Off the Record with Brian Murphy

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 S...

At ACDIS 2026 I delivered an unofficial episode of Off the Record with my guest today: Tracy Ferro, Executive Director, System CDI for Medical University of South Carolina Health (MUSC). The “podcast” was delivered on stage, at the outpatient symposium. MUSC’s OP CDI program is new and being built in flight, and Tracy and I presented on it together, running the session a bit like an episode of #OT...

This country does a decent job in our primary schools working with children and young adults with special needs. Certainly many improvements have been made in the last 40-50 years.   But once neurodivergent kids become adults, that support seems to vanish.  Tami Gomez stepped into this large breach by launching the UC Davis Neurodiversity Coding Internship Program. This new program creates profess...

A lot has changed in the world of Faisal Hussain since he last went under the white-hot spotlight of the Off the Record podcast studios.  A new career path, with a new company.  Growing children, with whom he gets to spend more time.  A surprise award, bestowed by his college alma mater.  And many new changes in the CDI industry he continues to serve, including a new ethics paper and now a new phy...

We need a “human in the loop” in mid-revenue cycle work, experts say.  What they fail to answer is the more interesting question:   Where in the loop, exactly? Back-end AI fact-checker? Front-end query authorizer? Or, maybe something like my current OTR guest Penny Jefferson envisions:  Medical record maestro.   The end-to-end connectedness of the medical record, evolving API standards, increased ...

Payers are constantly shifting tactics to find new and creative ways to do their favorite thing: Not pay claims. And if you can’t deny? Downgrade!  We’re seeing a lot of new patterns and tactics on this front, especially on the Medicare Advantage/private payer side of the house. And so it was time to take a look at where we are on the state of denials, with just the right person: Richelle Marting...

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...

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...

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 foun...

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 whistleblow...

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...

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’...

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? N...

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 s...

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 g...

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 a...

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 an...

Many healthcare organizations know they need an outpatient CDI program, but are tripped up by the most fundamental question: What is the expected return on investment after a considerable upfront investment of time, human capital, training, and technology?  Discover the tangible impact of outpatient CDI on revenue, risk capture, provider alignment, and compliance in this special session of Off the...

If you’ve been in the CDI space for any length of time you probably know the name Fran Jurcak.  After a memorable stint as an ER/trauma nurse, CDI and then consulting, Fran made an impact in ACDIS, serving on the CCDS certification committee and later the ACDIS advisory board. She authored and continues to author the CCDS Exam Study Guide.   But what makes Fran unique is that she’s never afraid to...

Cheryl Manchenton and I go back a long way—I once took a ride from a Las Vegas casino to the airport with her after an ACDIS conference well over a decade ago. And I’ve learned over the years she also happens to be as sharp—and as outspoken—as anyone I’ve ever met regarding the subject of healthcare quality, specifically measuring hospital quality with coded or abstracted data and how it all relat...

Some of us dream of being able to say, “Thank you for Coming to my Ted Talk.” Others wilt at the thought of getting on stage to deliver not just a lecture on a complicated or sensitive topic, but a performance.   My guest today Dr. Chris Petrilli has delivered. My first Ted Talk alumni on Off the Record (of which I’m aware) recently presented How AI could help doctors detect patterns before a Ted...

I don’t know this with certainty, but I probably have more than one listener dreaming of starting their own business, in the mid-revenue or elsewhere. Others might be content in their current roles as CDI, coding, or mid-revenue cycle professionals, but are also looking forward to their big trip in August.  Today’s guest is living the best of both worlds.   Melanie Kiss started Chicas Abroad in 20...

For this week’s episode I’m bringing you something a little different, but of such importance that I had to share it with my Off the Record audience: The massive audit expansion of Medicare Advantage announced by CMS.  In case you missed it, CMS in May rocked the mid-revenue cycle industry with the unveiling of a startling mandate. It will hire 2000 medical coders, beef up its audit technology, an...

In 1990 the heavy metal band Queensryche asked its listeners, “Is there anybody listening?”, a lament for not being heard in a world of overstimulation, noise and artificially.   In healthcare in 2025, the answer is yes: someone is listening. But the listener just might be a machine.  Ambient AI is one of the most promising applications of the recent AI wave, in my opinion anyway and possibly that...

Regular listeners of Off the Record will recall Keisha Wilson, whom I hosted on the program in June 2024 to talk about telehealth as well as her story of entrepreneurship. She was a bright light and a great guest, so I asked her to return to the show a couple months ago.  Keisha accepted, and is here today, but it’s a near miracle.  Eight months ago Keisha suffered an unimaginable tragedy, the los...