Life as a Coder

In today's episode, we have a captivating discussion about a groundbreaking book that turns our understanding of healthcare as we know it today. Joining us is the esteemed Dr. Henry Buchwald, a seasoned healthcare professional who has witnessed the transformation of healthcare over the past 50 years. Drawing from his vast experience and keen observations, Dr. Buchwald offers a unique perspective on the current state of healthcare in the United States. Dr. Buchwald unveils a startling truth—that our healthcare system has strayed from its core purpose of prioritizing patient well-being. Instead, it seems to cater more to administrators and bureaucracy, resulting in an expensive and impersonal system that may not truly serve the best interests of the nation or its people. Dr. Buchwald fearlessly addresses the broken doctor-patient relationship and explores the profound effects of pandemics like COVID-19 on our healthcare system. He leaves us with his vision for the future and the areas where he believes our healthcare efforts should be focused. Prepare to have your perspectives challenged and your curiosity ignited as we venture into the world of "Healthcare Upside Down" with Dr. Henry Buchwald. So, grab a cup of coffee, sit back, and get ready to reexamine what you thought you knew about healthcare Grab a copy of this transformative masterpiece Now by visiting https://www.amazon.com/Healthcare-Upside-Down-Critical-Examination/dp/303107162X --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

In this episode we delve into the critical issue of healthcare cybersecurity and its increasingly vital role in protecting sensitive patient data. As digital transformation accelerates within the healthcare industry, the risks and challenges associated with cybersecurity have become more pronounced. Join our expert guest, Britton Burton with Corl Technologies. Britton is a cybersecurity specialist in the healthcare sector. He shares invaluable insights and practical advice on fortifying healthcare systems against cyber threats. Britton brings a wealth of experience in safeguarding patient privacy, mitigating vulnerabilities, and implementing effective cybersecurity strategies. During this engaging conversation, we explore the evolving landscape of healthcare cybersecurity, highlighting the following key topics: The Current Threat Landscape Emerging Cybersecurity Technologies Best Practices for Healthcare Organizations The Human Factor Join us for this eye-opening episode as we unpack the challenges and opportunities within healthcare cybersecurity and discover practical strategies to safeguard patient data and maintain trust in the digital era. --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

In this captivating episode, we delve into the realm of digital transformation in healthcare and explore its profound impact on patient care. Our expert guest in digital transformation Unmesh Srivastava, will shed light on various facets of this transformation, including the adoption of value-based care, harnessing the power of AI technology, and the crucial aspect of cultural sensitivity. Join us as we uncover how healthcare providers are redefining their practices to prioritize value-based care. Discover how value-based care not only improves patient satisfaction but also enhances overall health outcomes while reducing costs. We then delve into the vast potential of AI technology in revolutionizing healthcare. We will discuss cutting-edge applications, such as predictive analytics, machine learning, and natural language processing, which are transforming the way healthcare is delivered. Learn how AI-powered systems can streamline diagnosis, personalize treatment plans, and optimize resource allocation, ultimately leading to improved patient care and more efficient healthcare workflows. But amidst the rapid technological advancements, our discussion takes a thoughtful turn towards cultural sensitivity in healthcare. We explore the importance of recognizing and respecting diverse cultural backgrounds, beliefs, and practices in the context of patient care. Our guests highlight the need for healthcare organizations to foster cultural competence, train their staff, and leverage technology to bridge cultural gaps, ensuring equitable and inclusive healthcare for all. Learn more about what Clever Healthcare is doing to advance digital transformation in healthcare. --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

This episode will discuss how to build meaningful relationships with patients, caregivers, and healthcare professionals. You will learn to build strong relationships with your teams, peers and external stakeholders. We will provide insights on how to build and maintain relationships that are beneficial to the organization as a whole. We will interview Jennifer Krippner Chief Experience Officer at the Institute for Healthcare Excellence Developing trust, communication, accountability, feedback and teamwork. Impacts that health care organizations have on the broader community, which will help leaders better understand the big picture. Valuable lessons that will equip and empower leaders to improve their relationships. Guest Jennifer Krippner Chief Experience Officer The Institute for Healthcare Excellence Jennifer Krippner is a leading expert on patient experience and relationship centered care. Jennifer has more than 20 years of expertise in strategic planning, patient experience, physician development and employee/community engagement. Prior to her lead role at The Institute for Healthcare Excellence, she was director of physician development and guest relations at Maple Grove Hospital in Minnesota. While there, she led staff-driven patient experience advisory teams and developed projects that directly contributed to consistent top tier performance in key patient and staff satisfaction results. --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

