Off the Record with Brian Murphy – Détails, épisodes et analyse

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Off the Record with Brian Murphy

Brian Murphy

Business & Entrepreneuriat

Fréquence : 1 épisode/15j. Total Éps: 94

The only show where today’s top mid-revenue cycle leaders share the personal stories, struggles, and successes that you won’t hear on the big stage—but made them who they are today. Join host Brian Murphy as he interviews leaders and interesting personalities from HIM/coding, clinical documentation integrity (CDI), case management, and related healthcare fields about their origins, current challenges and successes, and lessons that you can apply to grow your own career.

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Chronic Conditions, Clinical Outcomes, and Risk Adjustment’s True North: Baylor Scott and White’s OP CDI story

Saison 5 · Épisode 94

mercredi 15 juillet 2026 • Durée 01:02:23

When you work deep in the hospital mid-revenue cycle there can be an unfortunate but understandable tendency to divorce your work from the patient. To become separated from clinical care and outcomes, and even, in the case of value-based care, from its intended objective of improving affordability and quality.

Those points are not lost on Dr. Sunita Varghees or Carrie Horn, who spearheaded an outpatient CDI program at Baylor Scott & White Health. One that is truly patient-centric and focused on reducing ER utilization and delivering the right level of service, not just the most profitable.

Listen in as we discuss:

Baylor Scott and White Health—Lay of the land of the organization and how and when they got started in outpatient CDI.
“Successful risk adjustment starts with the patient”--the why of OP CDI and how their work ties into chronic condition management, not just capture. We discuss KPIs and financial metrics, too.
New heart disease screening initiative—what it is, what it entails, and early successes.
Is knocking down ER visits and IP admissions and getting the right level of care at the right price at odds with hospital revenue gains? Are they making it up with shared savings or care funding?
Tech enabled/tech forward approach including ambient AI.
Biggest success and biggest do-over, if they could do it all over again.
What’s next on the OP CDI roadmap?
Favorite song for the Off the Record Spotify playlist...

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Beyond the Query: Cheryl Ericson and the case for clinical judgment in CDI (and life)

Saison 5 · Épisode 93

mercredi 1 juillet 2026 • Durée 54:54

Cheryl Ericson is a veteran, in every sense of the word. Someone who has seen and experienced a lot in the CDI profession—and so has a wealth of knowledge and wisdom to confer.

I go back a long way with Cheryl, to early ACDIS days when she was the lead educator of the CDI Boot Camp and developed the organization’s educational curriculum. She’s had a few stops since then but settled in nicely as Senior Director of Clinical Policy and Education at The Brundage Group.

Cheryl is a shrewd, incisive observer of the CDI field, with a rich history of where we’ve been but also where we need to go. Recently she’s weighed in on some big mid-revenue cycle topics for ICD-10 Monitor which I read with avid interest (and recommend you do too).

In this week’s episode we hit on a few of those topics, along with a bit of a look into her life and career. Listen in as we discuss:

Formative background in nursing and entry point into CDI at MUSC.

Thoughts on the new/2026 ACDIS/AHIMA query brief (currently in draft stage)--concerns with clinical indicators, her belief they are unique to each patient and may not meet guidelines established by payers: “It is not about determining if a condition exists; it should be about deciding if the physician has a reasonable expectation to treat the condition,” she writes. “Rather than asking if the condition exists, CDI and coding professionals should determine if it ‘was it reasonable for the provider to diagnose and treat the condition as if it exists.’”

Pushing query compliance down to the end user—is this how the new brief reads, and if so, is it a fair expectation?

Artificial intelligence: State of current tools and limitations. “GenAI tools show great promise in many areas, but for now, it does not appear capable of performing the type of complex critical thinking required for accurate inpatient coding and billing,” Cheryl observes.

(Incorrect) payer allegations of hospital “upcoding,” using the example of acute blood loss anemia

ACDIS heydays: A look back on teaching and educating.

Her personal health journey, story of breast cancer and her husband’s simultaneous serious illness, and how it transformed her outlook on life.

Sharing wisdom and lessons learned: Career advice to a new or young CDI professional—what has she learned to pass along to the next generation?

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A reckoning for Medicare Advantage: Inside the Kaiser case with Mary Inman and Liz Soltan

Saison 5 · Épisode 84

mercredi 11 février 2026 • Durée 52:04

Medicare Advantage is undergoing a reckoning ... and that reckoning is coming from within.

In January Kaiser Permanente affiliates agreed to pay $556 million to resolve allegations that it violated the False Claims Act by submitting invalid diagnosis codes for their MA Plan enrollees in order to receive higher payments from the government.

The case was instigated by what is known as whistleblowers.

Regular listeners might recall my podcast on this topic back in January 2025 with Mary Inman, a Partner at Whistleblower Partners LLP, and Head of International Whistleblower Practice for the firm. We had a fascinating conversation about the process of whistleblowing and New York insurer Independent Health, which agreed in December 2024 to pay $100M to settle allegations it had upcoded claims to inflate MA payment.

