Podcasts about billers

June 19, 2026In this episode, Scott, Mark, and Dr. Ray Painter tackle three challenging reimbursement scenarios submitted by listeners: Medicare denials for category III code 0816T, handling patient payments when claims are denied for timely filing or missing prior authorizations, and the ongoing complexities of billing urodynamics studies in a group practice setting. The discussion explores why “unprocessable” claims often require deeper investigation, how payer contracts influence whether patient payments must be refunded, and the pros and cons of global versus split billing for urodynamics services. The key takeaway: many reimbursement problems are not coding issues at all—they are workflow, contract, and claim-processing issues that require practices to understand both the rules and the business side of medicine. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Does your front office feel overwhelmed? Kiera shares what the problem is 99% of the time, as well as how to clear up the confusion, and three tactics that bring about clarity and control very quickly. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Trasnscript: Kiera Dent- Dental A Team (00:00) Hello, Dental A Team listeners, this is Kiera. And today, I just wanted to talk about front office overwhelm. Like, dun, dun, dun, dun, dun. That's a real thing, it's a real deal. This happens all the time. And I just want you guys to be able to fix that quickly and easily. So today, we're here to wrap. We're here to have a good time. We're here to talk about the front desk overwhelm and how you can fix that and do it with a ton of ease. So.   If your front office feels overwhelmed, if you feel like they're overwhelmed, if you're ever scared to walk up there because you're like, my gosh, they're always stressed out. This is the episode for you and your front office team, because honestly, it's usually not that they have too much to do. It's that they're just, I call it front office soup. Then they're just all like, it's a bowl of spaghetti and we're all slurring and slopping and it's just a mess up there. But because we just have to figure out what matters and who does what.   And it usually, in front office team members, I hope you hear me loud and clear, I'm not being a jerk, I'm Kiera Dent from the block and I've sat in your shoes and I understand it and I've been in your shoes and I know this overwhelmed feeling. It's not usually a workload problem. Usually what it is, is it's a role clarity problem. 99.9 % of the time, if we clean that up and we like untangle the ball of spaghetti, everybody's super happy, everybody's clear and things start rocking and rolling. So.   Again, this is where we're at today. I wanted to just give a quick tactical podcast for you for that front desk overwhelm. And I want you to just know that like at Dental A Team , every single consultant on our team has been in your shoes. ⁓ I don't just say these words on the intro to the episode. We don't just understand you. We genuinely are you. We've been in your shoes. We've sat in your shoes. We've sat at the front office. We've taken the phone calls. We've had the schedule fall apart last minute. I've had the treatment plans not close. I've had doctor on my case saying, Kiera.   get the schedule full and I'm like, I don't really know what to do, okay? I've had that phone running a million miles a minute. We get it. It's chaotic up there, but it doesn't need to be chaos. And so when we have all that, how can we take the urgency away and help you focus on the important thing? And so this is gonna help us kind of figure out like, why do people get overwhelmed? How do get the confusion cleared up? And then what are three things that bring clarity and control very quickly? That's not gonna take months and months to get that stabilized, but to actually do it really quickly.   If you don't know us, hi, we're the Dental A Team. I'm Kiera Dent. Dent really is my last name. It took me three fiancees. You can ask me about that later. It's a real joke, but it's a real life. I love dentistry. I love helping people have their best lives. And I love the dentistry as the platform that brings us all together. I've been a dental assistant, a treatment coordinator, a scheduler, biller, an office manager, regional manager. have all my own practices. I took my first office from 500,000 to 2.4 million in nine months and opened a second location.   To say I've been around the block is not a lie. I have bought practices, I've sold practices, I've been parts of DSOs, I've been part of boutique practices, I've merged offices, you name it. I don't think that there's a single thing that I haven't done yet in dentistry, so try me. I'd love to meet somebody that I'm like, yep, never heard of that before. ⁓ And our job is to make dentistry fun again. Our job is to make you love your life again. Our job is to bring simple clarity. But as a business owner myself, I hated where I'd go to conferences and people would just talk.   to me and I have to go back and rally my team and I realized I'm gonna create a business that's gonna make your life easier. So we actually work with doctors and teams. We help doctors set the vision, where are we all going? And then we figure out your finances. Let's make sure you're profitable. And if you have tax aversion, like you're so scared of it. Not that you don't pay it, don't get me crazy on that, but that you're so scared because you feel like you're making money but you're always broke. We help offices actually like find the money, keep the money, make the money. Like let's have you be profitable.   And then the other part is how do we do system and team development together? I call that the yes model. You first vision, making sure you're taking care of E stands for earnings and profitability. S is systems and team development. Doing that yes, success model. So you can say yes to more in your life. Truly, truly. And teams freaking love us because guess what? We get this. We understand it. Doctors love us because we're magic magicians that can fix it with your team, but also help you be profitable. It's like.   Let's put a bow on all the beauty together. So let's talk about your front office because everything freaking feels like a priority. my gosh, I gotta answer the phone and check patients out. I gotta try and schedule all the doctors asking me questions. I gotta keep my doctor busy. I've got constant interruptions nonstop. As soon as feel like I get patients checked in, that hygiene team's bringing them right back out. It is nuts. And it's because we just don't have priorities hierarchied. And also we're not using time when we need to.   So when front office is jumping between five tasks and finishing none of them well, that's chaos. And so how can we actually make it to where things aren't as chaotic? Because yes, you're always gonna have interruptions. And I think for us to never feel like, I can never have interruptions, like that's not my perfect date. That's not real life. We signed up for an amazing job that's very busy up front. And I feel like my job in front office, I say like, I'm here for air traffic control. Like that's my job. And I'm gonna make sure every plane lands easily, AKA every patient has an appointment. I get them scheduled. We're gonna have calm.   Like I want to feel like JFK's airport. Like we're there. I just think about that airport and that air traffic control. I'm like, they have people flying in and out like mayhem or you can go to Atlanta or you can go to like any big city. Like think about that air traffic controller. And that's who like, I want to be at the front office. So front office team members, hopefully that's a good vision for you of, Hey, yes, we've got a million things going on, but we are laser focused on what's the most important thing. And so I love to give like, okay, number one, our scheduling person, what's their number one job? Their number one job is to make sure our schedule is filled to goal every single day.   That's your job. So hygiene and doctor like bada bing, bada boom, that's your role. You keep them on there and you do not leave the day until your schedule is full. Like I'm not having you go home like, well, I did my best. ⁓ Outcomes over activities. I am big on this. We own our role. We don't just do a job. We own that. So if I'm a scheduling guru, you better believe I'm going to have my hygiene schedule full, full. That doesn't mean perfect. It means full and productive. And I'm going to have my doctor schedule the goal.   treatment coordinators, your number one job is to have your doctor's hitting goal or exceeding goal every single day. Not a full schedule. I don't want all the white space filled in. But if my doctor needs to be hitting 5,500, you make it rain sister or gentlemen, you go figure out how to do it. You go look at your unscheduled treatment plans. I'm not gonna say you sit here and call 20 unscheduled treatment plans unless you're an office that's 7.5 million, then yes, maybe we'll put that as a job. But 99 % of the time, your job is to call as many as needed to get your schedule full, period.   So scheduling coordinators, it's to make sure we're running on time, hygiene's full. Sometimes I have doctor over there. Treatment coordinators, you're always responsible for getting doctors scheduled to go. Billers, 98 % collections, non-negotiable. We gotta have money in the bank, otherwise we're broke and we can't feed our team. And we've done the work, we need to collect the money. So from there, and then office managers, your job is to make sure profitability is there, KPIs are being hit, and the whole team is flourishing. So that's just like a very simple like.   Yeah, but Kiera who's first on phones first on phones is scheduler first person they're always on it unless you guys like no we want them to be concierge style we have a concierge then they're not first on phones but we have somebody who's first who's second who's third on phones so as that phone rings we've got it can you set up a phone tree so where if they've got billing questions it just goes to the billing line and the biller can help with that if you're like Kiera I only have two people in my front office fan freaking tastic we need to have dedicated power hour time so front office and scheduler usually does insurance verification too typically that's who's gonna do it   but sometimes my treatment coordinators, like they want to make sure that they get all their insurance verification done and they have maybe a bit more time than our schedulers do. So again, it's who's got the most amount of time and who's the best with bandwidth on that. That's how I'm gonna set it up. If you have a bill or a dedicated bill or they're gonna do insurance verification for you, insurance verification should take you two to four hours max. And I'm talking to max a day. If we're taking longer than that, we gotta figure out how to be a bit more efficient and I got great ways to do it, like lump them together. I got a ton of podcasts onto it.   but we've got to just make sure that each person, and I love end of day checklist where, and it's not we wait till the end of the day, it's we get this stuff done during the day, but by the end of the day, all this needs to be stamped, signed, delivered. So scheduler, you're responsible for hygiene, making sure it's full and up to par, possibly insurance verification, possibly doctor, depending upon your office. Treatment coordinator, non-negotiable doctor scheduled to go every single day. I'm talking if I'm working four days, three of my four have to be to go, period. And the first patient of the day,   Please, please, please, please, please do not leave me one that's unconfirmed. And you're like, well, it's full. If they're unconfirmed, they're not showing. Like I might get lucky, but don't do that. Make sure it's a guaranteed confirm. Move those patients off. I've got a ton of verbiage for getting patients off the schedule. So we're not sitting there with like, to me, those are like gap fillers. Like it makes us feel good, but it's not gonna actually, like that's not me owning. I know that patient's not gonna show up. I call and call and call until I get people.   