In this podcast episode, we sit down with Joey Dizenhouse, an expert in pharmacy benefit management (PBM). We explore the latest data trends in the PBM market, including rising healthcare costs. We also delve into the growing importance of data analytics and technology in managing pharmacy benefits and improving patient outcomes. Throughout the episode, Joey shares his experiences and observations from his work in the PBM industry and as a patient advocate, offering valuable insights into the challenges and opportunities facing patients, providers, and PBMs in today's rapidly evolving healthcare landscape. Whether you're a healthcare professional, patient, or simply interested in the latest trends and developments in the pharmacy benefit management industry, this podcast episode is a must-listen. Rising Healthcare Costs Growing importance of data tracking for improved patient outcomes Benefits and Challenges of Increased use of technology Focus on patient engagement Impact and lessons learned since Covid19 Patient Advocacy and Copay Assistance Programs Ale.desjean@healthtrustpg.com and todd.devree@healthtrustpg.com https://healthtrustpg.com/thesource/candid-conversations/inflation-reduction-act/ https://healthtrustpg.com/ihp/human-capital/ --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

In this episode, we are showing our support for primary care physicians and how we can help them improve documentation.Primary care physicians are the backbone of our healthcare system. They provide comprehensive health care services to patients and serve as the first line of defense against illness and disease. Unfortunately, primary care physicians often struggle to keep up with the mountain of documentation requirements required which means that their time spent with patients is diminished, resulting in less efficient patient care. That's why we are here today, to discuss ways that primary care physicians can improve their documentation without sacrificing the quality of their patient care. We will chat with our special guest, national speaker, and risk adjustment expert Christine Hall CHC (AAPC Instructor) CPC , CPB, CPMA, CRC, CEMC, CPC-I Let's break down HCC and documentation areas of concern to improve efficiency, and calculation of true patient risk and help improve the quality of care. Direct Supervision and Telehealth post-PHE What is extended until 2024? Proper telehealth communication post-PHE Documentation that supports clinical indicators --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

The documentation of the chief complaint is a crucial part of a patient's medical record. The chief complaint is the primary reason a patient seeks medical attention, and it is important to document it accurately to ensure proper diagnosis and treatment. In this episode, we will discuss Documentation vs Guidelines What the payers are saying There is a level of critical thinking needed by coders and auditors. Our advisors will discuss these areas in detail Let's tune in to our advisors Jennifer McNamara CCS,CPC,CDEO,CPMA,CRC,CGSC,COPC AAPC Approved Instructor Email Jennifer at ⁠jmcnamara@oncospark.com⁠ Visit her website: ⁠https://www.sparkadvise.com⁠ Hear her speak at RevCycle Symposium and AAPC Healthcon Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM Email Terry at ⁠terryfletchercpc@aol.com⁠ Visit her website: ⁠http://www.terryfletcher.net/⁠ Christine Hall CHC(AAPC Instructor) CPC,CPB,CPMA,CRC,CEMC,CPC-I Email Christine at ⁠christine.hall.guru@gmail.com⁠ Visit her website: ⁠https://www.stirlingglobalsolutions.com/⁠ Hear her speak at various ⁠Oncospark Conferences⁠ Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI Email Betty at ⁠bettyhovey@chcs.consulting⁠ Visit her website: ⁠https://chcs.consulting/⁠ Follow Betty to a location near you: ⁠https://chcs.consulting/events/⁠ Sonal Patel, BA, CPMA, CPC, CMC, ICDCM Email Sonal at ⁠paintthemedicalpicturepodcast@gmail.com  --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcrossroads/message Support this podcast: https://podcasters.spotify.com/pod/show/healthcrossroads/support

In this episode, we are joined by our friend Glenn Krauss from CORE-CDI. Glenn and I had the opportunity to sit down and review the CDI programs for Inpatient and Outpatient and how important CDI is to the healthcare industry. We will discuss the following: The medical record as a communication tool versus a reimbursement tool Physician documentation improvement must be physician-centric and physician driven Compliance and ethics in Physician Documentation Improvement must be an integral part of any program Can CDI programs elevate compliance risk unknowingly without proper precautions being taken? Find Glenn at the upcoming Pain Management Compliance Symposium on April 13 and CDI Symposium 2023 on September 13-14 --- Send in a voice message: https://anchor.fm/healthcrossroads/message Support this podcast: https://anchor.fm/healthcrossroads/support

