Wiser Wednesday - Experience Speaks

Glenn Krauss talks with Dr. Kush Singh, MHA CPC, about consulting with MA Plans about HCCs and Risk Adjustment, and the unfortunate contributing factors to the latest examples of improper "loading" of HCCs to secure greater reimbursement for the plan - now perhaps up to $9 Billion. https://www.core-cdi.com/ http://www.topgunauditschool.com/

Glenn Krauss talks with Ernie de los Santos, co-founder of "TopGun Audit School" and creator of "Finally Friday! LIVE" - about how CDI Specialists are being shackled by KPIs that measure tasks instead of effectiveness in documentation that survives audit. https://www.core-cdi.com/ http://www.topgunauditschool.com/

Glenn Krauss talks with Ernie de los Santos, co-founder of "TopGun Audit School" and creator of "Finally Friday! LIVE" - about how CDI can help with both the advantages and dangers of templating for documenting in EMRs. https://www.core-cdi.com/ http://www.topgunauditschool.com/

Glenn talks with Robin Sewell, creator of "Cleopatra: Queen of Denials" - Denial Management and CDI Tool, a former auditor for hospitals and payers. Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: https://www.topgunauditschool.com/

Glenn Krauss speaks about Revenue Cycle moving to the future of clinical documentation integrity Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: https://www.topgunauditschool.com/

Glenn Krauss speaks about more tips for documenting necessity Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/

Glenn Krauss discusses a recent conversation with a CFO who understands the value of CDI Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/

Ernie de los Santos and Glenn Krauss discuss the recent OIG Report. Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/

Ryan Kelly is the executive director of the Louisiana Health Information Management Association (www.lhima.org) and Mississippi Health Information Management Association (www.mshima.org) Ryan Kelly on LinkedIn: https://www.linkedin.com/in/ryan-kelly-2843898/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

CDI - Building Upon Fundamentals with Tisha Titus, MD, MPH Dr. Titus on LinkedIn: https://www.linkedin.com/in/tisha-titus-8494741/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Jim Zelem is a former VP of Operations who transitioned to be an effective leader that coached many successful teams. Jim started his career as a simple factory worker who held many positions such as Industrial and Manufacturing Engineer as he worked his way up to VP. Jim currently resides in Madison, Wisconsin. He loves sports as he officiated high school football for 18 years. Jim still remains active as he volunteers for the Red Cross and the Senior Center. He enjoys walks in the woods, swimming and golf. Jim strongly believes that experience is a great teacher as it helped him throughout his career. He believes his experiences in leadership and teamwork can definitely help others. Jim created a blog site “urjustanumber.com” to share these experiences and has opened the blog site for others to tell their story as well. Additionally, Jim has written a book “Stepping Stones of Leadership” that lists some essential steps that he believes will guide you on becoming an effective leader. Every step is supported by stories of his own personal experiences. He is presently working on his next leadership book with more stepping stones. Jim on LinkedIn: www.linkedin.com/in/jim-zelem-bab0963/ Jim's Blog: urjustanumber.com/ Jim's Book: urjustanumber.com/products-available/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Mike Kertes is the National Director of Clinical Documentation Improvement Australia. Mike Kertes on LinkedIn: https://www.linkedin.com/in/mike-kertes-625328156/ Clinical Documentation Improvement Australia: https://www.cdia.com.au/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

