Healthcare practices face a growing revenue cycle challenge as payers use AI to process and deny claims faster and more aggressively.
In this episode, host Sandy Vance chats with Rob Ware, the SVP & General Manager at ModMed, about the hidden cost he calls the "RCM tax" and how practices can use AI to fight back. They discuss the disconnect between clinical documentation and financial billing, how AI-powered scribes can improve the flow of information from the patient encounter into the claim, and why keeping a human in the loop remains critical for healthcare revenue cycle automation. Rob also explains how real-time AI can help practices identify denial trends faster, reduce administrative burden, and build a more agile financial infrastructure.
In this episode, they talk about:
- What the "RCM tax" really means and where revenue, time, and resources are lost throughout the billing process.
- Why gaps between clinical documentation, coding, and billing can lead to denials, lost revenue, and patient frustration.
- How AI-powered clinical documentation can capture information that might otherwise be missed and carry it directly into the revenue cycle.
- Why healthcare organizations need a human-in-the-loop approach to AI-powered billing, particularly when accuracy and compliance are critical.
- How provider organizations can use AI to respond to payer AI and identify denial trends in near real time.
- Why Rob believes fully integrated systems will ultimately outperform a collection of point solutions.
- The first practical step practice leaders can take to identify where their RCM tax is coming from and determine which tools can address it.
A Little About Rob:
Rob Ware serves as the Senior Vice President and General Manager of Revenue Cycle Management (RCM) at ModMed®. In this role, Rob leads the Business and Office Operations Services and Technology (BOOST) team and is focused on delivering a consistent, high-quality RCM experience to ModMed BOOST customers. Rob has spent more than 20 years driving strategic and operational improvement. Before joining ModMed, Rob served as the Senior Vice President and General Manager at Curae Finance, a fintech company that enables flexible patient payment options. Rob was responsible for post-sales operations and driving operational improvements, which included product strategy, implementation and service delivery processes, customer success management, and technology integration.
Prior to Curae, Rob was the Vice President and General Manager of RCM at Greenway Health, where he led the RCM leadership team to double the scale of the RCM business, while improving customer outcomes and KPIs. In the first half of his career, Rob was in private equity as a member of the operations team at Vista Equity Partners and held numerous consulting roles, where he focused on go-to-market strategy creation, merger and acquisition management, and process and operational improvements. Rob holds a Bachelor of Science degree in mechanical engineering from Cornell University and earned his Master of Business Administration degree from MIT Sloan School of Management.