In the second installment of our series on Evaluation and Management, we dive into the importance of two keys areas Prescription Drug Management Major vs Minor surgery There is a level of critical thinking needed by coders and auditors. Our advisors will discuss these areas in detail Let's tune in to our advisors Jennifer McNamara CCS,CPC,CPMA,CRC,CGSC,COPC AAPC Approved Instructor Email Jennifer at jmcnamara@oncospark.com Visit her website: https://www.sparkadvise.com Hear her speak at RevCycle Symposium and AAPC Healthcon Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM Email Terry at terryfletchercpc@aol.com Visit her website: http://www.terryfletcher.net/ Christine Hall CHC(AAPC Instructor) CPC,CPB,CPMA,CRC,CEMC,CPC-I Email Christine at christine.hall.guru@gmail.com Visit her website: https://www.stirlingglobalsolutions.com/ Hear her speak at RevCycle Symposium Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI Email Betty at bettyhovey@chcs.consulting Visit her website: https://chcs.consulting/ Follow Betty to a location near you: https://chcs.consulting/events/ Sonal Patel, BA, CPMA, CPC, CMC, ICDCM Email Sonal at paintthemedicalpicturepodcast@gmail.com  She is  speaking  @1pm EST on February 20 and 21, 2023 at Assent Global on Auditing in 2023 Part I: Focus on New E/M Standards in the Office/Outpatient Setting; and Auditing in 2023 Part II: Focus on New E/M Standards in the Inpatient Setting, respectively. She has a weekly Compliance & Auditing Tip for NAMAS® on 2/23/2023 titled, Dawning of a New Era: The Sun Rises on New E/M Standards in 2023 and Beyond. --- Send in a voice message: https://anchor.fm/healthcrossroads/message Support this podcast: https://anchor.fm/healthcrossroads/support

The world of healthcare is in a state of chaos. With the rising costs of medical care, the increasing complexity of healthcare systems, and the changing landscape of insurance and payment options, it can be difficult for patients and providers to navigate the system. While there are some efforts to organize healthcare chaos, there is still much work to be done. In this episode, we sit down with Healthcare data and expert Jordan Johnson, MSHA, iMPaCT to discuss: Staff Shortages ️SDOH ️Population Health ️Coding and Billing Challenges Learn more at the RevCycle Symposium on Feb 23, 2023 Grab Tickets HERE --- Send in a voice message: https://anchor.fm/healthcrossroads/message Support this podcast: https://anchor.fm/healthcrossroads/support

In this exciting three-part series we will hear from our advisors all about how to unravel the E/M guidelines and how to interpret areas of documentation. In this episode, we will look at how to interpret some key definitions in the MDM that affect a patient's condition. The meaning of acute vs chronic Exacerbated conditions vs severe exacerbations Complicated vs uncomplicated conditions There are many areas to dissect and you simply cannot do it without research, communication, and a good understanding of anatomy and disease processes. . Let's tune in to our advisors Jennifer McNamara CCS,CPC,CPMA,CRC,CGSC,COPC AAPC Approved Instructor Email Jennifer at jmcnamara@oncospark.com Visit her website: https://www.sparkadvise.com Hear her speak at RevCycle Symposium and AAPC Healthcon Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM Email Terry at terryfletchercpc@aol.com Visit her website: http://www.terryfletcher.net/ Christine Hall CHC(AAPC Instructor) CPC,CPB,CPMA,CRC,CEMC,CPC-I Email Christine at christine.hall.guru@gmail.com Visit her website: https://www.stirlingglobalsolutions.com/ Hear her speak at RevCycle Symposium Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI Email Betty at bettyhovey@chcs.consulting Visit her website: https://chcs.consulting/ Follow Betty to a location near you: https://chcs.consulting/events/ Sonal Patel, BA, CPMA, CPC, CMC, ICDCM Email Sonal at paintthemedicalpicturepodcast@gmail.com She is speaking @1pm EST on February 20 and 21, 2023 at Assent Global on Auditing in 2023 Part I: Focus on New E/M Standards in the Office/Outpatient Setting; and Auditing in 2023 Part II: Focus on New E/M Standards in the Inpatient Setting, respectively. She has a weekly Compliance & Auditing Tip for NAMAS® on 2/23/2023 titled, Dawning of a New Era: The Sun Rises on New E/M Standards in 2023 and Beyond. --- Send in a voice message: https://anchor.fm/healthcrossroads/message Support this podcast: https://anchor.fm/healthcrossroads/support

In our first episode of Season two, we start out with a very important topic that affects all in healthcare-Compliance! It's more than understanding what it is, but also how we view it and how we navigate the many levels. Today we sit down and chat with Compliance and Legal expert Susan Walberg JD, a consultant, and writer in all things compliance. Susan will tell us all about her latest Compliance Books and Non-Fiction books that are designed to shed light on meeting industry standards and navigating the legal minefields in healthcare. We will discuss What compliance is and why we need it Areas of Compliance concern Better communication skills are needed between clinical and business teams Compliance hot topics such as Privacy/Security and OSHA Compliance and Technology concerns Prepare your practice and facility for compliance challenges and jump over to Amazon to check out all things Compliance with Susan Walberg Susan Walberg Books on Amazon : Insiders Guide to Compliance for Physician Practices Paperback – November 28, 2019 Insider's Guide to Compliance: Real-World Advice for Building a Successful Compliance Program Paperback – February 20, 2018 --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this final episode of 2022, we are bringing back a fan favorite and a very important topic. We must continue advocating for improved access to care, a better quality of care, and better patient rights and protections. We sat down with Jared Walker the Founder of Dollar For and we dig into the importance of hospitals being transparent about their charity programs and empowering patients to take control of their healthcare Dollar For is a program that provides financial assistance to individuals advocating for themselves or their loved ones in the healthcare system. Dollar For offers financial assistance to help cover the cost of medical bills, medications, and other expenses associated with medical bills. The program also provides resources and support to help individuals navigate the healthcare system and make informed decisions. Learn how you can help others by volunteering and becoming a patient advocate Volunteer as a Patient Advocate at https://dollarfor.org/get-involved/ Apply for assistance at https://forms.dollarfor.org/ Do you need education for your facility on how to improve your patient advocacy and improving in your billing and communication process?  Sign up for the Rev Cycle Symposium to be held virtually on Feb 23, 2023 Tickets are on Sale Now!  Visit https://www.eventbrite.com/e/revcycle-symposium-tickets-482774289897 --- Send in a voice message: https://anchor.fm/healthcrossroads/message

