On Episode 2 of Season 4, Vanessa Moldovan interviewed me on her podcast, For the Love Of Revenue Cycle, which I am excited to share. Since starting the Healthcare Reimagined podcast, I founded a healthcare company, Covered Health, and Vanessa interviewed me about what we're doing and why we're doing it.

At Covered, we are automating the most challenging and time consuming elements of appealing denied medical claims for providers. By streamlining access to diverse databases and inputs, Covered uses technology to helps RCM specialists identify denial root causes, and appeal them.

Vanessa and I came together because we share the same vision: preventing patients from getting stuck with bills that should be covered by their insurance, and helping to empower revenue cycle management experts to resolve those denials with greater efficiency.

We discussed my motivation for starting Covered - my brother Russell's experience with unfair insurance denials during his struggle with Ulcerative Colitis. Our family was hit with massive bills, and at a time when we wanted to focus on Russell’s health, instead we were focused on denied claims. Covered intervenes to help providers overturn denials, and prevent bills from becoming patient responsibility.

We discussed my journey through the Special Forces, Parachute Health, and running sales for healthcare companies, and eventually selling into insurance plans prior to starting Covered. We also spoke about Vanessa's career, and her choice to turn down Harvard undergraduate in pursuit of a life and career that aligned with my values of giving back and sharing what I've learned with others, which is why I started this podcast.

Vanessa and I met, funnily enough, because I was looking for a podcast on denials and found this one! We connected over a shared passion to create a denial resolution tool with the goal of harnessing the multitude of databases & sources of truth that a biller has to access in order to identify the root cause of a denial and create an appeal.

We are not only reducing the clicks required to gather the information, but creating a smart tool that will guide RCM professionals through the decisions required to compile the body of the appeal, and eventually generate it for them.

We addressed Covered’s competitive differentiation within the denial management space, and the rapid advancement of AI and LLMs, which have given an advantage to new companies. We touched on the slow moving nature of incumbents, and why they often don’t succeed in building product lines that are as innovative as their original core offering.

If Covered’s mission to fight back against incorrect denials resonates with you, we want to connect! Especially (but not exclusively) if you are an independent specialty provider group, an RCM company fighting denials, or a regional/community hospital/health system. If you are struggling to address denials as a result of staffing shortages/payer policies/behavior, or you are just passionate about denials, please reach out!

Today, Covered acts as a software enabled services company, utilizing technology and Vanessa to overturn denials (we've returned tens of thousands of dollars to physicians). If you're struggling with denials, we can immediately step in and help you, and help identify trends and root causes. In special cases, we also provide consulting services.

You can learn more about Covered on our website, CoveredHealth.ai.