Why Autonomous Outpatient Coding Was Harder Than Expected

Shaping the Future of RCM: Leadership Lessons and Vision

Sandra Lood · Vice President of Revenue Cycle, Cottage Health

Sandy Lood shares a practical operating approach for how revenue cycle leaders set priorities in an environment defined by growth, regulatory pressure, and constant execution tradeoffs. She explains why alignment with executive leadership comes first, followed by disciplined problem statements and data-driven prioritization that focuses on quality, not volume, to protect both patient experience and downstream denials. The conversation goes deep on two strategic fronts: denial prevention and patient financial engagement. Sandy outlines how to move from denial management to denial prevention by fixing foundational reporting and remittance mapping, then choosing a focused starting point by payer, department, or root cause. She also describes how organizations can lead with compassion while building reliable financial assistance and payment plan workflows that reduce friction for patients with high-deductible coverage. Sandy closes with a candid implementation lesson from autonomous outpatient coding, highlighting the importance of clear scope, defined success metrics, and realistic change management when introducing AI into revenue cycle operations.