So I start doing my confirmations at usually eight or nine in the morning. So I've got time and I do a 48 hour confirmation guarantee. So if they're not there, and then we started implementing with a lot of offices that if they don't call and confirm you, we are moving you off the schedule to open that space up because we do need confirmation you will be here. I have moved patients off the schedule. Yeah, I'm gonna have about five people mad at me, but guess what? It's gonna fix 95 % of my problems. I can handle those five upset patients with me. I can handle that. If someone comes in duplicative, I can handle that.   Ladies and gents in the front office, air traffic controllers, you're also word ninjas. And you gotta learn to word ninja your way through a lot of things. Words are free. You can handle those hard conversations, but what we can't handle is not having productive schedules to where doctors aren't making money, we're not making money, and we're gonna go under. We can't handle that, but I can handle one or two upset patients. But I can also set up expectations so they're not upset with me, because I don't want to get berated. That's no fun for anybody.   So clear ownership, who does what, what are the simple KPIs for each of them? Put that in place, have us track it. That just right there, hopefully cleaned up 90 % of your issues. Now everyone was like, yeah, but we all do it together. High five. I love that you have teamwork. Like genuinely love it. Teamwork though is that game where it's who's on first, what's on second, I don't know, is on third. it's like who, like what thought everybody was going to do it? Everybody thought nobody was going to do it. So then somebody picked it up, but then nobody respond like,   It's a mess. So I love that y'all help each other. We just have to know at the end of the day, who's the one who puts the button on it? Who's the one who puts the final bow on it? Yes, we can all help each other, but I need a clear owner of each specific thing. I need a clear owner of hygiene and getting them scheduled. I need a clear owner of insurance verification. I need a clear owner of doctor's production. I need a clear owner of collections. Like I need those clear buttoned, tidied, and I need a clear owner of who answers the phone first.   There are several others. I know that there's more and you're like, but what about this? What about this? Again, it's just playing this game and you guys can get sticky notes, write them all up, put them there. I have end of day checklist. I'm happy to share with people, but we've got to have roles are shared, but they've got to be owned. So like it's a clear owner. You can have help. I'm fine with that, but you have to own it and you've got to own those results. Again, it's outcomes over activity. I am so grateful you called 50 people, but if we don't have people on the books, you gotta call 51 or 52 or 53 or 54.   And when you own that and you know that, guess what? How do I become a killer treatment coordinator? Because I knew I had to put people on the schedule and I wasn't gonna call them all night long. I was like, I got a family, I wanna go home. But I knew that that was my responsibility and I owned that result. So when we have shared responsibility, it actually creates drop in responsibility. So clean it up, if everyone owns it, no one owns it. So we have clear owners. And then what we have from there is we just have set systems. So what is our system for doing scheduling?   What's our power hour? I put schedulers back there, I put insurance for everybody. Put them behind the door for two hours where they're not being disrupted. Unscheduled treatment plans. Give that treatment coordinator one hour of blocked time. Go make it rain, honey. Like call the patients, text the patients. We are focusing on highest level priority things. Look over your treatment tracker. Practice your verbiage. What are the things that aren't closing for you? Why? But we actually spend it. And so put the systems into place. What is it? Some people have like...   To me, these are slightly aggressive checklists, but if it works for you, it's not aggressive. It's like by 10 a.m., all confirmations need to be done. By 12, all insurance verification needs to be done. By two o'clock, all of the schedule is filled to capacity. And then we're scheduled two days out or whatever it is. You can have it where it's benchmarks like that so we don't get stuck and then it's like four o'clock. I'm like, where did our day go? Sometimes those mile markers really can help, but we have to have set systems, set processes that everybody's following and we all know it.   And that's going to help because this helps when we bring on new people. How do we schedule? How do we treatment plan? How do we follow up? Getting those protocols written so it's not just living in our head. If it's in our head, we're dead. We got to get it out. We got to have those systems and protocols written. so systems don't live in people. ⁓ Systems like we're not relying on people. We're relying on systems. So when I look at that, systems are on paper or in video form, not in memory. That then helps.   Like if there's just one person that's like, well, Sue's out. We had a Sue in one of my offices. I'm like, I don't know how to do the billing. I don't know how to collect the money. I don't know how to schedule patients. Sue did it all. But if Sue goes on vacation, the practice is donezo. Like you cannot be reliant on a Sue in your practice. We need to have systems. We need to have processes. Yes, I want clear owners. But if that owner's on vacation, which they should be like our marketer Eve, she just went, she's like, it was awesome. I disconnected for an entire week. Didn't check Slack.   I knew everything would be taken care of and I came back and she had like three Slack messages of things that were missed. That is truly a systematized organization. Yes, I'm having a little kudos moment. It just happened yesterday. So yes, it's a brag moment on our side. But I think about that. Like could your Sue, Alison, Kiera, Tiffanie, Jenny take off for two weeks and would you guys be okay? And if the answer is no, we gotta get those systems written and then we need to send them on vacation and test it and see how we survive.   because we've got to be able to have it. So the three things that will fix this very quickly is number one, we've got to get clear ownership and that's ownership, not just job descriptions. Ownership, who owns scheduling, who owns phones, who owns our collections, who owns our treatment plans, who owns our doctor schedule. Get those things and eliminate overlap. Everybody in the front office is going to feel 20 times better and then have it on KPIs where we're tracking it every single week so we can see the progress and make sure it's true ownership, not just checking boxes.   Number two is we have a priority framework for an office. So what is it? Because like I can have my checklist and I can know this. Number one is my KPI. But before my KPI, patient in front of me, always. Always, always the patient who's in front of me. Then it's my KPI, that's my number two. And then it's gonna be team needs. And then from there, always phone for me. Phone is pretty high up there. Like I say, it's patient in front of me, phone. And then it's gonna be my KPI.   So you can be like, well, that phone's ringing. Okay, great. So then I can throw it and be like patient in front of me, KPI phones. Phones are so valuable. And if we don't answer and take care of it, but let's get a phone tree because we don't need to answer every phone call. The phone calls I really need to answer are my new patients. That's what I need. Also stop letting cancellations happen on your voicemails. Save yourself some time. The dermatologist that I'm going to, no voicemail. Like literally it's not even there. I can't leave a voicemail. And I have to call during business hours, period.   Like that's just how it works. And if I want to get into them and you might be like, but I'm so nervous. I'm going to have patients that won't call. That's fine. But I leave a voicemail and I have it. And I say, don't accept any appointment changes via voicemail. Please call during business hours. I also do not accept them via text message. I make my patients, if they're going to break up with me or having a phone, a voice to voice conversation, you're not just able to text me. Like we don't break up via text here. You get to call me, have a conversation. And that's how I'm going to help save my time on that as well. Have a phone tree.   Make sure that it's really set. So you know it's patient, my KPI, phones, whatever your guys' thing is, but make that priority framework for you so everybody's following it, we all know. So that way we're not sitting here with this like built up resentment of like, duh, you should be fixing the schedule. When it's like, they're with a patient. Now, team members, I have that priority framework, but that doesn't mean I don't get to own my KPI. My number is my responsibility. And yes, I can sit here and chat all day long with my patient, because they're number one, but that doesn't mean that I don't get to own my number.   I'm responsible for owning, like own that thing, air traffic controllers. You can't just be like, well, my job is to like make sure the plans land, ⁓ treatment and schedules. And then be like, but like I got busy and we were chatting with the pilot. They're gonna crash. No, you can chat, but you need to still own your role, okay? And then number three is build simple, repeatable systems. So that way like Sue, Jenny, Sarah, Kiera, Tiff, anybody can go on vacation.   and we're not gonna drown and think, yes, we'll be tired and we'll be glad they're back. Like I missed Eve, I'm super happy she's back, but our company didn't go under without her. And that's how your team should be as well. So, front office overwhelm is usually not about the team, it's just about clarity and consistency. It's about roles and systems being clear and defined, so that way confidence can go up and stress can go down. And I know you might be like, this was such a like 20 minute podcast to clean up my whole front office. And I wanna say like, it really can be that easy.   I think that teams get in this, I think ego gets a little bit in the way of like, I've always been doing this. I think it's a little scary to shake up a role cause you're good at it. ⁓ But I think, not I think I know, if I have done this in 500 plus practices with our entire team, I know we can do it for you and your team too. And it's not a set, deadly team is not a set like, you have to do this. Like that's a cookie cutter. That was me like pressing my Christmas tree into the cookie. ⁓ You don't have to just be a Christmas tree or.   an ornament or a square or a triangle. It is what is best for your practice. We will share best practices, but ultimately this is your teen year practice. They live there, I don't live there. So let's make it a place that they're happy to live. Let's make it a place that you're clear. And then doctors is great for you. So if you need a scheduling issue, you go to Kiera. If you have a treatment plan issue and your day's not scheduled, the goal, you go to Sarah. If you have an issue with billing, you go to Monica. Like you just go to your correct people. So that will help you. So look at that, see it really does like.   clear front office creates a calm place. And ⁓ I just want to say that it's very doable. We do this all the time. think I'd say probably like 70 % of our consulting is on front office and just helping because it is a slush pond up there and it does get messy and we're all trying to help each other and we all have the same goals and desires, but it's on the execution of those goals and desires and how it's being done to create the simplicity or the chaos. So reach out. I'd love to help you out. Let's see if you're a great fit. Let's see if we can help you.   take the pieces, implement today, whether you reach out to Dental A Team to get help for your front office because they just don't know it. If your front office listens to this and you guys have a meeting and you divide it up and make your end of day checklist, whatever it is, but do something to go from that chaos to that calm. It is very doable. We do this all the time. I would say we are freaking experts at it. So reach out, Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.  

