She billed me $902 for a two-second X-ray. The insurer pays $78.

In this episode of Broken Healthcare, Ray Kober sits down with Dr. Dana Mincer DO - physician, Direct Primary Care founder, and certified yoga instructor - to break down what really happens when a doctor becomes a patient and gets the bill.

Dana slipped on the ice on New Year's Eve, fractured her elbow, spent an hour in the ER, saw a PA for 7 minutes, and never met a physician. The bill? Over $3,300. She brought slides.

In this episode:

→ The itemized bill from Sentara Health - and what insurers actually pay for the same procedures

→ Why a physician was billed who never walked into the room - and what happened when Dana called to dispute it

→ How CPT billing codes work and why hospitals always bill at the highest possible level

→ Why the chargemaster means the same procedure has hundreds of different prices at the same hospital

→ Why most US hospital systems are for-profit organizations operating under nonprofit status

→ How auto-adjudication works - and why insurance companies are blindly paying claims nobody is reviewing

→ Why self-funded employers using United, Cigna or Aetna as their TPA are paying full retail. Always.

→ What PREVENT Consent is and why you should know it before you ever need an ER

→ How to cite EMTALA - and why it immediately changes the conversation with hospital administrators

→ Why by 2035 healthcare premiums could exceed 50% of annual household income

→ What Direct Primary Care actually looks like - same day appointments, your doctor's cell phone, no insurance billing

→ Why Ray is now 3 months alcohol-free - and what Dana thinks about it as a physician who ran an addiction medicine center

Plus: less than 400 food additives are approved in Europe. The US has over 10,000. They get into that too.

If you're an employer, a CFO, an HR Director, a patient, or just someone who has ever been shocked by a medical bill - this episode was made for you.

🔗 Love Health DPC: LoveHealthDPC.com

📱 Dana's Instagram: @drdanalovehealth

🎙️ Subscribe to Broken Healthcare: youtube.com/@BrokenHealthcarePodcast

Timestamps:

0:00 Introduction & How Ray and Dana Met

4:37 Ray's Magic Mushroom Experience & Sobriety

9:06 Dana's Response as a Physician & Addiction Medicine

13:56 The Vibroacoustic Table & Teaching the Body Calm

22:06 Hospital Consolidation & Energy Medicine in Practice

26:00 The Broker Problem & How Insurance Incentives Work

30:11 Nonprofit Hospitals Masquerading as For-Profits

33:00 Food Additives, Glyphosate & RFK Jr.

50:35 Dana's New Year's Eve ER Visit - The Story Begins

1:01:00 The Bill Arrives - What She Expected vs Reality

1:07:00 CPT Codes Explained & How Hospitals Maximize Billing

1:17:10 What Insurers Actually Pay vs What You're Billed

1:23:01 The Sentara Numbers Revealed - The Real Data

1:30:00 How Self-Funded Employers Pay Full Retail

1:37:00 How to Challenge Your Bills & Independent Auditing

1:44:00 PREVENT Consent, EMTALA & Your Patient Rights

1:57:00 Direct Primary Care Explained - The Alternative

2:03:50 Love Health DPC & How to Find Dana

#BrokenHealthcare #DrDanaMincer #HospitalBills #HealthcareBilling #MedicalDebt #HealthcareTransparency #DirectPrimaryCare #DPC #HealthSharing #EMTALA #HealthcareCosts #CFO #EmployerHealthcare #NonprofitHospitals #PriceTransparency #Podcast

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Yeah, this one's different.

No guests. No healthcare policy. No claims data. Just me, sitting down and talking about something I've never talked about publicly before.

For years, a couple of drinks at the end of the day was just part of life. Business dinners, networking, winding down. A few glasses of Don Julio. Nothing dramatic - just a quiet daily habit that, somewhere along the way, became more than I wanted it to be.

A guided psilocybin journey changed that. And I haven't had a drink in over two months.

I'm not a doctor. I'm not here to tell anyone what to do. This is just my story - and I'm sharing it because I think too many people, especially in business, are carrying things they don't talk about. The shame around that needs to stop.

In this episode I talk about the months of preparation before the journey, what the experience actually felt like, the memories that surfaced - including seeing my dad, who passed away when I was two years old, and reliving the hardest conversation I ever had with my kids, but this time through their eyes. I talk about what changed after. The calm. The presence. The fact that I just... stopped thinking about drinking.