Do you communicate effectively with your patients? Is your business staff up to the challenge of the necessary communication needed to keep your patients happy? Let's chat about necessary conversations that require communication Explaining Financial responsibility Communication regarding Prior Authorizations Effectively communicating prior to the patient appointment Legal requirements for Copays Join us fo the RevCycle Symposium February 23, 2023 Online and On Demand --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode I had the privilege of interviewing my friend Dr. Michael Cross. Conversation with a Surgeon: Does your patient come first? -Unique challenges in Breast Oncology -Burdens physicians face -Communication with teams -Patient education -Preventative measures and cost --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode we discuss Diabetes. November is Diabetes awareness month and we want to understand the impact on patient care and reimbursement and the cost of treating the condition. How Diabetes affects Cost in Value-Based Care ICD10-CM Coding Guidelines Documentation and Risk Learn more by scheduling an onsite review and education session with your physicians - Contact our Advisory Network --- Send in a voice message: https://anchor.fm/healthcrossroads/message

We have a bonus episode this week, to take a look at how we portray ourselves on Linkedin. Do we understand the proper etiquette? Have we made our profile attractive to a future or current employer? Let's take a break and get Linkedin Savvy! --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode we discuss the importance developing a Value Based Care Mindset.  What can we do to improve in documentation in light of the new EM Revisions for 2023 that now encompasses Hospital Charges? Do we understand basic definitions and how they will affect Value Based Care payments? Do we understand basic documentation guidelines? Contact jmcnamara@oncospark.com to schedule your physicians annual Value Based Care training.  --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode I invite my special guest Christine Hall CHC (AAPC Instructor) CPC , CPB, CPMA, CRC, CEMC, CPC-I to discuss the Global Package. We will discuss the proposed revisions by CMS and the history of it since 1992. Are we ready for a revision? Let's find out What changes have technology and advances in medicine brought us? Are you getting involved and sharing what challenges your practice is facing? Specialty Specific Global Care for Orthopedics and Dermatology Is your EMR up the challenge? Using Subject Matter experts to improve operations and discover missed opportunities costing your practice Could revising the global package lead to better patient care? Check out some great resources: Global Package FAQ Global Surgery Indicators RAND Report CMS-1751-F Contact jmcnamara@oncospark.com for more information on improving your operations with coding and revenue challenges --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode, we sit down with my friend and fellow podcaster Terry Fletcher and discuss the relationship between Physicians and coders. This is a significant relationship that helps utilize both the clinical and business sides of medicine. This partnership ensures compliance, and accurate revenue and allows the physician to focus on patient care while enabling the coder to make sure the revenue is solid. When physicians keep their hard-earned income, the practice can flourish and patients can continue to receive services. Terry and I will discuss: Expectations of Physicians and Coders Eliminating communication gaps with the assistance of Practice Management Having difficult conversations with physicians How consultants have become effective educators Increase your revenue and decrease denials with an effective denial management program that consists of Data Reviews, Audits, and Education with Oncospark! Contact jmcnamara@oncospark.com for more information. Check out more episodes from our special guest Terry Fletcher at the CodeCast Podcast on Apple, Spotify, Google, and many more platforms --- Send in a voice message: https://anchor.fm/healthcrossroads/message

Are you feeling burdened down with the Prior Authorization processes? You are not alone. In this episode we will chat with Manish Jain, Co-Founder and VP, Business Development of Oncospark and get his insights. We will answer: Why do insurance companies require authorization? Are internal process issues delaying treatment? Tips for organization, demographic errors, treatment changes and miscommunication in scheduling vs approval Can you truly automate the authorization process? We will look at different kinds of authorizations such as: Medication Infusion Surgery Diagnostic testing Check out www.authparency.com to augment your process. --- Send in a voice message: https://anchor.fm/healthcrossroads/message

