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Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 17th Season starts up and Episode 4 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on surgical dressings.Spark inspires us all to reflect on beauty, abundance, and innovation based on the inspirational words of Vincent Van Gogh.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 17th Season starts up and Episode 3 features a return to her spotlight series on Newsworthy interviews that are also filled with Trusty Tips. Join Sonal on welcoming Robyn Alvarado and hear her talk about her Journey.Find Robyn on LinkedIn:https://www.linkedin.com/in/robyn-marie-alvarado-cpc-cpma-12507a22/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Taylor Bowker - Mindful Insurance Agency On Common Mistakes in Medical Billing: "She ended up getting a bill for $14,000 for a pee test." Health insurance in the United States is a pain. We all know that. As business owners, we often get stuck needing to shop for our own insurance. Only during certain times of year and only with all of these rules. But how do you buy health insurance, without going crazy? There is a marketplace, but it isn't exactly like going to buy grapes. It helps to have an expert on your side, as with most things. In this case, the expert offers their expertise at no additional cost to you. Taylor Bowker is the health insurance expert. She started Mindful Insurance Agency to help people navigate the murky waters of health insurance. As an entrepreneur, a business owner with multi-state employees, or someone simply trying to make sense of the marketplace, this episode breaks down the trends, challenges, and solutions in health insurance. Listen as Taylor offers tips on choosing the right coverage, using HSAs, and understanding group versus individual enrollment periods. Enjoy! Visit Taylor at: https://mindfulinsuranceagency.com/ Podcast Overview: 00:00 "Starting My Own Business" 05:11 Health Insurance vs. Cost Sharing 12:34 Cost Challenges in Employee Insurance 19:59 "Updating Marketplace Applications Challenges" 26:40 "$14K Surprise Medical Bill" 29:26 "Health Insurance Subsidy Reduction Impact" 37:36 Snowbirds, Coverage, and Emergencies 38:45 Healthcare Coverage Tips by Age 45:35 "Streamlined Application Support Platform" 51:59 "Insurance Enrollment Rules Explained" 55:45 Employee Coverage Plan Explanation 01:01:10 "Specializing in Individual Coverage" 01:08:09 QSEHRA Benefits and Marketplace Savings 01:11:50 "HSA Usage and Restrictions" 01:16:07 FSA Contributions and Usage Rules Sponsors: Live Video chat with our customers here with LiveSwitch: https://join.liveswitch.com/gfj3m6hnmguz Some videos have been recorded with Riverside: https://www.riverside.fm/?utm_campaign=campaign_5&utm_medium=affiliate&utm_source=rewardful&via=james-kademan Podcast Transcription: Taylor Bowker [00:00:00]: I saw the largest health insurance increase of my entire career this past open enrollment because these folks no longer qualified for a subsidy because their income— your income could literally go a dollar over the threshold to receive a subsidy and you no longer qualify for $1,000 a month's worth of savings. You could owe, you know, $12,000, $13,000, $14,000, $15,000 back at tax time if you go even a dollar over. So that's kind of where the issue lies. James [00:00:35]: You have found Authentic Business Adventures, the business program that brings you the struggle stories and triumphant successes of business owners across the land. Downloadable audio episodes can be found in the podcast link found at drawincustomers.com. We are locally underwritten by the Bank of Sun Prairie, and today we are welcoming slash preparing to learn from Taylor Belker of Mindful Insurance Agency. So Taylor, How is it going today? Taylor Bowker [00:00:59]: Hello. Good. Staying warm or attempting to. James [00:01:02]: Wisconsin, here we are. So tell me a story. What is Mindful Insurance Agency? Taylor Bowker [00:01:07]: Oh, sure. So at Mindful Insurance Agency, we assist individuals and businesses get health insurance, health, dental, and vision. And we are a brokerage. So we are essentially the middle person between the members and the health insurance carriers and just try to advise and educate and help people get health insurance. James [00:01:30]: Right on. How do you end up in health insurance? Taylor Bowker [00:01:33]: Well, um, so I started in the insurance industry back in 2012. I was 5 years old. I'm just kidding, I was a little bit older than that. Um, yes, yes, yes. Um, so I started very entry-level job at an agency in Waunakee, around town here. Um, again, just doing very entry-level things. And then I shortly got promoted to a business development role. Um, and then from there, there there was a different agency hiring that was focusing on health insurance, and I was ready for a change. Taylor Bowker [00:02:11]: They needed a customer service rep, front desk person, so I went there to work, and within a year of me working there, they actually asked me if I wanted to become an agent or a broker, and I had never thought that that was something I wanted to do. Insurance, it can be a very just like cutthroat kind of a situation with sales and quotas and things like that. And that always kind of made me a little nervous. But I am very much a people person. So I, you know, I thought, why not? Let's give it a try. So I got licensed and became an agent back in 2016 now. And then, so started as an agent