meet Tressa
TRANSLATOR. STRATEGIST.
ARCHITECT. GUIDE.
If you want to summit Everest, you don’t do it alone. You hire a Sherpa.
No one decides to climb Everest and thinks, ‘I’ll figure it out as I go.’ You may know the goal, be highly capable, well prepared, and have an experienced team, and still recognize that this terrain calls for someone who knows it differently. A Sherpa has navigated it repeatedly, successfully led others through it, knows where the risks and wrong turns are, and understands the terrain so deeply that much of what a climber would have to stop and figure out, has already been calculated.
That’s the role I bring to provider-payer relations. After more than two decades inside health insurance, I don’t just know the route, I understand the terrain: how payer functions connect, how decisions move, where breakdowns occur, and where to look when something isn’t working.
Most practices want to get paid correctly the first time, recover more of what they’re owed, negotiate stronger rates, fix problems before they accumulate a 6 figure A/R, and stop feeling like they simply have to accept whatever the payer decides.
You don’t need to learn everything I know about health insurers. You need access to that expertise in a way your practice can use to change the outcome.
My role is to create leverage for your practice, helping your practice maximize reimbursement without requiring your team to become payer experts to do it.
I’m Tressa, Founder of MD Office Insights
You should know … I’ve never had a résumé for any job I’ve had
Well, not literally. But every opportunity in my career required me to step into something I hadn’t done before.
I started as a temp on the phones with zero health insurance knowledge. A new manager came in and, during our first one-on-one, asked what I thought could be improved in the department.
I told her. All of it.
What she didn’t know was that I was already on my third round of interviews with another company, a completely different industry. I planned on leaving, so there wasn’t much downside to being unapologetically honest.
The thing is, I didn’t just give her a list of issues. I told her how to fix them.
No new technology. No additional budget. It was mostly restructuring the training program, and with a clear, short, easily executable timeline.
Right there, on the spot, she asked me, “Do you want the job?”
And that became the pattern of my career.
The departments changed. The subject matter changed. The titles changed. The responsibility changed.
The skills underneath it didn’t: take on difficult problems, see what others miss, understand how the pieces connect, and solve in a sustainable way that removes or significantly lessens the complexity.
Economics was my background
Not databases, or clinical operations, or provider contracts
Yet over the course of my career, I’ve had to learn countless parts of the payer business. Well enough to understand the day-to-day operations of each, where they fit in the larger picture, what each one influences, and what happens when even one small piece changes.
This Is So Much More Than Insider Knowledge…
My career, from front-line operations to leadership, wasn’t built inside one payer department or one narrow part of the reimbursement process.
The experience afforded me a cross-functional view of the payer functions that shape health insurers, specifically provider reimbursement.
That breadth of perspective matters because payer problems are rarely neatly contained in one place. What appears to be a claims issue may begin with credentialing. A recurring denial may trace back to contract terms, authorization requirements, payer policy, network configuration, or a breakdown inside the practice itself.
When you only see one piece, it’s easy to spend enormous amounts of time & effort solving the wrong problem.
The ability to see across the system became the reason I was consistently brought into C-suite conversations. To offer unique, detailed perspective on highly complex problems, including corporate level redesign & reorganization.
It’s Insider Mastery
Claims
Provider Contracting
Appeals
Credentialing
Utilization Management
Provider & Member Servicing
Network Services & Operations
That’s the difference between knowing how a payer works and having the mastery to use that knowledge strategically on your behalf.
TRANSLATOR
Turn Payer Complexity Into Clear Direction
Payers communicate for an entire network of 40,000+ providers, not for the day-to-day realities of each individual practice. Hence the broad policies loaded with legalese, scripted responses, and the sophisticated “no” that sounds authoritative and complete, but doesn’t actually tell you what you’re supposed to do.
Our solutions translate all of that into what applies for your practice, how to get beyond the generic answer to the real one, and the direction your team needs to protect reimbursement.
STRATEGIST
The Power of Leverage
More staff, hours, follow-up, & effort will never give a practice the same scale as a payer. Strategy has to make up the difference.
The strategic advantage is knowing what assets you already have, where influence exists, and how to position both before the next issue arises.
If the goal is to maximize reimbursement, create leverage before you need it. Then more of the provider-payer relationship is positioned to work in your favor.
ARCHITECT
Solutions Built for the Problem & What Sits Beneath It
Good architecture starts with the right specifications. That means looking beyond the issue on the surface, from both the payer and provider side.
Every solution shares the same foundation: fewer denials, a payer relationship that works more in your favor, and strategy built for practice profitability.
Form follows the problem. The foundation makes it fit together & continue working as the industry evolves.
GUIDE
Navigation For the Details You Don’t See
The best route isn’t always the most obvious one. It’s the one that accounts for the terrain, your practice’s capabilities, and everything that can affect the outcome, not just the problem sitting in front of you.
That broader perspective comes from having lived the terrain long enough to know what matters, what to prepare for, and which course gives your practice the strongest chance of reaching the goal. You get the advantage of that experience without having to learn it all yourself.
The Landscape Has Changed
Twenty years ago, the question was largely: How do we get paid?
Today, it’s much more complicated.
There’s automation. Less human assistance. More requirements and rules.
Getting from care delivered → reimbursement maximized requires the practice to account for a whole host of details that determine whether that care is reimbursed in part or reimbursed without obstacles.
Add to that, there’s no single person or department at a payer who is responsible for making sure your practice receives every dollar it should.
Today’s Goal is TwoFold
Because trial-and-error has a cost that directly works against your reimbursement and profitability goals.
Every additional call, repeated explanation, wrong turn, avoidable denial, or hour spent deciphering what the payer really means has an unrecoverable dollar value attached to it. The economics no longer support figuring it out as you go.
That is the gap MD Office Insights was built to close.