Join me and special guest Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI as we look "Behind the curtain with an Auditor" What is behind more audits in 2022? What does a lack of Audits say about your organization? Is Compliance your priority? What does an Auditor do? Why are Auditors vital in Healthcare? Schedule your next audit by emailing jmcnamara@oncospark.com --- Send in a voice message: https://anchor.fm/healthcrossroads/message

Check out me with my friend Pam Vanderbilt as we talk about Medicare and Modifiers. We will discuss the MPFS Indicators and why all in the Revenue Cycle need to know how Medicare processes claims, because Guess What? "Coding can change based on these Indicators" --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

Join me and my special guest Leslie Boles, BA, CCS, CPC, CPMA, CHC, CPC-I, CRC as we discuss the shift that needs to happen in the Business of Healthcare. As the Co-Owner & President at Revu Healthcare Leslie and her team offer comprehensive regulatory compliance solutions to healthcare providers, hospitals, health systems, physician groups, and other healthcare entities. In the past 10-15 years there has been a progression of gaps in communication between physicians and coders. Has technology played a role? What happened to good old-fashioned educated conversations? Do your coders and billers have access to the Physicians and Clinicians in your practice? We will also look at what Physicians are facing and how we can help them succeed. Burdens physicians face in patient care What can we do to be their advocate? Compliance issues we have seen in the documentation before and during PHE How administrators can bridge the gap between coders and billers and encourage open communication Do you know your EMR? Technology tools enhance a successful practice and do not do all the work Check out Code Interceptor Video and visit Oncospark to see all their technology solutions that may be the solution for your practice or facility. --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

This week we dive into the Revenue Cycle as it relates to Medical Coding. We encourage all to think about how their role as a Medical Coder is a peice of that Cycle and how we approach that role will effect all members of a Healthcare facility. Ultimately it effects the patient. Do you know you are more than a Medical Coder? --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this special episode I am joined by my friend Barbara Cobuzzi MBA CPC COC CPC-P CPC-I CPCO CENTC CMCS. We will catch up with her and see what she's been up to. We will break down the Global Package for ENT Services and discuss Common issues in ENT Audits Endoscopic Sinus Surgeries Modifier 58 vs 78 Appropriate use of Modifier 59 and CMS X(ESPU) Contact her at http://crnhealthcare.com/ You will also want to check out our ENT Virtual Summit On Demand --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this weeks episode we continue our discussion from last week and discuss the purpose of the Global Surgical Package. It is a lot to discuss so we will break it up into 2 episodes. This week we will review: Modifier 57 The Medicare Physician Fee Indicators What is Included in the Global Package Interpreting 0, 10 and 90 day Packages You can learn more about these modifiers as it relates to Orthopedic Services at our Upcoming Virtual Summit July 13-14 and earn 15 CEUS! Sign up today! Register Here --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this weeks episode we are joined by Sonal Patel, CPMA, CPC, CMC, ICDCM. She is a repeat guest and we are very excited to discuss Modifier 25. It has been in the news lately and a very controversial Modifier for years now. We will discuss: Modifier 25 Definition News from Commercial Payers OIG report from 2005 Using Authoritative Guidance Check out these cool references: OIG Report CMS Global Booklet Fact Sheet CMS Processing Manual Check out the Podcast Paint the Medical Picture Check out our Upcoming Ortho-Care Virtual Summit where we dig into Using Modifier 25 for Orthopedics This episode qualifies for a CEU for our All Patreon Squad Members. Become a member today at www.patreon.com/lifeasacoder --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

We are on Vacation this week. Check out a replay of one of my favorite episodes with my dear friend Christine Hall --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this episode we will chat with Jared Walker, Founder at Dollar For where the goal is Advocating for patients to eliminate medical debt. We are all patients at one point in our life. The Burdens to provide healthcare are great for providers and healthcare staff but the burden for patients are great indeed! According to Jared " Many patients are involved in payment agreements and going into debt for medical bills they do not have to pay" Let's discuss: Charity Care Patient Advocacy Medical Bill Education Being a proactive patient Want to volunteer? Join NOW as a Volunteer and help Dollar For continue to #crush medical debt Jared and I will both be speaking at the Healthcare Advocate Summit September 7-9 in New Orleans. Get your Tickets: https://www.healthcareadvocatesummit.com/ --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