I also talk about what my doctor said when I told him. That part stuck with me.

This isn't a healthcare episode. It's a human one. If it helps one person feel less alone - that's why I recorded it.

⚠️ Not medical advice. Psilocybin can be dangerous for people with certain mental health histories or on specific medications - please speak to a medical professional before considering anything like this, and check the legal status in your area.

brokenhealthcarepodcast.com

youtube.com/@BrokenHealthcarePodcast

linkedin.com/in/raykober/

#BrokenHealthcare #Psilocybin #MagicMushrooms #MentalHealth #PsychedelicTherapy #Sobriety #PersonalGrowth #RayKober #MensHealth #Healing

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Your healthcare claims have an error rate of 8 to 12%. Most employers have no idea.

In this episode of Broken Healthcare, Ray Kober sits down with Stephen Carrabba - CEO and Co-Founder of Claim Informatics - to break down what's really happening behind the scenes in healthcare claims, payment integrity, and fiduciary oversight.

Stephen's team recently found $7.4 million in improperly paid claims for a single client. In two months. At a 10.9% error rate.

And the fix isn't complicated. It just requires someone with no conflicts of interest to actually look.

In this episode:

→ Why 8-12% of healthcare claims are paid incorrectly

→ The "sub $15,000" TPA story that should make every CFO furious

→ Why the shared savings model creates perverse incentives and what Claim Informatics does differently

→ How AI is being used to analyze 15,000 pages of contracts and find violations hiding in plain sight

→ Why combining two clauses on page 1 and page 111 of your ASO can legally authorize spread pricing — and nobody catches it

→ The fiduciary exposure every plan sponsor is carrying right now

→ Why post-payment recovery gets harder over time and why prepayment is the smarter play

→ What Marilyn Bartlett found when Montana finally just asked some simple questions ($113 million, as it turns out)

→ Why "garbage in, garbage out" applies to AI - and why building a real system took 8 months

If you're an employer, CFO, HR leader, broker, TPA, or benefits consultant.. this episode will change how you think about every claim your plan has ever paid.

🔗 Claim Informatics: claiminformatics.com

📊 Independent assessment for employers: benefixa.com/#consult

🎙️ Subscribe to Broken Healthcare: youtube.com/@BrokenHealthcarePodcast

Timestamps:

0:00 Why Healthcare Claims Feel Broken

2:12 How Stephen Got Into the Space

5:10 From Pharma Audits to Claim Informatics

8:20 Why Medical Claims Are More Complex

11:35 The Broker and TPA Problem

14:20 What Changed After the CAA

17:10 Why Data Access Matters

20:20 How Claims Are Audited

23:35 Prepayment vs Post-Payment

27:00 Real Savings at Scale

30:15 How Their Fee Model Works

33:20 Why Shared Savings Creates Conflicts

36:40 Independent Oversight and Fiduciary Risk

40:05 Why Recovery Gets Harder Over Time

43:10 How Much Money Gets Missed

46:20 Why Contracts Matter

49:30 The AI Layer

53:05 What Employers Should Demand

57:00 Final Thoughts

#BrokenHealthcare #HealthcareClaims #ClaimInformatics #StephenCarrabba #PaymentIntegrity #ERISA #CAA #FiduciaryDuty #HealthcareTransparency #AIinHealthcare #EmployerBenefits #HealthcareCosts #TPA #SelfFundedHealthcare #Podcast

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Katy Talento joins the show in-studio to share her unique journey from religious life to advising on healthcare policy at the highest levels of government - and what she believes it will take to fix the U.S. healthcare system.

With a background in epidemiology, public health, and federal policy, Katy brings rare insight shaped by her experience working in the U.S. Senate and advising on healthcare issues at the White House. Her career spans global public health work, infectious disease research, and shaping national healthcare policy that impacts employers, patients, and the broader healthcare system.

In this conversation, Katy shares how her early desire to change the world led her into public health, policy, and ultimately into healthcare reform efforts in Washington. She explains how incentives inside the healthcare system influence decision-making, why meaningful reform can be difficult to achieve, and why healthcare costs continue to rise despite ongoing policy changes.

