Megan Struxness is Head of Payer Operations and Revenue Cycle Management at Bridge, a healthcare platform that helps telehealth providers accept insurance nationwide.

In this episode, Megan and Zack discuss payer enrollment – the industry term for what healthcare providers need to do to accept insurance.

They cover payer contracting, credentialing, what superbills are, how out-of-network claims work, and how small operational details – like enrollment and eligibility checks – determine what providers actually get paid.

Watch on YouTube: Click here to watch a video of this episode.

• (00:00) - Intro
• (00:27) - What is Bridge?
• (02:20) - How Bridge helps providers accept insurance
• (04:36) - Can a brand new practice work with Bridge?
• (07:31) - What is an EMR?
• (10:27) - What it takes for a provider to accept insurance
• (13:15) - What are super bills?
• (15:41) - How out-of-network payments work
• (18:35) - What is payer enrollment?
• (22:41) - The alternative to self-managing revenue cycle management (RCM)
• (28:50) - How does Bridge onboard providers in 45 days?
• (32:44) - What are MSOs?
• (37:05) - Why eligibility checks can’t guarantee payment
• (41:42) - What is guaranteed payment?
• (44:48) - The source of truth for provider contracts
• (51:36) - What would Megan change about RCM?

Learn more about Bridge: https://www.usebridge.com/
Connect with Megan on LinkedIn: https://www.linkedin.com/in/megan-struxness-79962866/

Referenced in the episode:
- "Reality has a surprising amount of detail" by John Salvatier: http://johnsalvatier.org/blog/2017/reality-has-a-surprising-amount-of-detail

---

Listen and subscribe to the Understanding Healthcare with Zack Kanter podcast:
YouTube: https://www.youtube.com/playlist?list=PLZ4o7H5Som0Zlo2dGH4jMJy0nlL1oqxDo
Spotify: https://open.spotify.com/show/6cyz5JaAoG3R995QokLR2d
Apple Podcasts: https://podcasts.apple.com/podcast/understanding-healthcare-with-zack-kanter/id1860618431
RSS feed: https://feeds.transistor.fm/understanding-healthcare-with-zack-kanter