We have a great Bonus Episode for everyone with my special guest Jessyka Burke. We discuss the ins and outs of Podiatry Billing and Coding Challenges. Routine Footcare NCCI Bunion Coding Hammertoe Know your LCD Policies --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this episode we highlight why we are all here in the Business of Healthcare. To provide access to care for the patient population. It doesn't matter what our role is, we have an obligation to fight for the patient so they can get what they need to improve their quality of life and in many cases save their life. I had the privilege of speaking with two Healthcare Advocates and I am sharing that conversation with you all. Elizabeth Johnson and Melissa Paige join me today to talk about how they became Patient and Healthcare Advocates and how Healthcare Advocate Summit came about. Learn more about our guests: Elizabeth Johnson is the Chief Executive Officer for MedicoCX, a group of independent specialists unified by patient centric access to biologics in a timely and cost effective manner, as well as a co-founder and the President of NAMAPA, National Association of Medication Access & Patient Advocacy, Inc. Their goal is to empower healthcare advocates by providing a collaborative community focused on resources to navigate medication access and support. Melissa Paige is the Co-Founder of HealthCare Advocate Summit, and the Co-Founder of NAMAPA. She is Recognized as an expert in patient access programs and navigation. She is a Prolific public speaker and educator. She uses her Leadership skills to oversee and coordinate process improvement projects that enhance business models and redesign workflows for improved efficiencies. Her passion for the patient and this drives her to break down access barriers and seek avenues for the highest quality care. The Healthcare Advocate Summit is LIVE in person September 7-9 in New Orleans. Grab your Tickets Today and support this very important event. --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this week's episode I dig into the heart of getting your providers paid. Many of the breakdown starts with the data collected at the time of the appointment. In my career I started at the front desk. The most important role beside the Physician! I will walk you through my career from Receptionist to Consultant --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this Bonus episode I am joined by Kimberly Clayson of Jaffe Raitt Heuer & Weiss as we give you a preview of the legal issues facing the industry and some insight into No surprise billing that she we give us at the Orthopedic Conference. What is No Surprise Billing? What it means for Orthopedics? Upcoming topics for the OrthoCare Summit Join us and get your Tickets --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

Welcome to Episode 1 of Season 6! We are happy to invite our first guest of the Season Laurie Bouzarelos MHA,CPC on the show today to talk about Behavioral Health audits. Laurie Bouzarelos, MHA, CPC is a health care consultant with a special interest in supporting the unique business needs of behavioral health practices. Laurie works with psychiatrists and behavioral health providers to improve practice revenue and address compliance shortfalls. Laurie helps providers understand their revenue and facilitates operational changes to meet managed care and government payer requirements and state and federal laws. Areas of focus include managed care contracting, documentation improvement, EHR templates, coding accuracy and medical billing. We will discuss the recent OIG audit that was done in NY and what we can learn from it. Read more Our focus will be on the areas of: Treatment Plans Frequency Documentation Incident to requirements Time documentation Telehealth Know the OIG Workplan --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In todays episode we dive into LCD policies, Coverage and Evaluation and Management tips for Diagnosis Documentation. It is so important to understand the impact that Medical Necessity and Coverage guidelines play in reimbursement. Outside of direct care providers many patients rely on their insurance coverage to get the services they need. By accepting assignment on their behalf and submitting their claim we can aid them as professionals to continue getting these service and to be reimbursed the highest amount available. We can do this by understanding: Current Active LCD Policies Prior Authorization Criteria vs Coverage Guidelines Documenting Risk and conditions that effect the risk Timely Submission of accurate claims with supporting Documentation Medicare Coverage Process Patient LCD Disputes LCD What's New Report LCD Q/A Diagnostic Colonoscopy LCD Do not keep writing off claims for preventable Prior Authorization Denials. Get started with Authparency Watch it in Action! Earn a CEU for this Episode by becoming a Patreon Member --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this Episode I welcome my colleague and Fellow Physician Educator Crystal Watters. Remote vs Onsite jobs Passing an exam doesn't guarantee a job Social media ettiqite True value of CEUS Apprentice Credentials, do we need them? What does having a credential tell a prospective employer? Different Credentials Earn a CEU for this episode by joining our All Access or VIP Membership www.patreon.com/lifeasacoder --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this final episode of our 4 part series with Behavioral Health I wanted to close out with awareness of Stress and Anxiety awareness. April is #stressawarenessmonth and we discuss the damage prolonged stress can have on our mental and physical health.