In this episode, I sit down with Jack Hayes, founder of H&P, one of the fastest-growing legal executive search firms in the world.Jack launched the business after just two years in recruitment, with no management experience and no existing database, and has spent six and a half years figuring out how to build something truly world-class.We cover the hybrid exec model that sets H&P apart, the six-vertical mistake that nearly diluted everything, and the structural shift that saw them do £5M in revenue in their last six months alone.Connect with Jack here: https://www.linkedin.com/in/jack--hayes/-------------------------Watch the episode on YouTube: https://youtu.be/oN_wwYqkens-------------------------Podcast Sponsors: Claim your exclusive savings from our partners with the links below:Sourcewhale - Check Out Sourcewhale & Claim Your Exclusive Offer Here.Atlas - Check Out Atlas & Claim Your Exclusive Offer HereRaise - Check Out Raise & Claim Your Exclusive Offer Here.-------------------------Want more content like this?The Wednesday Debrief is our free weekly newsletter for recruiters who take their craft seriously. Join 7,000+ subscribers here: https://newsletter.recruitmentmentors.com/-------------------------Get in touch with me:Linkedin: https://www.linkedin.com/in/hishemazzouz/-------------------------

June 12, 2026In this episode, Scott, Mark, Dr. Ray Painter, and special guest Marianne DeSciose discuss the growing wave of payer scrutiny impacting urology practices, including automatic E/M downcoding, stealth denials, medical record requests, takebacks, and RAC-style reviews. Drawing on real-world experiences from hundreds of recently identified downcoded claims, the team shares practical strategies for detecting reimbursement issues before appeal deadlines expire, prioritizing revenue cycle resources, and building processes to monitor payer behavior more effectively. The discussion emphasizes the importance of strong clinical documentation, payer audits, contract monitoring, and team-wide coordination. The key takeaway: clean claims are no longer enough—practices must actively monitor, audit, appeal, and defend their reimbursement to avoid losing revenue. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

June 5, 2026In this episode, Scott, Mark, and Dr. Ray Painter provide an important update on the evolving C9761 reimbursement landscape, including CMS's decision to revise the code description and introduce a new HCPCS code for suction-enabled ureteral access sheaths. The discussion explores what these changes could mean for ASCs, HOPDs, and physicians involved in stone management. The team also answers listener questions about billing intraoperative consultations versus procedures and addresses payer denials related to place-of-service restrictions when procedures are performed in the office setting. The key takeaway: understanding documentation requirements, reimbursement rules, and site-of-service limitations is essential as coding and payment policies continue to evolve. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

“Et war emol....a wa se net gestuerwe sinn”: dat geet fir eng gutt Geschicht net duer. D'Essenz ass d'Handlung dertëscht, respektiv den Handlungsoflaf, op englesch “Storylines”. Mam Titel “Storylines” sinn eng hallef Dose Fotoexpoen am ëffentleche Raum zu Klierf iwwerschriwwen, dat well dës Billersérië vum Liewen, vu Wandel an Emotiounen zielen, an esou fir nei Geschichten an eise Käpp suerge sollen. Zanter dem Vernissage de leschten Hierscht hate mir iech e puer vun de Kënschtler hannert de Fotoe virgestallt. Vu datt dir elo just nach 5 Deeg, also bis den 31. Mee, hutt, fir d'Expoen ze gesinn, an d'Kerstin Thalau dës Geschicht och op e “gutt” Enn brénge wollt, hëlt et iech eng leschte Kéier mat op Klierf.

May 22, 2026In this episode, Scott, Mark, and Dr. Ray Painter revisit ureteral stent removal and replacement coding after listener feedback highlighted the need for additional clarification on when cystoscopic codes versus fluoroscopic exchange codes apply. The discussion then shifts to emerging RAC audits targeting prostate artery embolization (PAE) claims involving CPT codes 37242 and 37243, emphasizing the importance of detailed documentation and medical necessity support. The episode wraps with a deep dive into Medicare's medically unlikely edit (MUE) for add-on code 55715 for additional prostate biopsy lesions—exploring why the edit conflicts with CPT guidance, how practices should report multiple lesions, and why appeals may be necessary to receive proper reimbursement. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

May 15, 2026In this special live episode from the AUA Annual Meeting in Washington, D.C., Scott, Mark, and Ray Painter share highlights from the AUA Innovation Nexus program, where emerging companies, investors, and industry leaders are working to bring new urology technologies to market  . The discussion focuses on the growing importance of reimbursement strategy early in product development, the operational and financial realities practices must consider before adopting new technology, and why collaboration between innovators, physicians, and practice teams is critical for success. The episode also explores how efficiency, workflow, and return on investment increasingly drive whether promising technologies ultimately make it into everyday urology practice. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

De "Dicke Berta", en Lüchttorn bi Cuxhaben, is frisch renoveert. To dat Freilichtmuseum "Rieckhuus" in de Veerlannen gifft dat en nieget Book mit Billers un Texte op Hoch un Platt - un en Masse to beleven. Un de Mudderdag, de speelt ok en Rull.

May 8, 2026In this episode, Scott, Mark, and Dr. Ray Painter discuss the growing wave of innovation in urology and why reimbursement strategy must be part of the conversation from day one. Ahead of the AUA Innovation Nexus meeting in Washington, D.C., the team explores how new technologies move from concept to clinical adoption—and the reimbursement hurdles that can slow that process down. The discussion covers coding, coverage, payer adoption, workflow planning, AI-driven practice tools, and the importance of building a realistic business plan before introducing new technology into a practice. The key takeaway: exciting technology alone is not enough—successful adoption requires clinical value, operational readiness, and a clear reimbursement strategy. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

May 1, 2026In this episode, Scott, Mark, and Dr. Ray Painter break down key differences between ureteral stent removal and replacement codes—50385, 50387, and 50688—highlighting how anatomy, access (internal vs. external), and the requirement for radiologic supervision drive proper code selection. They also tackle a growing issue with ICD-10 coding for bladder cancer, where the correct use of “history of” codes during BCG maintenance therapy is leading to unexpected payer denials. The discussion explores when to follow strict coding guidelines versus when payer-specific rules may require strategic adjustments. The takeaway: understanding both the technical details of coding and the realities of payer behavior is essential to avoiding denials and protecting revenue. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

April 24, 2026In this episode, Scott, Mark, and Dr. Ray Painter break down the latest guidance on HCPCS code C9761 and the growing confusion around what qualifies for payment under this new technology APC. They walk through key interpretations from the AHA, AMA, and MACs, highlighting the critical distinction between steerable ureteral catheters, scopes, and access sheaths—and why that difference can determine whether a case is paid or denied. The discussion emphasizes the importance of precise physician documentation, understanding device labeling, and verifying payer-specific policies before billing. The takeaway: while new technology offers higher reimbursement potential, it also introduces real risk—making clarity, compliance, and payer alignment essential. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