We’ve now more than 5x-ed that fine with Kaiser. Per the Department of Justice the claims resolved by the settlement are allegations only and there has been no determination of liability. But it was a major wakeup call for MA.

Mary is back for today’s show along with her colleague Liz Soltan, a senior associate in the firm’s NYC office. Listen in as we discuss:

Key terms: What is whistleblowing and the concept of qui-tam?

Kaiser case origins which began more than 12 years ago, and Mary and Liz’s evolving roles in the case

The facts on the ground, as alleged by the whistleblowers and the DOJ, specifically the issue of addenda to the medical record

Unfolding of the case, a behind the scenes look as new whistleblowers joined, and reaching of the settlement

What can we learn from a medical coding/reimbursement perspective?

What can healthcare organizations do to ensure their employees don’t blow the whistle and avoid similar fines and headlines?

From Encephalopathy to Edema: Talking chart review with Dr. Tarman Aziz

Saison 5 · Épisode 83

mercredi 28 janvier 2026 • Durée 55:23

I’m consistently surprised at how few CDI or IP coding professionals talk about their most basic job function. The very reason they are hired, and what most do for eight hours a day:

I'm talking about chart review.

Go on Linkedin or Facebook and it’s rarely discussed.

Yet it’s ... everything. Nuanced, complex, clinical, critical to the quality of financial health of hospitals. It’s how patient acuity is expressed in coded data, how hospitals get paid, and why CDI and coding professionals are employed.

I’ve heard it described as akin to detective work, puzzling together the pieces and presenting an informed query to the provider. Yet like detective work it often remains a mystery.

Dr. Tarman Aziz joined me to open up that conversation. He is founder and CEO of CDIQ Consulting, LLC, a physician-led healthcare education and consulting firm focused on closing the gap between clinical reality and coded data. On this episode of #OTR we discuss:

Is chart review unique to the individual/healthcare organization/assistive tech, or are there underlying principles everyone can follow?
How evolving clinical indicators in a case drive a concurrent CDI workflow—the differences of reviewing a chart at 24 vs 72 hours as clinical indicators morph
How early is too early to look at an inpatient chart?
Underutilized and underrated areas of the health record
Review strategies for encephalopathy, dehydration, hyper- and hyponatremia, and cerebral edema/compression
Tarman’s work consulting and educating non-traditional CDI candidates
The remarkable story of Tarman’s fiancé Anna, an 11-year survivor of Stage 4 breast cancer

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From Risk to Revenue Clarity: How One Health System Transformed OP CDI Performance

Saison 5 · Épisode 82

mercredi 14 janvier 2026 • Durée 57:21

And we’re off! The first episode of #OTR of 2026, From Risk to Revenue Clarity: How One Health System Transformed OP CDI Performance.

I continue to beat the drum of outpatient CDI because I believe in it.

Risk adjustment and capitated payments are a superior reimbursement mechanism than fee-for-service. Certainly not perfect, but I believe they are better aligned with keeping patients healthy.

It’s also an exciting new avenue for CDI and coding professionals to work.

Making it work isn’t easy. Success requires new workflows, new metrics, and an even greater level of physician education/buy-in than acute care settings.

We get into all of this on today’s show.

My guest Jason Jobes, SVP of Norwood Solutions, is a whiz when it comes to value-based care, you will be hard-pressed to find a more informed speaker.

Note: You can download the slides referenced on the show here, though they are not needed.

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Closing out 2025 with its biggest story: Artificial intelligence

Saison 4 · Épisode 81

vendredi 19 décembre 2025 • Durée 20:32

Here we are, our last episode of Off the Record this year.

I hope you’ve had a great 2025.

Just my voice today.

I’m ending with a solocast, a reading/summary of a paper about the biggest news story of the year: The explosive growth and proliferation of artificial intelligence, or AI.

You might recall my poll from a couple weeks ago; you all confirmed it.

Where do people fit with this tech? None of us really know, but I offer my opinion here.

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Outpatient OG: Amy Campbell on Pre-Visit Reviews, Pet Peeves, and People Management

Saison 4 · Épisode 80

vendredi 5 décembre 2025 • Durée 55:54

Outpatient CDI is still in its pioneer-”ish” stage. Why do I say that? Per the most recent ACDIS survey data, only 31% of respondents indicated their organization had a dedicated OP CDI program.

Progress, but not enough, and still a minority.

So when you find an “OG” who has been working in risk adjustment for well over a decade, you need to pay attention. Odds are they’ve got some lessons to share and wisdom to confer. That certainly describes Amy Campbell, Director of Outpatient CDI for LifePoint Health.

Listen in as we discuss:

“Building the airplane as we were flying...” Her start and early days in OP CDI.

A “day in the life of” her role as OP CDI Director today for a large and growing healthcare organization

Dashboard for success and most impactful/important KPIs

Manual chart reviews (yes, they do this—no assistive tech). What does a pre-visit review look like/how is it conducted, and what common clarifications and dx opportunities are her team finding?