We also discuss how employer-sponsored healthcare plays a central role in the U.S. system, why prevention-focused models such as Direct Primary Care (DPC) are gaining attention, and how transparency may help improve healthcare outcomes over time.

Subscribe for more conversations focused on improving healthcare outcomes and fixing the broken healthcare system.

#HealthcareReform #HealthPolicy #HealthcareCosts #DirectPrimaryCare #EmployerHealthcare #HealthcareInnovation #HealthcareLeadership #HealthInsurance #PublicHealth #HealthcareTransparency

00:00 Intro

00:23 Welcome Katy Talento

01:30 Early life and desire to change the world

04:30 Faith journey and decision to enter religious life

08:00 Global public health work and infectious disease research

12:30 Working internationally in public health

16:00 Entering Washington health policy

20:00 Writing healthcare legislation in the U.S. Senate

24:00 How healthcare policy is shaped in Washington

29:00 Speechwriting and political communications

32:30 Industry influence in healthcare policy

36:00 Why healthcare reform is difficult to achieve

40:00 How incentives influence healthcare decisions

45:00 Employer-sponsored healthcare and system complexity

52:00 Insurance incentives and unintended consequences

58:00 Why healthcare costs continue to rise

1:05:00 Transparency and accountability in healthcare

1:12:00 Direct Primary Care and prevention-focused models

1:18:00 Where meaningful reform may come from

1:25:00 The future of healthcare policy

1:31:00 Final thoughts on fixing U.S. healthcare

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Emma Fox joins the show in-studio to explain why healthcare costs keep rising and how incentives inside the traditional health insurance system often work against employers and patients.

Drawing on her experience inside the industry, Emma breaks down how compensation structures, carrier incentives, and consolidation influence employer-sponsored healthcare decisions. She explains why more organizations are exploring self-funded health plans, independent TPAs, direct primary care, and reference-based pricing as alternatives to traditional insurance models.

We also discuss how collaboration between employers, advisors, and physicians can help create more transparent healthcare strategies, and why education initiatives like Symposium are helping drive innovation across the healthcare ecosystem.

If you are an employer, advisor, HR leader, or healthcare professional trying to better understand rising healthcare costs, this conversation offers practical insight into how the system works and where change may happen.

Subscribe for more conversations focused on improving healthcare outcomes.

#HealthcareCosts #SelfFundedHealthPlans #HealthInsurance #EmployerBenefits #HealthcareInnovation #HealthcareTransparency #DirectPrimaryCare #ReferenceBasedPricing #BenefitsStrategy #HealthcareReform #TPA #HealthcareEconomics #HealthcareLeadership #BUCAIncentives

00:00 Intro

01:10 Emma’s journey from the UK to U.S. healthcare

03:00 Starting in life insurance and entering the insurance industry

08:30 Understanding health insurance incentives

12:00 Ethical conflicts inside traditional insurance models

15:00 Advisor compensation structures and industry challenges

18:00 Capitalism and healthcare economics

21:00 Government influence and healthcare policy realities

23:00 The employer’s role in fixing healthcare

27:00 The origin of Symposium

30:00 Bringing employers, advisors, vendors, and physicians together

32:00 Why physicians must be part of the healthcare conversation

35:00 Private equity and healthcare delivery challenges

38:00 Collaboration between doctors and advisors

42:00 Purpose-driven advisory models

45:00 Vision for improving the healthcare system

52:00 Advice for employers evaluating healthcare strategies

58:00 Industry collaboration and future outlook

1:04:20 How to connect with Emma Fox

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Tim Organ, CEO of the Health Business Growth Collective, joins the show in-studio to discuss why the traditional healthcare system focuses on symptoms instead of root cause - and how functional medicine is changing the future of patient care.

Tim shares his personal health transformation, including reducing body fat, optimising metabolic health, increasing protein intake, and improving longevity through lifestyle changes. He explains how functional medicine identifies underlying causes of illness, why regenerative therapies may reduce the need for surgery, and how practitioners are building independent health businesses outside the insurance model.

We also explore AI-driven healthcare tools, preventative testing, and why the future of medicine may be more personalised, data-driven, and focused on long-term health outcomes.

