AI feels like a bubble. A bubble that keeps expanding until it fills the entire room—including the Off the Record podcast studio.

I remain bullish about some aspects of this game-changing technology and intensely skeptical of others. Which makes it a fascinating topic. Worthy of a fascinating guest, who not only has opinions but has real-world applications for the tech you might not have thought of.

Sharon Easterling has a towering, all-consuming passion for AI, specifically bridging the gap between technology and the mid-revenue cycle and navigating a technological future that can seem overwhelming. But she also leans into its creativity. She even sent me a new OTR podcast jingle created with AI! You can hear it on this episode.

Listen in as we discuss:

• Who is Sharon Easterling, “Fractional AI Governance and Enablement Executive | AI and Digital Transformation Leader”?

• Are we lost in the wild west of AI? Coders are using ChatGPT to code and pass certification exams, and employers screening employees with AI bots.

• How much has AI actually penetrated the mid-revenue cycle, use-wise? Can ChatGPT code? Will AI applications replace people?

• Where AI ais ctually making a tangible difference in the mid-revenue cycle: Denials management, surfacing diagnostic indicators, writing appeals letters, and more

• Some out-of-the-box suggestions of using AI in your daily workflow: From monitoring coding productivity to sending daily education to your inbox.

• How Sharon thinks people should view AI more broadly.

Referenced on the show: Sharon’s article “The Medical Record: How Artificial Intelligence (AI) Impacts Coding”: https://icd10monitor.medlearn.com/the-medical-record-how-artificial-intelligence-aiimpacts-coding/

In a day and age where we’re too often looking in the mirror and focused on our own problems and successes, Tiara Minor is all about empowering others.

As the Director of CDI for University of Miami Health system Tiara makes things happen for her team, because she’s all about sharing her expertise and education, growing her staff, and now the CDI profession itself. She’s giving back on the broader stage as an ACDIS advisory board member, conference speaker, and now biggest achievement—guest on Off the Record.

(I wrote that last one with a straight face, barely).

One of the things that impressed me about Tiara was her observation that most training seems to be geared for CDI leaders. Her focus is on her staff, making sure that they have not just mastered the fundamentals of chart review, but also clinical nuances across service lines.

We get into education, mentorship, and more on today’s episode. Listen in as we cover:

• Tiara’s broad responsibilities and a typical day in the life
• System focus, CDI metrics, and dashboard
• Her nontraditional journey into CDI--ER nurse to pediatrics, a foray into consulting, and return to the hospital setting. And winning over some skeptical coders along the way...
• Mentorship: Growing her staff and how she differentiates mentorship that from management.
• Her role as educator and an example of an interesting clinical query/quality opportunity she presented to the team
• An ACDIS splash—getting elected to the advisory board, winning both an individual award (recognition of professional achievement) and an organizational award (Diversity in CDI), and the speaking circuit.

This year has been something of a reckoning for Medicare Advantage. Senator Grassley’s scathing report of UHG’s risk adjustment practices, and the Kaiser $556 million settlement to resolve False Claims Act allegations of upcoding, opened eyes, and got many in the industry talking.

I wanted to get someone on the show with opinions, unafraid to speak their mind and share their perspective.

I’ve found that person.

Betty Stump is Senior Solution Consultant for Edifecs, a Cotiviti Business. She is in the business of risk adjustment and value-based care on the vendor side, but is never afraid to offer her opinion on the industry, pro and con. And with more than 20 years in the industry across multiple well-known companies, it’s an informed one.

Listen in as we discuss:

• What is working in value-based care/risk adjustment—and where have we gone wrong? Recent conference disillusionment.
• Kaiser DOJ fine and the Grassley report taking aim at UHG’s aggressive risk adjustment strategy: Betty’s thoughts and where does this heightened era of scrutiny put risk adjustment coders. Do we need to elevate the MEAT standard?
• What are organizations missing with risk adjustment?
• Great, practical, low-tech suggestions for RAF capture including using your 2025 end-of-year roster to identify those patients with high-risk conditions and engage in proactive outreach to get patients seen.
• V28 of CMS-HCCs with V24 in the rear-view mirror.
• Truthful tech talk: How leaders can get a seat at the table, how to get a vendor’s ear to modify functionality, and truth and hype in CDI tech
• How should a CDI or coder interact with a machine prompt from a suspecting tool?
• Looking back at a colorful 20-year career in the consulting life, and a thoughtful selection for the Off the Record Spotify playlist by a fellow music enthusiast.