April 17, 2026In this episode, Scott, Mark, and Dr. John Lin tackle a deceptively simple question: does it make sense to perform more complex procedures—like Optilume and other minimally invasive treatments—in the office setting? The discussion breaks down the three critical pillars every practice must evaluate—clinical fit, financial viability, and operational execution—while highlighting key factors such as reimbursement, equipment costs, anesthesia logistics, staffing, and workflow efficiency. They also explore opportunity cost, geographic variability, and how in-office procedures can improve both patient experience and physician productivity when done right. The takeaway: success requires a fully developed plan—because bringing procedures in-house is never just a simple yes or no decision. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

April 10, 2026 In this episode, Scott and Mark Painter break down the rapidly evolving and increasingly uncertain landscape surrounding UTI PCR testing, following heightened scrutiny from the OIG and a surge in payer denials—particularly for CPT code 87798. They discuss confusion around MUE limits, shifting interpretations from MACs, and the growing use of N35 denials triggering documentation requests. The episode outlines how practices should respond, including when to appeal, how to support medical necessity, and the risks of prematurely changing billing behavior without clear guidance. The key takeaway: stay disciplined, document thoroughly, and play the long game as policies continue to evolve.  PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

April 3, 2026 In this episode, Scott, Mark, and Dr. Ray Painter tackle two areas where interpretation is driving real-world coding challenges: when a prostate biopsy truly qualifies as a stereotactic template-guided saturation biopsy (55706), and whether diagnostic cystoscopy meets moderate risk under E/M guidelines. The discussion breaks down what differentiates saturation biopsy from standard transperineal approaches, including the importance of 3D templating and full-gland sampling, and why payer expectations may not align with physician interpretation. They also revisit the E/M risk table, reinforcing why cystoscopy is generally considered moderate risk—even if not explicitly stated in current guidelines. The key takeaway: as coding becomes more nuanced, balancing guideline interpretation with payer expectations is critical to staying compliant and getting paid correctly. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

He spent years managing luxury restaurants in Los Angeles and London. Then he walked into a recruiting office with zero industry knowledge — and became one of Europe's top billing recruiters. Jean-Louis-Philippe Girardet (JLP) didn't just cross industries. He rewired how recruiting gets done.

March 27, 2026 In this episode, Scott, Mark, and Dr. John Lin dive into the challenges of navigating Medicare Advantage (Part C) plans—what happens when you're out of network, why reimbursement can feel like a “surgical lottery,” and how to decide whether to participate at all. Prompted by a real-world scenario involving UnitedHealthcare narrowing its network, the discussion explores out-of-network billing strategies, patient responsibility, contract pitfalls, and the risks of unpredictable payments. The team also breaks down the key differences between traditional Medicare and Medicare Advantage, highlighting how payer incentives, network restrictions, and administrative burden impact both practices and patients. The takeaway: know your numbers, know your leverage, and be intentional about the payers you choose to work with. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

March 20, 2026 In this episode, Scott, Mark, and Dr. Ray Painter break down a new UnitedHealthcare policy that could impact payment for professional components of diagnostic services—including urodynamics and other PCTC-coded procedures—and what practices must document to avoid denials. The discussion outlines the need for clearly separated diagnostic reports with findings and impressions, as payers increase prepayment scrutiny.   The key takeaway: as payer oversight intensifies, precise, structured documentation—and understanding how rules are applied—is essential to getting paid. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

March 13, 2026 In this episode, Scott, Mark, and Dr. Ray Painter tackle three emerging reimbursement challenges affecting urology practices: widespread denials for testosterone pellet (Testopel®) therapy, the growing trend of secondary payers requiring prior authorization for high-cost drugs, and whether urology questionnaires qualify as billable health risk assessments. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

March 6, 2026 In this episode, Scott, Mark, and Dr. Ray Painter break down the complex “alphabet soup” of Medicare coverage and auditing tools—including NCDs, LCDs, LCAs, RAC audits, and the emerging WISER program—and explain how they work together to shape reimbursement policy. Prompted by a new multi-state LCD affecting Botox coverage, the discussion walks through how coverage determinations are created, how Medicare contractors enforce them, and why documentation requirements continue to expand. The panel also explores how practices can adapt by building workflows, intake forms, and clinical documentation processes that capture the data Medicare expects—helping physicians navigate audits while still delivering appropriate patient care. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Most recruitment agencies believe in training. Very few build a structured system that consistently produces top billers. Larissa Gerlach experienced the hard version first. In year one, she earned $40,000 and questioned whether she would make it in recruitment at all. By year three, she had reached President's Club. Soon after, the CFO of a private equity-backed recruiting firm asked her to replicate her results across 25 offices. That request became the foundation of a national recruiter training programme. In this episode, Mark Whitby and Larissa unpack what actually drives recruiter performance, why activity metrics alone don't create top billers, and how recruitment business owners can build scalable training systems that reduce ramp-up time and increase recruiter billings. If you are serious about recruitment agency growth, search firm leadership, and building consistent performance inside your team, this conversation goes beyond theory. It's about systems. What You'll Discover • Why 200+ calls per week worked — and why most recruiters still fail at high activity • The difference between knowledge and live desk performance • How to turn individual billing success into a national training framework • Why daily role plays accelerate recruiter revenue • The three structural reasons founders struggle to implement training • Why cohort-based onboarding produces stronger long-term performance • How to build recruitment agency systems that scale beyond one top performer Episode Highlights [03:56] From fashion sales to recruitment after the 2009 recession [08:37] The $40,000 first year and the meeting where she nearly quit [12:35] Why most recruiters struggle in year one — and what actually starts to click [22:15] The 200-calls-per-week discipline that changed her trajectory [26:07] The CFO email that led to building a national sales training programme [28:17] What the training playbook looked like — from binder to LMS [35:51] Why daily role plays create elite performers [1:05:49] The three reasons most founders struggle to train their teams [1:10:29] Why group cohorts outperform one-to-one onboarding About Larissa Gerlach Larissa Gerlach is the founder of Vibrant Talent Group, an executive search firm specialising in marketing, product, and design roles across New York and San Francisco. She has over 15 years of experience across billing, business development, national learning and development, and agency leadership. At a private equity-backed recruiting firm, she became the fastest-growing salesperson in company history before leading national recruiter training initiatives. Resources Mentioned Recruiter Training Programme https://recruitmentcoach.com/training Seven Figure Freedom Scorecard https://recruitmentcoach.com/scorecard Recruiterflow https://recruitmentcoach.com/recruiterflow Trusted Voice Video https://recruitmentcoach.com/video Book a free strategy session with Mark Whitby https://recruitmentcoach.com/strategy-session If you want weekly conversations with recruitment business owners, executive search leaders, and top billers focused on recruitment agency revenue, recruiter performance, and long-term business resilience, follow The Resilient Recruiter on Apple Podcasts. The difference between average billers and elite teams is rarely motivation. It's structure.

February 27, 2026 In this episode, Scott, Mark, and special guest Dr. John Lin tackle real-world evaluation and management (E/M) scenarios submitted by members of the Thriving Urology Practice Facebook Group.  Through practical examples—including BPH follow-ups, elevated PSA management, overactive bladder, recurrent UTIs, and constipation—they break down how to apply medical decision-making rules to determine the correct level of service. The discussion highlights chronic stable conditions, prescription drug management, documentation pitfalls, automatic downcoding, and the ongoing gray areas that make E/M leveling “clear as mud.” The key takeaway: understanding the rules is essential—but precise documentation is what ultimately gets you paid.  PRS Coding and Reimbursement HubAccess the HubFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

February 20, 2026 In this episode, Scott, Mark, and Dr. Ray Painter break down the financial realities of the new prostate biopsy CPT codes and what they mean for urology practices. Moving beyond coding mechanics, the discussion focuses on the economic differences between transrectal and transperineal approaches, MRI fusion versus ultrasound guidance, targeted lesion add-on payments, and the site-of-service differential between office and facility settings. They explore how practice expense values, capital equipment costs, disposable supplies, physician time, and block scheduling all factor into the decision to bring advanced biopsy techniques in-house. The episode emphasizes balancing clinical judgment with financial sustainability—helping practices evaluate whether expanding in-office prostate biopsy services makes sense now and in the future. PRS Coding and Reimbursement HubAccess the HubFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

“What's Buggin' You” segment for Friday 2-20-26

February 13, 2026 In this special live episode recorded at the Urology Advanced Coding and Reimbursement Seminar in New Orleans on January 31st, 2026, Scott, Mark, Dr. John Lin, and Marianne DeSciose dive into one of the most contentious coding battles in urology: billing E/M services with cystoscopy on the same day. Prompted by a real-world question from the Thriving Urology Practice Facebook Group, the panel explores when modifier 25 is appropriate, why denials happen, and how to build documentation and appeal strategies that get results. With input from attendees, the episode brings practical insights from the front lines of coding, billing, and payer negotiations. PRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