Let's discuss the Clinical side of Personality Disorders. I have a special guest Paul Sheesley MA, LPC,LCPC,LCADC a clinical Psychotherapist and Consultant specializing in Personality disorders and Substance Abuse. We will discuss: Personality Disorders Presentation of these disorders Effect on Family and Society Risks Early Detection Effect on Anxiety, Depression and Overall Health Paul's Bio: Paul Sheesley, is a mental health practitioner with almost 20 years of experience in the field of clinical psychology and human behavior. He equips high-powered professionals, prominent couples, and families committed to healthy interpersonal relationships with personalized support, tailored treatment, and necessary steps to regain a balanced self that positively impacts all areas of life. Paul Sheesley, is an expert in the treatment of narcissism and borderline personality disorders and offers a specialized use of schema therapy in the treatment room. Schema Therapy is a systematic approach that draws on the cognitive-behavioral, attachment, psychodynamic, and emotion-focused traditions and conceptualizes patients who have personality disorders. Located in Washington, DC and Maryland his practice is available to assist clients and loved ones experiencing personality, emotional, and behavioral challenges associated with such challenges common in BPD and NPD. Check out our Amazing new Prior Authorization tool for Behavioral Health Services and many other service lines at www.Authparency.com This Saturday we welcome our Industry Leaders and attendees to the Pediatric Summit where we will dig into some Behavioral Disorders for Pediatrics Register Here --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this episode I am joined by my colleague and friend Barbara Shaw, CPC, CPCO, CDEO, CRC, CEDC . W will discuss Risk adjustment and Social Determinants of health as it relates to Mental Health Services What is Risk Adjustment? Important reminders about SDOH Risk Adjustment Documentation Mental Health and SDOH Join the Risk Adjustment Masterclass created by Risk Adjustment leaders and educators. Ask us about our special programs for Hospital Employee education This episode qualifies for 1 CEU for our Patreon Squad Members. Jump over to www.patreon.com/lifeasacoder --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this episode we begin our four part series on the Behavioral Health Crisis. I will be sharing my thoughts on mental health in the workplace. I share what I have learned in my career and the things that have contributed to my professional growth. We can all improve in our way of dealing with others at home and in the workplace. Mental Health in the workplace Communication between departments A Leader vs a Boss Growth opportunity suggestions There will be CEUS offered for certain episodes. Please join the Patreon squad to support the show at www.patreon.com/lifeasacoder Learn more about #authparency and schedule a Demo today! https://authparency.com/ You will also enjoy our April Webinar on Billing for BHI and telehealth during and after the PHE. Register HERE for your staff or for your facility. Learn about Leadership --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this episode we begin our four part series on the Behavioral Health Crisis. I will be sharing my story that begins with my struggles with mental health. Through this series we will be talking with professionals in the Behavioral health field, from both Clinical and Business side of medicine. Mental illness is not talked about like it should be. Talking is what promotes the healing. The signs are not visible for many of these conditions. Join me in Part 1 as I share my professional struggles and what I learned on the other side. There will be CEUS offered for certain episodes. Please join the Patreon squad to support the show at www.patreon.com/lifeasacoder Learn more about #authparency and schedule a Demo today! https://authparency.com/ You will also enjoy our April Webinar on Billing for BHI and telehealth during and after the PHE. Register HERE for your staff or for your facility. Learn about Personality Disorders --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this Episode I'm joined by Sarah Ragan. A seasoned coder and auditor. She's a great educator and mentor. Today we talk about the benefits of Virtual Education and why it is a valuable way to get our education. Value of Education Virtual Education before and after the pandemic Benefits of Virtual Education on the community Networking Value Learn more about our Virtual events HERE Connect with Sarah Ragan, COC, CPC, CPMA, CRC, CFPC if you need a speaker for your next event! You can learn more about the opportunities to become a Certified Instructor HERE Does your Organization need help streamlining your Prior Authorizations and increasing revenue while decreasing unnecessary denials? Visit authparency.com for your FREE Demo --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

Join me and my special guest Stephanie Thebarge CPC, CPMA, CPPM, CPB, CEMC, CHONC, PESC talking about all things #Oncology We discuss the differences in Surgical Oncology, Medical Oncology and Radiation Oncology. We discuss the necessity of a proper understanding of Guidelines, Payer requirements and the natural desire to be a good reseacher. This specialty requires a desire to know all you can about how Oncology drugs happen and truly caring about the patients and being a #patientadvocate Do not miss her #infusion presentation at #Healthcon22 "Breaking Down Billing for New Drugs" #session 3G Learn more about #authparency at https://authparency.com/ You will not want to miss Hyperoncology Summit 2022! Medical Oncology Infusion Rita Genovese Radiation Oncology Jordan Johnson, MSHA, iMPaCT Surgical Oncology/CPT/ICD10-PCS Jennifer McNamara CPC,CCS,CRC,CPMA,CPC-I,CGSC,COPC Risk Adjustment Barbara Shaw, CPC, CPCO, CDEO, CRC, CEDC Evaluation and Management Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI Want to sponsor or sign up as a virtual exhibitor? Download our Prospectus --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this Bonus Episode Kimberly Jolivette Williams CPC CPB CPMA CANPC CCC CEMC is my special guest. Its March Madness with Modifiers and we are here to talk about our favorite ones and some very important tips and guidance. *Always check your state and local plan websites for Modifier guidance Why do we use modifiers? Modifier 24,25, and 57 Modifier 58,78,79 New F Modifiers Modifier TC,26 Modifier 50 and 59 Modifier List Medicare Proper Use of Modifiers 59 & –X{EPSU} OIG Modifier 25 OIG Modifier 59 CMS PHE Modifiers UHC Do not miss our upcoming Conferences that are Virtual, On demand and have CEUS! Visit our Conference Page Earn 1 CEU for becoming a All access or VIP member of the patreon squad at www.patreon.com/lifeasacoder --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this episode we will be joined by our special guest Mia Reddick-Smith, PMP, MBA, CPC-I. She has over 16 years' experience working in healthcare revenue integrity and project management with enterprise system implementations. She is a results-oriented professional leading development of reimbursement and charge capture programs as well as executing organizational operating and financial objectives. Currently she teaches medical coding/billing AAPC® CPC prep courses. As someone with a vision of processes and workflow development, she has a comprehensive knowledge of the health care nomenclature and systems, along with capacity to manage healthcare technical projects/programs to develop strategic products. We will sit down and discuss: Coding as a Profession Going from a Coder to Instructor Bridging the gap in departments for Billers and Coders Being successful in the CPC exam with our special tips Self study vs Results driven Instructor coaching Connect with Mia Get more Continuing education at our upcoming Specialty Virtual Conference series on Pediatrics April 16, LIVE and On Demand Register Here --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