📌 Subscribe for more conversations on fixing the broken healthcare system.

#FunctionalMedicine #Longevity #RootCause #MetabolicHealth #PreventativeHealth #RegenerativeMedicine #HealthcareInnovation #Biohacking #HealthOptimization #FutureOfHealthcare #Wellness #AIHealthcare

01:00 Tim Organ & Health Business Growth Collective

04:20 Personal health transformation & body composition changes

07:00 Protein intake, diet tracking & metabolic health

10:00 Lifestyle habits & fitness discipline

13:30 Longevity fundamentals: exercise, diet & sleep

16:30 Functional medicine vs symptom-based healthcare

20:00 Finding the root cause of chronic illness

23:00 Tim’s healthcare career journey

27:00 Digital healthcare systems & medical technology

29:30 Why practitioners are leaving insurance-based models

33:00 Challenges doctors face inside traditional healthcare

36:00 Regenerative medicine vs surgery

41:00 Why many orthopaedic procedures may be avoidable

45:00 AI in healthcare & interpreting lab data

48:30 Expanding access to functional medicine

51:00 Food systems, nutrition & chronic disease

54:00 Personal responsibility & preventative health

57:00 The future of personalised medicine

1:02:00 Business models for modern practitioners

1:07:00 Technology & data-driven health insights

1:12:00 Longevity mindset & maintaining muscle as we age

1:17:00 Final thoughts on fixing broken healthcare

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David Slepak & Caleb Parker (Angle Health) on fixing the broken U.S. healthcare system.

Why do healthcare costs keep rising? Why do employers feel stuck? And what would it actually take to fix the experience?

In this episode of Broken Healthcare, we break down what’s really driving costs, what most plans get wrong, and how smarter design + technology could reshape employer healthcare.

#BrokenHealthcare #AngleHealth #HealthInsurance #EmployerBenefits #HealthcareCosts #HealthcareInnovation #AIinHealthcare #Podcast #BenefitsConsulting #HealthcareLeadership

0:00 Why Healthcare Feels Broken

1:02 From State Farm to Fixing Healthcare

5:02 What Makes Angle Health Different

7:02 Bad Benefits vs Bad Experiences

11:00 The Tech + AI Advantage

16:00 Why Speed Wins in Healthcare

21:00 Palantir Roots & Data Strategy

24:30 Why Costs Keep Exploding

30:00 The Insurance Card Problem

34:30 Fixing Friction in Healthcare

40:00 Guiding Patients to Better Care

44:00 Why Legacy Carriers Struggle

49:00 Incentives That Actually Work

57:00 The Truth About Pharmacy Spend

59:30 Final Thoughts

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Sanju Sriram on fixing one of the most overlooked problems in business: IRS compliance.

Why do so many companies miss required filings? Why are IRS forms so difficult to understand? And what would it take to simplify a system that frustrates even experienced professionals?

In this episode of Broken Healthcare, Ray sits down with Sanju — CEO of Simple Tax Suite — to talk about her journey from Silicon Valley gaming engineer to building an IRS-authorised platform that has processed more than 5 million filings.

🔗 Learn more: https://simple720.com/ - Use code BROKEN for 10% off

#BrokenHealthcare #TaxCompliance #IRS #Fintech #HealthcareCompliance #EmployerBenefits #CFO #BusinessFinance #Startup #Podcast

0:00 Intro + Why IRS Compliance Confuses Businesses

2:05 Sanju’s Background (Gaming + Engineering Journey)

5:10 How She Got Into Tax Technology

7:15 The Moment IRS Forms Didn’t Make Sense

10:05 Partnering With the IRS

13:10 Identifying the Compliance Gap

16:00 What Businesses Get Wrong About Reporting

19:30 What Is PCORI (Explained Simply)

23:15 Who Needs to File + Deadlines

27:00 Why Companies Miss Required Filings

30:10 Paper Filing vs Electronic Reality

33:20 Avoiding Penalties & Getting It Right

37:10 Forms Explained (720, ACA, 5500, 5330)

41:45 Working With Brokers, TPAs & Employers

46:30 Small Businesses vs Enterprise Clients

50:10 AI + Automation in Compliance

54:30 The Future of Tax Compliance

58:20 Final Thoughts

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