February 5, 2026 In this episode, Scott, Mark, and Dr. John Lin break down the latest telehealth news—Congress has officially extended Medicare telehealth coverage through the end of 2027, offering long-term stability for practices. They also answer a listener's question about billing 52235 and 51720 together, covering when a modifier can be used and how to document instillation in the recovery room properly. The episode wraps with a cautionary tale about “medically impossible days,” where excessive use of time-based coding and level 5 visits can trigger audits and serious compliance risk. Stay informed, stay compliant, and keep calm—telehealth on. PRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

January 30, 2026 On this episode, Scott and Mark Painter sit down with Dr. Sida Niu and Tyler Hamik, co-founders of docology, an AI-driven clinical intake and workflow automation platform. Dr. Niu explains how docology was born out of his own frustration with after-hours chart review, and how the tool now distills massive referral packets into clear, focused summaries—saving hours of prep time. Tyler shares how docology integrates with EMRs to automate front-end document intake and insurance data capture, dramatically reducing administrative overhead. They also discuss their recent selection to the AUA Innovation Nexus and invite physicians to help shape the future of the platform.Get in touch with docology:https://docologyhealth.aiTyler Hamik PRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

January 23 , 2026 In this episode, Scott and Mark Painter discuss what the upcoming January 31 deadline means for telehealth coverage under Medicare, including expectations around funding extensions, potential payment delays, and bipartisan support for long-term access. They also introduce the expanded PRS Coding and Reimbursement Hub—an evolving resource offering disease-specific coding guides, product-specific reimbursement tools, prostate biopsy calculators, EOB insights, and more. Designed to help practices stay ahead of payer policy shifts and streamline claims for new technologies, the Hub is positioned to become urology's go-to coding and reimbursement resource in 2026 and beyond.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

January 16, 2026 In this episode, Scott, Mark, and Ray Painter revisit the new prostate biopsy CPT codes and provide a key update on the use of ProMaxo for MRI-guided biopsies. Mark shares recent insights confirming that CPT codes 55713 and 55714 are appropriate for procedures performed with ProMaxo, clearing up previous ambiguity around the “in-bore” language. Then, the team shifts to deductible season challenges, emphasizing front-desk protocols, eligibility verification, patient collections, and how to handle the increased complexity brought on by insurance churn and Medicare Advantage transitions. This episode delivers practical tips for optimizing both coding confidence and cash flow in the new year.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

January 9, 2026 In this episode, Scott, Mark, and Ray Painter tackle the growing issue of automated downcoding by commercial payers—where level 4 and 5 E/M visits are silently paid at lower levels without a formal denial. They explain how this tactic evades typical RCM detection, outline steps to flag and appeal these incorrect payments, and emphasize why accurate documentation is more important than ever. From setting up payer-specific protocols to understanding how AI-driven reviews can misinterpret records, this episode offers practical strategies to protect your top line and push back against unjust reimbursement practices.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

January 2, 2026 In this episode, Scott, Mark, and Dr. John Lin dive into the complexities of billing G2211, the Medicare add-on code for complex E/M visits, which now pays nearly $18 per use. They unpack a real-world case where a hospital system's blanket use of modifier 25 is preventing employed physicians from getting reimbursed for G2211, potentially costing them thousands in RVUs. The discussion covers payer-specific rules, how to appeal inappropriate denials, how contract structure affects physician compensation, and when to fight for carve-outs. They also explore why every urology practice should reassess payer mix and drop underperforming contracts when appropriate.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

December 26, 2025 In this episode, Scott, Mark, and Ray Painter answer listener questions about the new 2026 prostate biopsy CPT codes. They clarify global periods, explain the differences between transrectal and transperineal approaches, and tackle the nuances of coding for MRI-guided procedures—especially when using systems like Promaxo. They also break down the use of 55715 for additional targeted lesions, when modifiers like 52 may apply, and how payers might interpret these new codes differently. The team emphasizes caution, payer communication, and the evolving nature of both coding and coverage guidance.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptp

December 12, 2025 In this episode, Scott, Mark, and Ray Painter share highlights from the recent Urology Advanced Coding and Reimbursement Seminar in Las Vegas, including robust discussions on E/M coding, prostate biopsy changes, modifiers, and the Wiser program. They also provide an important update on the AMA's recent meeting about coding and payment for algorithmic services, detailing how CPT and the RUC are approaching AI integration in healthcare. From potential reimbursement models to risk assignment and FDA considerations, this forward-looking conversation covers the groundwork being laid for AI's role in clinical care and payment policy.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

The Pro Athlete Mindset That Creates World-Class Recruiters What happens when a former professional athlete brings elite discipline, visualization, and competitive fire into recruiting? You get a recruiter who treats the desk like a sport—and builds a fast-growing search firm in record time. In this episode of The Elite Recruiter Podcast, former pro athlete Jared Watts, founder of Next Play Search Group, reveals how the athlete DNA that took him from youth national teams to the professional level translates directly into high-performance recruiting. From reviewing “game tape,” embracing pressure, and tracking everything like a scoreboard to building trust with PE/VC firms, Jared breaks down the exact mindset and systems behind his rapid rise. He shares how he structured an in-house role to mimic agency upside, launched his firm intentionally, and built a relationship engine where candidates often become future clients. If you're looking to grow your desk, strengthen your business development, or operate with more precision and confidence, this conversation will push you to level up. If you want to: • Stop guessing and start tracking the right KPIs • Build a repeatable client engine • Improve your negotiation and influence skills • Create a personal operating system that compounds • Develop the self-belief and discipline of a pro athlete… This episode will change how you work. Key Takeaways • Elite recruiters track like athletes. Jared reverse-engineers every goal using metrics, patterns, and daily habits. • Relationships scale revenue. Giving without expectation—introductions, notes, referrals—creates a pipeline of repeat PE/VC clients. • Visualization drives performance. Confidence comes from preparation and treating every conversation like a high-stakes moment. • Do things that don't scale. Personal touchpoints create leverage automation can't match. • Protect your time. BD, candidates, and high-value conversations come first—everything else waits. Listen, subscribe, share, and connect with us!   SPONSORS & LINKS

November 21, 2025 In this episode, Scott, Mark, and Ray Painter explore the reimbursement challenges surrounding procedures that may not be covered by insurance, including those considered cosmetic, elective, or medically unnecessary. They discuss how to identify whether a service is reimbursable, when to use ABNs, how different payer rules come into play, and why collecting upfront may be the smartest move. You'll also hear strategies for handling denials, gray-area procedures, and why knowing the rules—and your contracts—can make all the difference.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

In this powerful episode, million-dollar biller Emily Audibert breaks down how she went from six months without a single placement to becoming one of the most sought-after recruiters in the go-to-market tech space. Her turning point wasn't a new tool or technique—it was understanding the balance between masculine and feminine energy in selling, sourcing, influence, and relationship-building.

Is your recruiting desk—or your entire firm—running on chaos instead of systems? You're not alone. Most recruiters feel the turbulence daily… but the top-performing firms operate differently. They run on an Operating System that eliminates chaos, drives consistent billings, and creates scalable growth. In this episode, Ben sits down with Kelsey Boyd, a transformational operator who helped overhaul a multi-brand recruiting organization—rebuilding systems, rewriting processes, revamping tech, and implementing EOS to create genuine business momentum. This conversation is a masterclass in turning recruiting chaos into predictable success.  

November 14, 2025 In this episode, Scott, Mark, and Ray Painter discuss the impact of the government's recent reopening on telehealth services for Medicare patients. With the new continuing resolution extending COVID-era telehealth flexibilities through January 30, 2026, they break down what this means for billing, coverage, and patient refunds. The team also explores what to watch for if another shutdown looms, how CMS might handle claims from the closure period, and why signs point to telehealth becoming a permanent fixture in Medicare.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Sponsors - Claim your exclusive savings from our partners with the links below:Sourcewhale - Check Out Sourcewhale & Claim Your Exclusive Offer Here.Raise - Check Out Raise & Claim Your Exclusive Offer Here.-------------------------Extra Stuff:Learn more about our online skills development platform Hector here: https://bit.ly/47hsaxeJoin 6,000+ other recruiters levelling up their skills with our Limitless Learning Newsletter here: https://limitless-learning.thisishector.com/subscribe-------------------------Get in touch:Linkedin: https://www.linkedin.com/in/hishemazzouz/-------------------------

What does it really take to grow a recruiting business to $300M, scale contract staffing revenue, and execute a profitable exit—while keeping your team together? In this high-impact episode of The Elite Recruiter Podcast, host Benjamin Mena sits down with industry veteran Jon Davis, who reveals the exact strategies that turned his firm into one of the most successful staffing organizations in the country. Whether you're running a solo desk or scaling an agency, this episode is your roadmap to recurring revenue, massive valuation, and building a business buyers fight to acquire.