CDI Partnering with Physicians Working Smarter Not Harder with Chandrasekhar Dinasarapu, MD, MPH, Physician Advisor & Hospitalist Find Dr. Dinasarapu on LinkedIn: https://www.linkedin.com/in/dr-dinasarapu-md-mph-fhm-chcqm-phyadv-mcg-guidelines-certified-43098118/ HospitalistX: https://www.hospitalistx.com/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Physician Challenges to Good Documentation with Tisha Titus, MD, MPH and Paula Wineland, MD, FACP. Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Melissa Rodriguez, CCS, CCS-P, CDIP, CPMA works for Salem Health as documentation and coding specialist, where her role is to provide education for both the coding and CDI team. She works in clinical validation denials and deals with varying audit functions such as queries and coding. She strives to continually educated herself and her team on the latest coding and clinical validation guidance. Since her time at Salem Health, she has helped implement a query policy and a regular audit schedule for both the coding and CDI teams. She has implemented a denials tracking method that highlights high risk areas with solutions to minimize risk. Melissa is an avid motorcyclist and a kayaker. Melissa Rodriguez on LinkedIn: https://www.linkedin.com/in/melissa-rodriguez-ccs/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Candice is an innovative, results-oriented, and experienced healthcare administrative professional with more than 13 years of successful experience in various aspects of revenue cycle and health information management. Candice is a graduate from Franklin University where she obtained her MS degree in Healthcare Administration and BS in Allied Healthcare Management. She is also a graduate of Sinclair Community College with an A.A.S in Health Information Management and a Registered Health Information Technician certified through AHIMA. She is currently the manager of clinical documentation and coding quality for Premier Health Partners. Candice on LinkedIn: https://www.linkedin.com/in/cnfaison1/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Sonal Patel, CPMA, CPC, CMC is the healthcare coding and compliance consultant at the law firm of Nexsen Pruet, LLC. She has over 10 years of experience in multi-specialty healthcare coding, auditing and compliance. She provides reimbursement investigations for Parts A and B providers. Ms. Patel delivers healthcare lawyers with strategies and analyses to overturn denials with private and government payers. She is a member of the AAPC Northbrook, Ill., local chapter, AMBA (American Medical Billing Association), PMI (Practice Management Institute), and NCMGMA (North Carolina Medical Group Management Association). Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and regular guest on industry podcasts. She created the Alpha Coding Podcast series to share her industry Pro-Tips. She also leads and mentors a network of HIM professionals across the country and serves as the President of the Orlando, FL AAPC Chapter. Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/ Nexsen Pruet, LLC: https://www.nexsenpruet.com/ Toni on LinkedIn: https://www.linkedin.com/in/toni-elhoms-ccs-cpc-crc-ahima-approved-icd-cm-pcs-10a47445/ Alpha Coding Experts, LLC: https://www.alphacodingexperts.com/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Noelle Dale-Brown is an experienced RHIA and RMA in both post-acute and acute care. She is Scrum Master/Lean Six Sigma Green Belt certified, and skilled in record management workflow assessment and redesign using methodologies to achieve productivity and efficiency. Noelle Dale-Brown on LinkedIn: https://www.linkedin.com/in/noelle-dale-brown-bshiim-rma-rhia-smc%C2%AE-a15a73132/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Mary-Claire is dedicated to her passion for health care & medicine. She has a unique background in health care. Over the years, she has contributed to clinical research & assumed leadership roles. She is currently completing her graduate medical education. Here she aims to obtain excellent medical & professional competencies. She considers herself a lifelong learner & is committed to engendering a culture of excellence wherever she goes. Mary-Claire Cotner on LinkedIn: https://www.linkedin.com/in/maryclairecotner/ Glenn Krauss on LinkedIn: https://www.linkedin.com/in/glenn-krauss-93521a19/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Eric Rubenstein is a seasoned federal law enforcement officer (25 years), specializing in white-collar crime investigations. Wide-ranging experience involving federal healthcare programs, with an emphasis on crimes involving the Medicare and Medicaid programs by health care providers, including physicians, pharmacies and health care entities. He is currently the Director of Litigation Fraud Waste and Abuse Support for Advize Health. Eric Rubenstein on LinkedIn: https://www.linkedin.com/in/eric-rubenstein-oig/ Glenn Krauss on LinkedIn: https://www.linkedin.com/in/glenn-krauss-93521a19/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

John Zelem, MD, FACS is the president and owner of Streamline Solutions Consulting, Inc. He is a Board-Certified general surgeon with more than 25 years of clinical experience, has transitioned out of clinical practice into Healthcare Executive Leadership. Dr. Zelem is a renowned industry author who has published many books and is a well-known motivational speaker and presents often to professional and public/patient audiences on health and wellness, personal development, and leadership and success. Joe Crea, DO is the medical director for Advisory Services for Sound Physicians. He brings a decade of physician advisory experience to this position as well as extensive experience in both clinical and academic settings. He holds a Health Care Quality & Management Physician Advisor certification. Dr. Crea considers himself an "amateur chef," and loves to cook in his spare time. He is an avid traveler who loves to experience new places and is looking forward to becoming a part of the Harlan, KY community. John Zelem, MD, FACS on LinkedIn: https://www.linkedin.com/in/john-zelem/ Streamline Solutions Consulting, Inc.: https://www.streamlinesolutionsconsulting.com/ Joe Crea, DO on LinkedIn: https://www.linkedin.com/in/jecrea/ Sound Physicians: https://soundphysicians.com/ Glenn Krauss on LinkedIn: https://www.linkedin.com/in/glenn-krauss-93521a19/ Core-CDI: CDI Consulting: https://www.core-cdi.com/ Top Gun Audit School: http://www.topgunauditschool.com/ This podcast was produced by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Terrance Govender, MD is currently the Vice President of Medical Affairs for ClinIntell, Inc. He has many years of clinical and healthcare management experience that goes beyond the borders of the United States, having also practice in the United Kingdom and South Africa. After being introduced to the concept of CDI early on in his non-clinical career, he realized that we still have a lot to accomplish as an industry. Terrance's passion lies in the ability to empower physicians, who want to do the right thing, by providing them the shortest distance between two points with regards to CDI. This approach can take on many forms and the exact solution may vary depending on different cultures, but Terrance believes that its time to leverage data, advanced analytics and performance monitoring to affect long term change in physician behavior. Terrance Govender, MD on LinkedIn ClinIntell.Inc Glenn Krauss on LinkedIn Core-CDI: CDI Consulting Top Gun Audit School This podcast was produced by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Heidi Hillstrom is a highly accomplished revenue cycle professional with a wide variety of experiences and accomplishments in clinical documentation improvement, case management, utilization review and coding. She is currently Clinical Documentation Improvement Manager and Denials and Appeals specialists at St Luke's Medical Center in Duluth, MN. Heidi Hillstrom on LinkedIn Glenn Krauss on LinkedIn Core-CDI: CDI Consulting Top Gun Audit School This podcast was produced by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

