Are Insurers Downcoding Claims?

Are Insurers Downcoding Claims?

In this eye-opening episode, Dr. Asha Voss sits down with Ethne Nance, EstrogenicA’s RCM partner, to unpack a troubling trend affecting private practices across the country: insurers downcoding physician-submitted claims and in effect, overriding the clinical judgment of providers. From invalidating high-level visit codes to denying prior authorizations for medically necessary procedures, payers are increasingly inserting themselves into the clinical process, often without accountability.

Ethne brings real-world clarity to what this means for physicians, patients, and practice sustainability. Together, they explore how these decisions impact cash flow, patient care, and physician autonomy. In return, shares how an RCM partner can become a critical line of defense. With the EstrogenicA MSO model as the backdrop, the conversation highlights the importance of proactive coding support, payer negotiations, and system-wide trust.

If you’ve ever wondered why a claim didn’t pay what it should or why a specialist can’t get approval to prescribe what a patient truly needs, this segment makes it plain: it’s not just about billing. It’s about the future of medicine.

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Avsnitt(22)

Freedom in Practice: The MSO Advantage

Freedom in Practice: The MSO Advantage

What does flexibility really look like for physicians today? In this episode, Dr. Asha Voss shares how partnering with a Management Services Organization (MSO) has redefined what’s possible in private...

17 Nov 20257min

Sovereignty in Practice: When RCM Is a Power Move

Sovereignty in Practice: When RCM Is a Power Move

What happens when private practices stop playing defense and start reclaiming control? In this episode, Dr. Asha Voss, MSO Administrator Christy Adeyemi, and RCM expert Ethne Nance return to unpack th...

7 Nov 202510min

Physician Care is Patient Care

Physician Care is Patient Care

In this episode, Dr. Asha Voss is joined by RCM expert Ethne Nance and MSO Administrator Christy Adeyemi for a meaningful conversation that flips the script on how we view healthcare leadership. Inste...

31 Okt 20258min

Insurers: The Healthcare Casinos

Insurers: The Healthcare Casinos

In this segment, Dr. Voss, Ethne Nance, and Christy Adeyemi dig into the disorienting reality many physicians are now facing: a system where insurers not only process claims, but appear to be playing ...

24 Okt 20255min

Beyond Billing: Rethinking RCM Partnerships PT II

Beyond Billing: Rethinking RCM Partnerships PT II

We’re back, and Season 2 kicks off with Part II of a two-part conversation led by Dr. Asha Voss leading a powerful conversation featuring RCM partner Ethne Nance and MSO Administrator Christy Adeyemi....

3 Okt 202528min

Beyond Billing: Rethinking RCM Partnerships PT I

Beyond Billing: Rethinking RCM Partnerships PT I

We’re back, and Season 2 kicks off with Part I of a two-part conversation led by Dr. Asha Voss leading a powerful conversation featuring RCM partner Ethne Nance and MSO Administrator Christy Adeyemi. ...

26 Sep 202544min

From Why to What's Next

From Why to What's Next

Across 15 episodes, Dr. Asha Voss (with Chanté Stephens often alongside her) unpacks the realities of private practice, leadership, and life as a physician-entrepreneur. The season begins with The Why...

12 Sep 202525min

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