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 that dominate near-term RCM roadmaps, 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. Her leadership throughline is consistent, involve the people doing the work, be transparent about the why, follow through on commitments, and build a culture where accountability and compassion coexist.
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 that dominate near-term RCM roadmaps, 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. Her leadership throughline is consistent, involve the people doing the work, be transparent about the why, follow through on commitments, and build a culture where accountability and compassion coexist.
"AI isn’t here to replace people, it’s here to elevate them to do the work that truly matters."
- Sandy Lood, Vice President of Revenue Cycle, Cottage Health
Guest: Sandra Lood, Vice President of Revenue Cycle, Cottage Health
Host: Praveen Chandran
Praveen Chandran (Host):
You’re listening to The RC Executive Lounge Podcast, the show where healthcare revenue leaders share real-world strategies, hard-earned lessons, and bold ideas shaping the future of revenue cycle management.
Hi everyone, welcome to another episode of The RC Executive Lounge Podcast. I’m your host, Praveen, and I’m really thrilled you’re all here.
Today, we’re honored to welcome Sandra Lood, Vice President of Revenue Cycle at Cottage Health. Sandra brings extensive leadership experience in healthcare finance and revenue cycle operations. At Cottage Health, she has been instrumental in improving patient access, strengthening revenue integrity, and driving innovation that balances financial performance with patient-centered care.
Her leadership reflects not only operational excellence but also a deep commitment to advancing the patient financial experience. Sandra has been recognized nationally for her contributions to the profession and was recently featured in the HFMA Member Spotlight. She is also an active thought leader shaping the future of healthcare and recently participated in the Women’s Disruptive Leadership Summit, where she shared perspectives on how AI is transforming revenue cycle management.
Sandy, welcome to the show.
Sandra Lood:
Thank you so much, Praveen. It’s truly a pleasure to be here today, and I really appreciate the kind introduction.
Praveen Chandran:
To start, we often talk with leaders about the pressures facing RCM teams today, from payer delays to staffing gaps. How do you go about setting your top strategic priorities, both looking ahead three years and in the next twelve months?
Sandra Lood:
It’s a great question. I really believe in setting priorities as a group effort. First, I align with our organizational leadership team. We have to be in sync on what we expect from revenue cycle and how we’ll deliver on those outcomes.
Healthcare organizations are managing growth, expansion, regulatory changes, and at the core, caring for patients. Revenue cycle must align with all of that. Once leadership alignment is in place, I bring the strategy back to my team.
The first thing we do is gather and understand our data. Data drives our decisions. We also spend a lot of time clearly defining the problem we’re trying to solve. It might be a people issue, a process issue, a technology gap, or something outside our control. Without that clarity, it’s easy to invest effort into initiatives that won’t have meaningful impact.
Collaboration is also critical. Even if we’re solving a patient access issue, I bring in voices from other teams like HIM. People outside the immediate workflow bring fresh perspectives and help avoid tunnel vision. This kind of collaboration leads to better problem-solving and builds stronger teams.
Finally, I prioritize quality over quantity. Revenue cycle leaders are constantly asked to do more with less, but if speed comes at the cost of quality, denials increase and patients suffer. Quality must remain at the center.
Praveen Chandran:
Leaders often have to say no to good initiatives because of constraints. Can you share an example of how you’ve handled that?
Sandra Lood:
Every year, we identify dozens of initiatives, sometimes more than sixty. We can’t do them all successfully. So we align projects to organizational goals, financial stability, and growth priorities.
We categorize initiatives into must-dos, revenue-generating projects, and nice-to-haves. When I say no, it’s often a “not right now.” We park ideas and revisit them later.
A great example is denials prevention. We wanted to launch a comprehensive denials prevention program, but once we started, we realized our reporting foundation wasn’t strong enough. Some denial codes weren’t mapped correctly. So we paused, fixed the fundamentals, and then returned to the initiative. That pivot was critical.
Praveen Chandran:
Denial prevention and patient financial engagement are major industry themes. How do these fit into your strategic roadmap?
Sandra Lood:
Denials prevention is a top focus. The key is understanding what’s truly preventable. Payer behavior has changed, and not everything we once considered preventable still is. We have to analyze the data carefully and take an incremental approach.
We also work closely with payers. In one case, we brought data showing we were an outlier in performance. Both sides came to the table collaboratively, identified issues, and resolved them. Within a few months, AR days improved significantly.
On patient financial engagement, I’m fortunate to work at an organization with a generous charity care policy. We never want patients to avoid care due to affordability concerns. We train front-office staff to have compassionate conversations and connect patients with financial counselors when needed.
We also offer interest-free payment plans and flexible terms based on patient needs. Importantly, we provide multiple ways for patients to interact, whether self-service or speaking with someone directly.
Our eligibility team has also done incredible work, converting uninsured patients to coverage through Medicaid or ACA plans. That work makes a meaningful difference for patients and the organization.
Praveen Chandran:
Can you share an initiative that didn’t go as planned and what you learned from it?
Sandra Lood:
Absolutely. We implemented an autonomous coding initiative, and it was a roller coaster. Outpatient coding is a great candidate for automation, but the implementation was more challenging than expected.
There was lack of clarity around scope, and the solution shifted from professional to hospital coding. AI is still new, and change can be intimidating. We underestimated the learning curve and the importance of defining success metrics upfront.
In hindsight, we also made things harder by carving out subsets of data instead of starting broader. The biggest lesson was the importance of clarity, scope, and change management.
Praveen Chandran:
What role do you see Agentic AI playing in revenue cycle management over the next few years?
Sandra Lood:
I always start with people. AI is here, and it’s part of everyday life. But you can’t just turn it on and walk away. AI won’t replace people, it will change how they work.
We need to upskill teams to focus on critical thinking and root cause analysis. Instead of manually fixing issues, staff can help design AI workflows that prevent problems entirely.
Clear communication is essential. Employees fear job loss, but the goal is to make work more fulfilling and impactful. AI can help accelerate clean claims and improve cash flow when implemented thoughtfully.
Praveen Chandran:
How do you build momentum for change in complex RCM environments?
Sandra Lood:
You must include the people doing the work. They understand workflows and where things will fail. Transparency matters. Explain the why, the expected outcomes, and follow through on commitments.
If leaders say automation won’t reduce FTEs, they must honor that. Trust is everything. Recognize team members who surface issues early and celebrate both wins and failures.
Praveen Chandran:
What advice would you give to other RCM leaders?
Sandra Lood:
Lead with compassion, but never lose sight of accountability. Create a culture where speaking up is expected. Celebrate together, make the journey fun, and build moments of joy at work. That’s how you unlock collective intelligence and integrity.
Praveen Chandran:
Sandy, thank you so much for joining us and sharing your insights. To our audience, thank you for tuning in to The RC Executive Lounge Podcast. Be sure to subscribe wherever you listen, and we’ll see you next time.