In this episode of Inspire to Lead, host Talia Mashiach sits down with Beth Warren, CEO and founder of Nourished by Beth, to explore the journey of turning a love for food and helping others into a thriving nutrition practice. Beth shares her story of starting out in marketing, landing a coveted internship at American Express, and ultimately pivoting to nutrition—navigating the challenges of building a business from her Brooklyn home while raising a family. The conversation dives deep into the realities of entrepreneurship: from the decision to accept insurance, scaling to multiple offices, and the importance of networking and self-advocacy, to the sacrifices and resilience required to balance motherhood, business growth, and personal well-being. Beth opens up about the lessons learned through divorce, the power of having your own career, and the evolution of her practice to focus on emotional well-being and authentic connection. 03:15 – Discovering Nutrition: From Marketing to Food 07:00 – Landing the American Express Internship 10:00 – The Power of Networking & Self-Advocacy 15:00 – Starting a Private Practice While Raising a Family 20:00 – Accepting Insurance & Scaling the Business 25:00 – Building a Team: Assistants, Billers, and Dietitians 30:00 – Work-Life Balance: Juggling Family and Growth 35:00 – Navigating Financial Pressures & Business Pivots 40:00 – Resilience Through Divorce & Reinventing the Practice 45:00 – Focusing on Emotional Well-Being & Authenticity 50:00 – Writing Books & Building a Personal Brand 55:00 – Advice, Mindset, and Final Reflections   About Our Guest: Beth Warren is a registered dietitian, entrepreneur, and author, known for her practical approach to nutrition and her commitment to helping others achieve lasting well-being. As the founder of Nourish by Beth, she has built a reputation for expertise, empathy, and innovation in the field of nutrition and wellness. Beth's journey is marked by resilience, adaptability, and a passion for empowering others to live their healthiest, most authentic lives.

In this conversation, Amarbir is joined by Will Grashoff, Founder and Managing Partner of Will's Talent.Will covers a lot of ground, referencing his wealth of experience running a rec-to-rec firm. One thing he's seen time and time again? Great—not just good—billers follow a consistent routine. Their days don't look wildly different from one to the next. In making this point, he highlights that, while personality traits can aid success, the key to high performance is actually a bit more fomulaic, with no "secret sauce." If that's the case: then anyone can become a top biller...which means you should probably listen in to learn how. Chapters:00:00 - Will's Talent Founder on the Consistent Routine to Recruitment Success06:10 - Strategies for Growing Your High-Impact Personal Brand as a Recruiter10:03 - The High-Biller's Routine for Continuously Growing Your Talent Network16:20 - How to Move From Good Performance to Outstanding Billings With Consistency28:10 - The Power of a Strong Company Brand in the Recruitment-to-Recruitment (Rec-to-Rec) SectorExplore all our episodes and catch the full video experience at loxo.co/podcastsBecoming a Hiring Machine is brought to you by Loxo. To discover more about us, just visit loxo.co

October 31, 2025 In this Halloween-themed episode, Scott, Mark, Ray, and special guest Dr. John Lin explore the “curse” of poor documentation and its real-world consequences, including payer audits, downcoding, and revenue loss. They discuss how vague or incomplete documentation—even when care is appropriate—can lead to denials and clawbacks, especially in today's AI-assisted claims review environment. The team also covers practical strategies to improve documentation, the risks of overrelying on ambient AI tools, and why every clinician must understand the rules of E/M coding. This episode is packed with actionable insights to help you protect your revenue and stay ahead of payers' increasingly aggressive tactics.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

October 24, 2025 In episode 264 of the Urology Coding and Reimbursement Podcast, Scott and Mark Painter sit down with Ken Mitchell, PA-C, a nationally recognized expert in men's health and a champion for advanced practice providers (APPs) in urology. Ken shares insights on the growing urology workforce shortage, the evolving role of APPs, and recent payer challenges—like restrictions on APP-administered Xiaflex in Arkansas. He also introduces his nonprofit, Gynecology, which promotes men's health education and training. This episode is a must-listen for practices navigating workforce limitations, payer pushback, and the future of urologic care.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

October 17, 2025 In this episode, Scott, Mark, and Ray Painter clarify the latest on the Medicare claims hold during the government shutdown, explaining that it applies only to services affected by expired COVID-era provisions like telehealth under traditional Medicare. They also address coding questions on billing for bladder stone removal during robotic prostatectomy—highlighting when to use 51050 vs. 51999—and revisit proper coding for Urocuff procedures following a UnitedHealthcare audit, emphasizing payer-specific strategies and the importance of reviewing operative details and coverage policies.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

October 10, 2025 In this episode, Scott, Mark, and Ray Painter address two pressing topics for urology practices. First, they provide the latest update on the government shutdown, its impact on Medicare claims processing, and the timeline for when the CMS-mandated 10-day hold may be lifted. They also clarify that Medicare funding is not in jeopardy—this is purely an administrative delay related to expiring telehealth and COVID-era waivers.Next, they tackle a listener-submitted question about hidden processing fees on payer payments—specifically, credit card reimbursements that reduce practice income by 3% or more. Mark shares practical recommendations, including switching to ACH/direct deposit to reduce costs, proactively managing PECOS and credentialing, and negotiating cost-of-living increases in payer contracts. They also explain the risks of neglecting PECOS updates and why contract management should be a routine business process—not a reactionary one.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

October 3, 2025 In this episode, Scott, Mark, and Ray Painter discuss two timely and important topics. First, they break down the current government shutdown and its effects on Medicare claims processing, including the 10-day hold issued by CMS to allow MACs to adjust their systems—especially around telehealth billing. They offer practical recommendations for urology practices, including billing guidance and the use of ABNs during the shutdown.Then, the discussion shifts to artificial intelligence in healthcare. After attending multiple urology meetings and AI sessions, Scott and Mark share real-world observations on how AI is being used across the urology landscape—from ambient documentation tools to claims scrubbing and patient scheduling. They emphasize the importance of human oversight, expertise, and carefully evaluating AI partners before implementing tools in your practice. Ray adds his perspective on the ongoing need for human knowledge and caution when embracing new technology.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

September 26, 2025 In this episode, Scott, Mark, and Ray discuss the looming federal government shutdown and how it could impact urology practices—especially telehealth services. They explain the latest developments in Washington, what Medicare and Medicaid payments will look like during a shutdown, and offer practical guidance for handling telehealth visits, front-office operations, and prior authorizations. Mark shares specific strategies and options for practices, including use of ABNs and billing considerations for Medicare Advantage and traditional Medicare patients. The episode wraps with insights on how the shutdown might delay CMS's final rule and the broader implications for AI, reimbursement, and practice management.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