there doing health, dental, and vision, like I said. And then back in 2019, I decided to start my own business. James [00:03:05]: So that's awesome. Taylor Bowker [00:03:05]: Yeah, I've been doing that for 6 years now. James [00:03:08]: So what was the motivator to start your own gig versus just maintaining with where you were at? Sure. Taylor Bowker [00:03:12]: Yeah. Well, I guess I've always kind of just been somebody who works just, I prefer to kind of be on my own. Being my own boss sounded really great. I was in a group of individuals at the time and other business owners, the group that you're in with me now where we met. And again, there were just a lot of business owners there and they were doing a really good job of owning a business. And it just sounded like a feasible option for me and something that I wanted to do. I also felt like I kind of had learned everything I really could being at the place I was at previously. So I figured, you know, why not give it a shot and rip the Band-Aid off? And it's been, yeah, it's been working out well so far. Taylor Bowker [00:04:00]: So that's good. James [00:04:01]: Right on. Taylor Bowker [00:04:02]: Yeah. James [00:04:02]: So has health insurance changed much over the past, what are we talking, 9, 10 years? Taylor Bowker [00:04:08]: Sure. So I would say yes, yes and no. So I think the biggest thing that's changed is rates, insurance rates. James [00:04:19]: They keep going down. Taylor Bowker [00:04:20]: Yeah, that would be amazing. No, similar to a lot of other things, they just keep increasing and by a lot, especially the last couple years. So a lot of other products have come into play to try to help mitigate those premium costs for people. There's a lot of other products out there now that aren't necessarily health insurance as it is defined by, you know, the commissioner of insurance, if you will, or the government. But there are other products out there that are designed similarly to help people, you know, still get the care that they need and save money on their premiums and their out-of-pocket costs. So I would say prices have changed and other products have been developed in the market to try to help with those pieces. James [00:05:08]: And other products, you mean, I guess, help me what you mean by other understand products. Taylor Bowker [00:05:11]: Sure, yeah. So obviously you have typical health insurance. This would be either through, it's all kind of under the Obamacare umbrella as we've known it for a while now. It can be a group plan through an employer that you work with, or it can be an individual plan on the marketplace or direct with an insurance carrier. And that would kind of be your more typical, just average health insurance policy. But as of the last, say, maybe decade, a couple of new products have come out, one of them being referred to as medical cost sharing. So medical cost sharing in layman's terms is essentially a product that you pay a monthly subscription fee for, similar to a premium, and you choose what's called an initial and shareable amount, similar to a deductible, where essentially you're saying, I'm willing to pay this cost upfront in the event that something catastrophic were to happen to me. And so because it's covering you for more catastrophic occurrences and not the full shebang like a regular health insurance policy would,, they tend to be less expensive for certain people in certain situations. Taylor Bowker [00:06:24]: Those types of products also work really well for lucky individuals that are more healthy, that don't necessarily use their benefits all the time, but just want something there in case. That also works well with what's called direct primary care, which is a newer model, at least around the Madison area. It's where you work with a primary care doctor directly. So they're not affiliated with any any hospital systems. You do pay them a small monthly subscription fee to utilize their services. However, it's, it's really very worth it because a direct primary care doctor is always going to make sure they have same-day or next-day appointments available for their patients, which is very unheard of nowadays. Yeah, unfortunately. And then they can also do a myriad of things for you, you know, because you're paying that monthly fee. Taylor Bowker [00:07:18]: They can run labs for a couple of dollars, which is also very crazy to say. They can run prescriptions for people at cost. If you have an appointment with them, it'll be either a 30-minute or an hour-long time block, which again is not very common if you go to a clinic through a hospital system. They can help you with most acute and even urgent care needs as well. So that can just be, yeah, those two things specifically go hand in hand pretty well together. There's also things out there that have been out there for a while, like short-term policies, you know, through UnitedHealthcare or Allstate or something like that. Those can be less expensive for folks,
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 17th Season starts up and Episode 2 features a Newsworthy update on the OIG Work Plan for January 2026.Sonal's Trusty Tip and compliance recommendations focus on the new industry segment-specific compliance guidance document issued by the OIG for Medicare Advantage parties.Spark inspires us all to reflect on beauty, abundance, and innovation based on the inspirational words of Elisabeth Kübler Ross.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
