at Scripps Health (San Diego): How do we balance the growing pressure to reduce costs with the need to invest in our people? Revenue cycle is increasingly complex, and while automation, AI and alternative workforce models offer opportunities, technology alone will not drive sustainable transformation. Our success depends on developing leaders who embrace change, empowering our teams to work differently and creating a culture of accountability and continuous improvement. I believe our greatest responsibility as leaders is to thoughtfully balance financial stewardship with investment in our people, recognizing that long-term success will require both.
James Hartman. Director of Revenue Cycle at Thorek Memorial Hospital (Chicago): A question other leaders can ask: What do we do in our departments that makes revenue cycle back-end processes harder? Revenue cycle leaders get asked about denial rates, days in A/R and cash collections. We rarely get asked by clinical, operational and strategic leaders how their own decisions show up in those numbers. They show up often. Documentation that lacks the specificity coding needs. A workflow change nobody told billing about. A service line that launches before anyone confirms payer coverage. A provider enrolled in a way that doesn’t match how claims are billed. Each decision is made without visibility into what happens to revenue cycle processes, and the denial lands months later in a report those leaders never see or connect to.
Angel Hovanessian. Vice President of Revenue Cycle, HIM, CDM and CDI at Emanate Health (Covina, Calif.): One question I wish more people asked revenue cycle leaders is, “How can we prevent revenue leakage before it happens rather than focusing on fixing denials after the fact?” The answer starts with shifting from a reactive approach to a proactive one by using data, strengthening front-end processes and identifying trends in denials and underpayments early. Revenue cycle performance is not just about getting claims paid; it’s about creating efficient, accurate and sustainable processes that protect financial performance while improving the patient experience. The greatest opportunity is working with contracting, clinical, operational and financial teams to address root causes rather than repeatedly treating the issue.
Sandra Lood. Vice President of Revenue Cycle Management at Cottage Health (Santa Barbara, Calif.): One question I wish people asked revenue cycle leaders more often is: “What are your most recent wins, and how did you achieve them?” In revenue cycle, we naturally spend a lot of time focusing on problems, errors and opportunities for improvement because that’s the work many of our teams do every day. We are the fixers. While it’s important to address challenges, I believe we should spend more time celebrating successes and sharing what made them possible, including the lessons learned from failure. Let’s talk about how a team partnered with a payer to overturn a denial trend, how a workflow improvement increased net revenue or how a process change saved hundreds of hours and improved the experience for staff and patients. The challenges will always be there, but so will the wins. By highlighting our successes and understanding how we achieved them, we not only recognize the great work of our teams but also create opportunities to learn, innovate and build on that success.
Jenn Mykland. Vice President of Revenue Cycle at MultiCare Health System (Tacoma, Wash.): What can my clinical and care team do to reduce rework and delays in processing? Think of revenue cycle as an extension of the care process, not something that happens after care is delivered. Validate that the services you provided are captured accurately, document completely and in a timely manner, and help resolve questions quickly. Clean information at the source reduces rework, prevents delays and allows revenue cycle teams to focus on higher-value work instead of fixing avoidable errors.
Karen Veselsky. Vice President of Revenue Cycle at UMC Health System (Lubbock, Texas): I wish more people would ask about the training and education it takes to be a successful revenue cycle leader. There aren’t any college degrees issued in a “revenue cycle” major, and it amazes me how some of my colleagues “fell into” revenue cycle or were drawn to this work. Think about it: Who would really want to work in a field where you aren’t paid the amount you billed on your invoice; where insurers require you to obtain prior authorization for an exact set of diagnosis and CPT codes for a surgery before it’s performed, even though it may not go as planned because medicine is not an exact science; where government and payer regulations and requirements are always changing; or where you receive a timely filing denial even though you sent the claim electronically and the payer insists it never received it? It baffles the mind!
Mike Vigo. Chief Revenue Officer at UC San Diego Health: How do we make revenue cycle a strategic partner in delivering exceptional patient care, rather than simply a function that collects revenue? Revenue cycle performance begins long before a claim is submitted, with the patient’s access to care, the accuracy of our processes and the collaboration between clinical, operational and financial teams. Working in a California academic health system, we must balance financial sustainability with complex payer requirements, regulatory expectations and our mission to serve diverse patient populations. The opportunity is to simplify the patient financial experience, reduce administrative burdens and use technology to improve performance while preserving the human judgment and accountability that healthcare demands. A high-performing revenue cycle strengthens our financial position so we can continue investing in patient care, our community, our staff and teams, innovation and clinical research.
Next question: What is one thing your revenue cycle team stopped doing in the past year, and what changed as a result? If you are interested in responding, please send responses to Andrew Cass at acass@beckershealthcare.com.
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