Rapid fire round: Biggest OP CDI pet peeve (a doozy), RN vs. HIM staffing decisions, and the hardest part of managing people

Interesting career stops, from critical care nurse and neurological intensive care nurse, to consulting, to content reviewer for Lippincott.

Being a mother of an adult child with autism

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From Resistance to Results: Provider engagement from the front lines

Saison 4 · Épisode 79

lundi 17 novembre 2025 • Durée 40:29

No matter how great your CDI program is—its spectacular workflow, outstanding chart review team, on-point KPIs, shiny new AI tools—nothing works if you don’t have engaged physicians.

It still all comes down to provider engagement. Without a physician staff who is bought in and willing to participate and document with specificity in the health record, all these efforts are for naught.

But with great engagement, great things are possible.

So where are we today with the big daddy of all CDI topics? Joining me on this episode of #OTR are two physicians with considerable experience and plenty of war stories. Trey LaCharite, Medical Director for CDI and Coding and Clinical Associate Professor for University of Tennessee Medical Center, and Vaughn Matacale, director of the physician advisor group for ECU Health in North Carolina, open up for a frank, no-holds barred discussion on the following topics:

What is overrated when it comes to provider engagement--and what is underrated?

The best high-tech solution each recommends, and a great low-tech solution that stands the test of time.

An ultimate success story winning over a difficult provider or service line.

Notable failures others can learn from.

RUSH reunion tour in 2026—yay or nay? Spoiler alert: Of course the answer is yes...

And other fun stuff you really shouldn't miss...

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Coaching Clinicians, Convincing Crowds: Susanna Baddiel on Delivering Impactful Presentations

Saison 4 · Épisode 78

mercredi 29 octobre 2025 • Durée 39:11

Fans of Off the Record may recall my recent episode with Chris Petrilli, Director of Revenue Cycle of Operations at NYU Langone, who joined me to discuss his experience delivering a TEDx Talk on artificial intelligence.

Chris was well prepared and delivered a great lecture, which you should definitely check out on YouTube. And on the podcast he sang the praises of a coach brought in to prep him and other NYU Langone staff for the big day on the big stage.

My wheels started to spin, I reached out... and landed that coach for OTR.

Susanna Baddiel is an actress, director, voice over artist and TEDx Speaker Coach. She works in both the UK and the US and is a founder member of Actors Shakespeare Company where she continues to act, direct and coach. She has more than 17 years of experience teaching public speaking, personal impact, presentation skills, leadership development, and executive coaching.

It was my honor to host her in a bit of an offbeat show than the usual mid-revenue cycle topics. But I picked up a few pointers about public speaking that helped me, and I think you will too.

This special episode kicks off November, a month in which I’ll be taking a deep delve into provider engagement. Odds are if you’re trying to engage providers you’ll have to present or educate, and Susanna offers some great advice and practical tips and takeaways.

On this show we cover:

Her background as an actress in Britain, transition into coaching, and eventually working with niche clients in science and medicine

Working with the team at NYU and Chris Petrilli—preparing them, building them up, and getting them ready for the big day.

Why preparation is everything in public speaking, as is gratitude for the opportunity

Balancing authenticity vs. general principles of good presentation

The differences between in-person and presenting on camera. Susanna offers some GREAT suggestions for being better on Zoom.

Documentation with a Pulse: Erin Kreider on ethics, CDI advocacy, and ambient listening

Saison 4 · Épisode 77

mercredi 15 octobre 2025 • Durée 54:15

Erin Kreider gives me hope for the future of the CDI profession. That’s a pretty positive first impression for someone I recently met. Why do I say this?

Erin is a newly-minted clinician who returned to medical school after nursing and CDI to become a nurse practitioner (NP), and now sees patients once a week. Her “welcome mat” on LinkedIn lists her core passions, which include clinical honesty and ethical integrity in the final code set, advocating for patients’ rights and best interests, and education and thought leadership.

Today the majority of her work is with a technology company, Ambience, where she is helping build out ambient listening technology that assists with documentation and coding.

Prior to that she had lengthy stop at Kettering where she was a CDI professional and a case manager.

How’s that for achievement—and purpose?

We get into all this on this episode of Off the Record, covering:

Erin's first day on the job as an NP and what becoming a clinician taught her about documentation/coding/the mid-revenue cycle that she didn’t know or fully appreciate prior.
CDI in the ED: Missed opportunity to improve documentation for admitted patients and strengthen Medical Decision Making (MDM)
Best practices for leveraging APPs: Support system for MD physician advisors, second level chart reviews, educators, and more—a topic she recently wrote about for ACDIS’ CDI Journal
UR/UM synergies with CDI and coding
CDI pet peeves: Queries for the sake of metrics, and perception of CDI as an easy retirement job for fatigued bedside nurses
How ambient listening can help with documentation, provider burnout, and surface additional missed diagnoses/HCCs

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