January's Wiser Wednesday-Experience Speaks podcast where Glenn Krauss invites our Special Guests: Dr. Vedi Patel, a practicing hospitalist in Chicago Elaine Maldonado, a 30+ year Coding Manager from California They share their thoughts on the role of documentation, especially in relation to communicating the patient's story, and what the effect of CDI work is on effective coding. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Glenn Krauss interviews Dr. Vedi Patel, a hospitalist in Chicago, and Elaine Maldonado, a coding manager from California, asking them about the role of documentation, especially in relation to communicating the patient's story, and what the effect of CDI work is on effective coding.

December's Wiser Wednesday-Experience Speaks podcast where Glenn Krauss invites our Special Guests: Dr. Mahesh Moolani, Adjunct Clinical Professor of Internal Medicine, KY College of Osteopathic Medicine Dr. Doug Cutler, a practicing hospitalist at Yavapai Medical Center They share their thoughts on why and how residents should be getting useful education on proper documentation and the need for being complete, accurate and compliant. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Glenn invites Dr. Doug Cutler and Dr. Mahesh Moolani to discuss the question of how, when and where residents should receive effective training on complete, accurate and compliant clinical documentation.

November's Wiser Wednesday-Experience Speaks podcast where Glenn Krauss invites our Special Guests: Craig Mills, Business Development Director for MBOS and Dr. Doug Cutler, a practicing hospitalist at Yavapai Medical Center They share their thoughts on why the EHR must be thought of as a communication tool rather than just a reimbursement tool. What should CDI be accomplishing to help facilitate recognition of the EHR as a communication tool that benefits the patient, the physician and all healthcare stakeholders. If the record is treated as a communication first and foremost, optimal reimbursement will be forthcoming. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

November's Wiser Wednesday-Experience Speaks podcast where Craig Mills, Business Development Director for MBOS and Dr. Doug Cutler, a practicing hospitalist at Yavapai Medical Center, will be sharing their thoughts on why the EHR must be thought of as a communication tool versus a reimbursement tool. What should CDI be accomplishing to help facilitate recognition of the EHR as a communication tool that benefits the patient, the physician and all healthcare stakeholders. If the record is treated as a communication first and foremost, optimal reimbursement will be forthcoming.

CDI Visionary Glenn Krauss moderates this show, with his special guests:  Dr. Terrance Govender, VP of Medical Affairs for Clinintell; and  Heidi Hillstrom, CDI professional at St Luke’s Hospital of Duluth. They discuss KPIs for CDI programs As they are commonly being used today… Do current KPIs in CDI accurately and dependably measure true performance of a CDI program? Are these current measures valid and reliable? If so, to what purpose? What constitutes valid and reliable measures of CDI performance for driving and achieving continual documentation improvement? Hear the scoop on the current state of affairs in CDI when it comes to KPI measures, and understand why the profession is … …simply measuring the wrong indicators,  …continuing to go down the wrong path, …using the wrong approach  …to achieving documentation improvement.  WISER WEDNESDAY PODCASTS ARE PRODUCED BY TOP GUN AUDIT SCHOOL, a Texas based Non-Profit https://www.topgunauditschool.com/ 

Our inaugural show was moderated by Glenn Krauss, CEO & Founder of Core-CDI with Special Guests: Terrance Govender, VP of Medical Affairs for ClinIntell Heidi Hillstrom, CDI Professional at St. Luke's Hospital, Duluth, MN They discuss KPIs for CDI programs as they are commonly being used today… Do current KPIs in CDI accurately and dependably measure true performance of a CDI program? Are these current measures valid and reliable? If so, to what purpose? What constitutes valid and reliable measures of CDI performance for driving and achieving continual documentation improvement? Listen in to hear the scoop on the current state of affairs in CDI when it comes to KPI measures and understand why the profession is simply measuring the wrong indicators, continuing to go down the wrong path using the wrong approach to achieving documentation improvement. Future shows will include cutting edge topics aside from CDI, with thought provoking discussion on the myriad of challenges hospitals face in the revenue cycle, begging the need for novel solutions to conquer and survive in the current economic climate of healthcare. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message

Creator and Host, Glenn Krauss, talks about what to expect on Wiser Wednesday - Experience Speaks. Glenn Krauss on LinkedIn Core-CDI: CDI Consulting Top Gun Audit School This podcast was produced by Brian Cui from MedicalCodingGeek.com --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wiserwednesday/message