UCR 259: Bladder Cancer Reimbursement Strategies – Using Unlisted J Codes and the New Zusduri Hub ToolsSeptember 19, 2025 In this episode, Scott, Mark, and Ray Painter dive into bladder cancer reimbursement with a special focus on billing strategies for new intravesical therapies like Zusduri, which currently lack established J codes. Mark outlines the complete reimbursement pathway from diagnosis coding through installation documentation, prior authorizations, appeals, and follow-up. They discuss the importance of accurate diagnosis flow, clear drug documentation, and the nuances of billing unlisted codes—including Box 19 tips and JW modifiers.The episode also introduces PRS Network's new Zusduri Reimbursement Hub, including a custom J Code calculator designed to help practices manage invoicing timelines, track payment cycles, and streamline claim submissions. This tool is a game-changer for practices adopting new therapies. The Painters wrap up with reflections on the importance of payer education, the role of pioneers in improving access to innovative urology treatments, and how this supports better outcomes for patients.Urology Advanced Coding and Reimbursement SeminarInformation and RegistrationPRS Coding and Reimbursement HubAccess the HubFree Kidney Stone Coding CalculatorDownload NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and AdminsPRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a Quote Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Re-releasing a DAT listener favorite! Kiera is all about key performance indicators in this episode, and why they're important. When framing KPIs as the vitals of your practice, it makes a lot more sense! Some of Kiera's favorite KPIs are … Production (net, not gross) Collection (at least 98%) How many new patients you're getting Average diagnosis Acceptance rate Overhead There are a lot more indicators she talks about in this episode, so whether you're a beginner with KPIs or elite status, there's something you can learn. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: Kiera Dent (00:05) Hey everyone, welcome to the Dental A Team podcast. I'm your host, Kiera Dent, and I had this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, pillar, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices coaching teams. Yep, we don't just understand you, we are you.   Our mission is to positively impact the world of dental. And I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A-Teams. Welcome to the Dental A Team Podcast.   Hello, Dental A Team listeners. This is Kiera. And you guys, how's your day today? You guys loving it? Are you crushing it? I hope you are, wherever you are. I am actually sitting in my bedroom. I ⁓ rarely ever podcast here, because usually my husband's home. But tonight, I have some friends over there in the front room, and I definitely needed to get some podcasts done. Sissy was asking me, I just love having team members that are great at what they do. And I hope you guys take time to acknowledge the team members that make you great. The team members that are   just awesome at what they do. guys, Sissy keeps me so on the ball and I love her for it. Shelby does, Tiffany does, Brittany, Dana, Kylie, they are just an incredible bunch of people. And guys, if you ever get the opportunity to meet any of them, you are one lucky person. So I hope you're having a great day. I hope you're loving it. So podcasting today from the bedroom. I hope the audio is great. I hope you're loving it. Sun's just going down and today I just wanted to dive into a topic that I think is really awesome and it's KPIs.   So what the heck is a KPI? A KPI is Key Performance Indicator. I'll be completely honest. You guys, know I'm like authentic Kiera Dent. People when they call me and they chat with us, like interested in working with us, the number one thing I get told is, Kiera, you sound just like you do on the podcast. And I'm like, this is really great because it is me.   I don't shake it up, I don't change it. The only thing I do differently is I talk in a microphone so my voice sounds a little bit like smoother, if you will, on the podcast than in real life. But beyond that, same cadence, same tones. This is Kiera real life. So you guys know I am always, I try really hard to just be authentic Kiera. So if you ever come meet me in person, you peel back the Wizard of Oz current, I would be the exact same person as I am on the podcast as I am in real life. So when I first started as an office manager,   I did not know what a KPI was. I did not know why they were important. I didn't know that I should be tracking these things. I literally had no idea. So guys, if you're in my boat, hey, welcome, welcome to the CureDent No KPI Boat. If you know what they are, welcome, welcome to the Elite Boat. And if you are using them, welcome to the Rockstar Amazing Boat. Let's make you even better. So KPIs, I call them, the way I describe a KPI is they are the vitals of your practice.   So just like when you go to the doctor and they take your blood pressure, your temperature, they listen to your heart rate, all those things, those are the vitals. They take your weight. ⁓ I just went to the doctor the other day and it's super cool, like, right? You sit on the chair and they say they'll take your weight. And it was funny, the gal asked me, she said, do you wanna know your weight today? I was like, wow, thank you. Like, thank you for not making me have a bad day if I don't want to or thank you for giving me the opportunity. It just made me giggle.   But bottom line is the vitals, we go to the doctor and they take those vitals first because if any of those are out of alignment, that's the first sign that we have trouble. So that's what I think of with KPIs in a practice. These are the core pieces that are going to show you, is your practice healthy or is it not healthy? So yes, it's tracking and there's lots of different KPIs you can track. That's why it's called a key performance indicator. I am a firm believer that you should be able to change these up.   I think there are certain things that you should be tracking consistently. But I also think as human beings, we get stagnant and bored. So give yourself a decent amount of time to track and then shake it up. That way you're growing constantly and we don't get bored with KPIs. So for me, some of my favorite KPIs, this is a question every consultant who comes to Dental A team to work with us, we ask them, what is your favorite KPI to measure? One, I'm checking to see if they know what a KPI is. Guys, I probably would have flunked the consulting test if I would have come on.   We're a more elite company, guys. I have to keep these consultants on their top notch. They can't be lower than us now. So I ask what your favorite KPI is to track and why. Most of the time I get production and collection. Production is a great KPI to track. It's something, and again, be careful on production. Make sure you're tracking it on net, not gross. A lot of people wanna tell me that they have.   These huge successful practices, but guess what guys, if you can't collect it, don't even tell me that number. I don't care. It does not impress me because guess what? That high gross number feeds your ego. Your net number feeds your family. So I don't care about it. So report that number in net. Next up is your collection percentage. I want to know how you're collecting. So if you're a $1 million practice and you're only collecting 700,000, that's stressful. That means you're at a 70 % collection rate. I am aiming for a 98 % collection rate. Now,   There are lots of other KPIs and I will say there are some great softwares out there. Practice by numbers, dental intel, divergent. Those are my top three favorites. I'd probably put them in the order of dental intel, divergent, practice by numbers. I think all three of them are great. I love them all for different reasons. The reason I'm pro-ing for dental intel is because they just merged with Medento and guess what? They are kicking it. So I love that. I love what they do and I love Medento as a company. So any company with Medento, that's going to be my favorite company right now. But bottom line is a lot of these track KPIs.   What I found that gets tricky and what a lot of offices do is we often track too many things that we don't actually move the needle on anything. I'm guilty of this. So in our company, was having Cissy track how many Instagram followers we were getting every single week. At first, I thought it was a great marketing metric. I thought it was great to see how our marketing was doing. Guess what? It was actually just feeding my ego. So guys, if you want to feed my ego, please just go follow us on Instagram. I would love it. Get your friends, get your family, get your siblings, get your kids. I don't care who.   You can boost that number just to feed my ego. At the end of the day, do the Instagram followers actually matter? No, they don't. They don't move our company forward. What matters, just like you guys, how many new patients we're getting. So don't actually care about social media followers. Yes, it's a fun number to track, but what I care is how many new patients are we getting? Then after that, I actually care about if I'm going to the elite boat or to our rock star boat on how many new patients you're getting. Do you know how much each patient's value is?   Do you also know what our average diagnosis is on each patient? And do we know what our acceptance rate is on each patient? If you don't know that and you're already tracking some of these numbers, that might be a fun zone for you to go to, to be 2.0 or 3.0 of KPI tracking. If you're just starting out, don't go there. Let's just get you tracking new patients and where they're coming from. Bottom line is these are the vitals. So first steps first, I want you with your KPIs to make sure that you have the vitals of your practice. Production, collection, new patients.   case acceptance, reappointment percentages. Those are like your main shebangs that are really gonna tell you where you're going. If you wanna add in your overhead, I also love that because that's gonna pull in the business side of it to make sure that we're actually profitable as a business and we're not just running around trying to serve, but not even being profitable as a practice. We need our practice to be profitable. Otherwise we can't serve more in our community. Those are my main things I love to focus on. So if you're just starting out, start tracking those.   I prefer you track them at a minimum every week at best. I actually like these ones to be tracked on your morning huddle. It's great. Everybody has it, have it on a whiteboard. Everybody can see it. That is the vital heartbeat of your practice. I would love you to do it. Just like on my Apple watch, I'm watching the rings on my Apple watch. That's honestly the only thing on my watch face guys, because it'd be really fun. But I decided I don't want to get distracted by other things. I need to master these items before I move on.   So that's why I love it to be front and center. Get these KPIs front and center. Get a whiteboard, guys, they're real cheap. Put it up, track these items. Production, we talked about it. Net, not gross. Collections, we wanna make sure we're collecting at least 98 % if not higher. And then I want you to know how many new patients you're getting out of goal, what your case acceptance is. A healthy practice, if we're talking dollar for dollar, I'd like you to be anywhere from 35 to 65%. Now there's a wide range on that because I actually, if you don't...   diagnose a lot of ortho and you're not diagnosing a lot of implants in larger cases, your dollar for dollar should be way up higher. If you're diagnosing these huge treatment plans constantly, you actually should be hanging out lower because we're presenting so much treatment that I'm okay with a lower case acceptance. If we're one for one, meaning one thing accepted off of our treatment plan, no matter how large it is, I want you actually to be sitting at at least a 90 % case acceptance. If you're not, we got to talk.   