In this Episode I invite back my friend and fellow Podcaster Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM. She is the host of the #codecast podcast. In our years working in the business of healthcare we have seen so much fraud, waste and abuse. Much of the waste is simply not understanding the appeals process. So much money is left on the table by needless Denials and decisions not to appeal. This is a #donotmiss episode CMS Appeals Process UHC Appeals Process Using ERISA Appeals Process Clerical Errors and Reopening Become a Patreon Subscriber to get CEUS at www.patreon.com/lifeasacoder Listen to the Codecast Podcast on your favorite podcast station Do not miss Terry and our Special Guests at the Virtual Cardiology Summit May 21-22. Learn More --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

Join me and my Special Guest Jessyka Burke, BSHA, CPC, COSC, CASCC as we dive into the world of billing for Workers Compensation, Tricare and Auto Insurance Billing. We thought these are areas of Billing that often get misunderstood or billed incorrectly. It takes organization and constant follow up. We give you the tips to be successful. Getting organized Know state guidelines Different types of military insurance Challenges in getting visits approved with Tricare. Suggestions for Billing Auto claims Tricare Breakdown Tool Schedule a Demo of our Authparency Software Solution: https://authparency.com/ If your Orthopedic practice is 60-70% Workers comp you will want to listen to this episode and do not forget to Join Jessyka and I at our upcoming Ortho-Care Virtual Conference July 15-16 Buy Tickets We have a special 10% off for our listeners with CODE ORTHO22 ✔️ICD10-CM Guidelines for Orthopedics ✔️Documentation for 2021 E/M for Orthopedics ✔️ICD10- PCS for Musculoskeletal ✔️Fracture Care: Closed vs ORIF ✔️Arthroscopy: Shoulder, Knee, Ankle ✔️Total Joints ✔️Appeals and Denials ✔️Spine Coding ✔️Podiatry ✔️Hand and Wrist ✔️ASC Billing ✔️Pain Management ✔️DME ✔️Stay Legal with No Surprise Billing ✔️Office Procedures and Injections ✔️LIVE Giveaways ✔️Expert Speakers ✔️Virtual Networking --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

Everyone has a role to play in the Revenue Cycle. Its important that we understand each other's role to work better as a team. Join Vanessa Moldovan and myself as we discuss: Overview of revenue cycle What is the difference in billing vs coding? Job responsibilities of a coder vs a biller What other roles in RCM can a coder be utilized in? Ways to improve communication Simple errors and how communication can improve these CMS Status B Guidelines OIG Coding Guidelines Join our Virtual Conference Series to help educate your Coding and Billing staff Register Today https://ozarkinstitute.oncospark.com/virtual-events/ --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

I get many questions about how to read and dissect an operative report. In an effort to answer some of those questions I have decided to talk about the process in this episode. Operative Report Elements Getting Organized Understanding the Medical Necessity Learn more about Surgery coding for OBGYN Services at our conference Saturday 2/12/22 www.obgynsummit.com Join our Annual Patreon membership to get CEUS for select episodes. www.patreon.com/lifeasacoder --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support

During the Public Health Emergency our world in the Business of Healthcare is constantly changing. One area we see constant movement in is Telehealth Services. Today my special guest Christine Hall and I will discuss this topic and some reminders on Coding based on the current IC10-CM Covid 19 Guidelines. What is the difference between Telehealth before and after the PHE? How can practices to be successful in making sure the claims get out to the right POS? For the Telehealth services there is a Telehealth Services List. How do we understand these different categories? What changes occurred in 2022 for Behavioral Health how will this benefit this service line? Under telehealth there are all these waivers and allowances. How can practices get organized and maneuver through all the changes? What are some reminders when reporting ICD10-CM Covid 19 based on the guidelines? Official Guidelines for ICD10-CM 2022 COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing Medicare FFS Response to the PHE on COVID-19 ACP Resources for Practices Check out the Authparency Website http://authparency.com/ Watch a Demo --- Send in a voice message: https://anchor.fm/lifeasacoder/message Support this podcast: https://anchor.fm/lifeasacoder/support