That's right, you and me, we're going to have a date, we're going to chat. We need to get that case acceptance up because what we're doing is we're dis-serving our patients. We're not helping them find a way to get this treatment done. You as a treatment coordinator, your job is to be a solution creator with the patient. So do your job, find the solution, get those patients accepted. That way we can help them have healthy mouths and a better life, right? That's what it's all about. Hey, Dental A Team listeners, how was your 2021? Have you reflected back? Where did you really win?   Where did you really not win? If 2021 was a year of years, congratulations. I am celebrating with you and I would love to invite you to take it to the next level. If 2021 wasn't quite your year, hey, it's all right. I'm there for you. And I would love to invite you to make 2022 the year for you. That's right, guys. If you're ready to take massive action, if you're ready to take your practice and your team to the next level, increase your profitability. Yeah, guys, through an easy way.   Get your entire team aligned and you're ready to just have your life be different. That's right. Team development, top to bottom system development, top to bottom, changing and shifting your culture, improving your team morale. If that sounds like what you're interested in guys, I'd love to invite you to join us in our Dental A Team platinum group. It's the exclusive group where we physically fly to your practice. We give you insider tips. We share with you. have a quarterly newsletter that goes to that shares all the updates we're coming up with and we share it with our platinum group.   We'd love to have you and I would like to invite you because guys remember you're always one decision away from a completely different life. So reach out guys. I'd love to chat with you. I'd love to see if you're a great platinum client or what works best for you. Email me Hello@TheDentalATeam.com and I can't wait to welcome you as our newest platinum client. Take massive action. This is your year. Let's make sure 2022 is your year. Hello@TheDentalATeam.com. Can't wait to welcome you. So those are my main KPIs that I love to track.   Once you get those dialed in and you're consistent on those and you know, then we're going to start diving into even more data. I want to know how well our hygiene department's doing. They should be producing at least three times their pay. So if I'm a hygienist making $10 an hour, wouldn't that be a dream guys? Welcome to 2022. Hygienist $10 an hour. Yeah, right. You guys are like a hundred and a billion dollars an hour. Like it's crazy how much hygienists are at right now, but let's say for the sake of this podcast, it's $10 an hour. Okay. I should be producing at least   $30 per hour as a healthy hygienist. That's on a PPO. If I'm fee for service, I like you producing at least four times your pay. So if I'm in a fee for service practice, I'm producing $40 an hour, okay? So that would be another great KPI to track. You can also break it down per department. So we might have our doctors. Great KPI to track on our doctors is what are they producing per hour? Most doctors should be producing at least $500 per hour at a minimum, okay?   So if we're working in an eight hour day, that's a $4,000 day per doctor, again on net, not gross. So that's a great metric to put in there. What are our doctors producing per hour? What's our doctor case acceptance? What's our doctor diagnosis? Great KPIs for you to start tracking. If we move on to our hygiene department, you can track fluoride, you can track perio. Perio is a great set to track. We can track ⁓ how many night guards they're doing. We can track how many orthostarts they're doing.   Great KPIs to track, again, if you're in the elite rockstar status. ⁓ Dental assistants, I like to track how many same day conversions you get. Also, how many times you leave the room is a great KPI to track. Also, how many Google reviews do dental assistants get? Those are all really, really great ones that you can do. For front office, scheduling. How often are we scheduling our hygiene and doctors to goal?   So I usually like between 80 and 90 % that they're scheduled to go. Schedulers can be how many openings they have in hygiene. It can also be how many new patients you're scheduling. For our treatment coordinators, case acceptance, right? We want to make sure that we're getting those cases up there. For office managers, what's our collection percentage that can also go to our billers? Billers, I love you to be tracking your AR. Also outstanding claims. ⁓ How long it's taking us to get our claims paid. It's a fan-freaking-tastic KPI to be tracking.   because we want to be paid quicker. Guess what? If I'm tracking that, I can see, are we not sending our claims clean and are we having errors? Could we fix that? Could we enter data better so we don't have these issues happening? Could also track how long our patients are waiting in the waiting room. If we're working on VIP new patient experience. As I just listed, there are a myriad of KPIs you could do. What happens is we often try to track too many things that were actually focused on nothing. So I suggest you usually have at least one primary KPI per   person in the practice. It's their primary. That's the one that no matter what, they're going to hit that. And we make sure it moves our needle forward. So what's going to move our doctors forward? What's going to move our hygienist forward? It's going to move our dental assistants, our scheduler, our biller, our office manager. What is the one thing if we could only focus on one thing, what's going to move each of those people forward the most and move our practice forward the most? Focus on that. Master that. Set a goal of what you should be hitting and report either weekly or daily.   on those. I'll be honest, if you report it daily, just like working out daily, you will probably see greater results than if you do it weekly or just monthly. So I also have with KPIs that you should really, really, really, really be ramping those up and making sure you're reporting consistently and that people know the goals. If we miss it, let's find out why. What's going on? Let's diagnose the problem. Let's find out what can we do to improve that. Again, I want you to think of these as vitals. KPIs are vitals of a practice.   If you don't track these, if you don't check them, you will die. Okay? If you think about it that way, well, instantly I'm like, maybe I don't need to track that. Maybe I don't need to focus on that. If you're already tracking it and you're breathing imperfect, guess what? What happened to the doctor? They start checking other things. They run blood tests on us and they check a thousand different things in that. Okay? So there are lots of KPIs you can do, but I would say keep it simple. Do the kiss method. Keep your KPIs simple. Then add to it. Maybe each quarter we add something.   Maybe each month we add something. It's also fun if you have your team help create these KPIs with you. What do they think is going to the practice board? What did they get excited about? Maybe they want to make social media posts. Maybe they care about how many followers we actually have. Maybe you guys want to do that. Maybe they do it on how many new patients they can get. I just had an office, super fun. The team decided that they were going to try and get more family members scheduled. So on average, this practice was averaging about 35 new patients. Guess what?   Guess what? Just by focusing on asking for referrals from patients and getting more family members scheduled, they use the phrase, what other family members can we get scheduled for you today? They have increased their new patients with no marketing to 50 new patients a month. Is that not rad? That's because they focus on a vital that the practice needed to do. They focus on where they were weak and they're able to move their practice forward. So guys, I would encourage each of you.   Look at these KPIs, get them set. If you don't have a regular KPI tracking, let's start there. If you do, I want to bump it up. Are those KPIs being reported weekly by all team members? And does the doctor and office manager review this? I will tell you at our company, Shelby, she's a rock star. Our whole team reports on a Google drive. We call our leadership scorecard. Those are where our KPIs hang out. Every person has a number that they're tracking. We review these, we make sure that they're the vitals of our company and they're moving us forward.   Every person reports on this every single Friday. We have a reminder that goes out, so everybody fills it in. Shelby then makes sure it comes over to me. I then with Shelby review this leadership scorecard. Then on our leadership team, we look at this every single month and make sure that those are vitals. And then we look to see where are we weak? What do we need to move forward? This is how you start to track. Also, if you want to stamp out and do more practices and you want to have more growth, having a leadership scorecard where you track these KPIs consistently.   allows you to then be able to manage and oversee multiple locations because everybody's tracking. And at a second, you can glance at this and you'll be able to know where your practice is weak and where it's strong and where you need to dive in and give it massive help. So guys, I strongly encourage you, if you're not doing it, do it. If you're doing it already, where can you ramp it up? If you're already ramping it up, get your team members involved and ask them where they want to take it to the next level. KPIs are magic. They're vitals. Also, if you're in that top, top tier,   Maybe I challenge you and say, where could you simplify? Are you overtracking? Sometimes when I look at dental intel, I'm like, holy guac. That's a lot of items you're tracking. How do they know where to focus? I think about the book, Essentialism. If you haven't read it, I would strongly encourage you to do it. If we're focused on too many things, we actually don't make a lot of progress anywhere. We make minimal progress. If we're focused on one thing, we kill it. We knock it out of the park. We dominate it. So I challenge each of you, look at those KPIs. Could you simplify them if you're already doing them?   What are the main drivers of the practice? Keep it to three per department is my recommendation. Make sure that what we're truly focused on is actually going to move you guys forward. If you need help getting those KPIs set up, if that's something you want to start doing, we make sure our practices are all tracking. Our offices have vitals. We look at them. We actually call it their vital scorecard. Truth. That's really what we call it. So if you guys want to help with this, if you'd love somebody to help hold you accountable, email me. Hello@TheDentalATeam.com. I'd love to help you out.   nothing else guys, go get these KPIs in place and know that you guys are in control of this. You can see your practice at a glance. You can know if you're healthy or not just at a glance, just like the doctor does when we go in for our medical doctors. So guys, try it out. I'd love to hear it. I'd love to hear your successes. Post your KPI scorecards and tag us. We'd love to see it. Share. If you guys want to, you can start to get on our Facebook group, Donuts with Dana. She's literally going around and she's pulling these ideas and she's sharing and she's answering questions.   So join her, she's on Facebook Live every Friday, Donuts with Dana. So hop on over there if you have questions getting this set up, she's there, she'll help answer questions. And as always guys, just take action, do it. Don't be afraid of KPIs, they're very easy. And if we can help you, email us, Hello@TheDentalATeam.com. I'd love to share it with you guys. If you need a sample, email us, Hello@TheDentalATeam.com. And as always, thanks for listening. I'll catch you next time on The Dental A Team Podcast. And that wraps it up for another episode of The Dental A Team Podcast.   Thank you so much for listening and we'll talk to you next time.