If you own or lead an RCM business, here's a question worth sitting with: Could your business run — and hold its value — without you? A new short solo series is coming to Leaders in Medical Billing. It's about building an RCM business that's structured, scalable, and resilient — whether you plan to sell someday or not. In this series, we'll break down: • What buyers actually look for in RCM companies • Why EBITDA alone doesn't tell the full story • Where value is created — and where it quietly erodes • How founder dependency, client concentration, and process maturity impact valuation This isn't about chasing an exit. It's about building leverage, clarity, and optionality into your business — now. If you want to think like an owner, not just an operator, this series is for you. Preparing Your RCM Business for an Exit (or a Higher Valuation)
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 17th Season starts up and Episode 1 features a Newsworthy update on 5 new telehealth services in 2026.Sonal's Trusty Tip and compliance recommendations focus on audit plans for office visits rendered via telehealth.Spark inspires us all to reflect on beauty, abundance, and innovation based on the inspirational words of Kahlil Gibran.Check out Sonal's NAMAS article:https://namas.co/5-steps-to-update-your-audit-plan-for-office-visits-via-telehealth/Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Medical Billing Marketing CTAs - Part 2
Medical Billing Company CTA for Landing Page
Half of all healthcare claims get denied, and most never get fixed—leaving you stuck with the bill. Authorization traps, coding disasters, and timing mistakes create a system designed to confuse you into paying for errors you never made.Learn more: https://healthlockplus.com/business&al=12-FDC HealthLock Plus City: Franklin Address: 612 West Main Street Website: https://healthlockplus.com/business&al=12-fdc Phone: +1 816 668 7965 Email: jim@shugart.com
Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Beth Morgan, a medical billing advocate and consultant, on navigating your medical bills. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own. Key Takeaways: [:51] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz. [1:12] Holly introduces today's topic, Medical Billing, and today's guest, Beth Morgan, a medical billing advocate and consultant. [1:31] Beth says a medical billing consultant is an individual who assists someone with medical bills to make sure that they are accurate and correct, and that they match the medical records, which are notes that the provider makes. [1:48] The medical billing consultant or advocate can make sure the bills are paid correctly and that the charges are within the reasonable prices for the treatment area. [2:19] Beth explains how medical insurance covers healthcare costs. It protects the patients and providers from very high expenses. It can also possibly help with the stress of navigating healthcare systems. [2:36] The goals of medical insurance are to help cover patient costs for treatments, preventive care, and prescriptions. It can also provide resources for telehealth visits or support visits, if needed. [2:48] With a telehealth visit, you, the patient, have to make sure that your insurance plan covers and allows it. Sometimes, the cost of a telehealth visit can be more than if you were to go to the office. [3:27] Beth says most people look at what insurance will cost them per month. They fail to look at their yearly deductible, per person or per family, their prescription costs, or what it will cost to see a specialist. They don't consider what therapies will cost them. [4:08] Beth had a client whose insurance company would only cover in-state providers. If she went out of state, she wouldn't be covered; even an emergency might not be covered. You have to look at the "nitty-gritty" of the policy. [4:32] Beth says the biggest things are the deductible and copay, or co-insurance. Don't just look at the cost. Most people will take out the $10,000 or $5,000 deductible plans, saying it only costs $75 for the entire family. What does it actually cover? [5:00] You don't want sudden surprises when you get to the emergency room. You want to know what your copay will be when you go into an emergency room. [5:11] Holly agrees with Beth and notes that Real Talk listeners have chronic illness. Some have multiple illnesses. When you're selecting insurance plans, those are the things you have to look into. [5:27] Patients with EoE often need endoscopies and other specialized procedures. Holly asks for tips on how someone can know what an endoscopy or other procedure will potentially cost. [5:41] Beth says to ask the doctor what the CPT code is. That's the code that describes the treatment. Then look up that CPT code on the insurance company website. They will show an estimated cost for that treatment, for a rough idea of the cost. [6:10] Keep in mind that it will not tell you what the providers will charge or what the hospital fee will be. [6:21] Holly says she has EoE and MS. She asks a social worker for the CPT code for every procedure so she has a record to double-check when the bill comes. The CPT code is the key. [6:50] Holly is a speech pathologist who does feeding therapy. She says to look at your plan to see if therapy is a copay or if it goes toward your deductible. If it goes toward your deductible, it will be very expensive until you meet that deductible. [7:10] People living with an eosinophilic disorder may find themselves in the ER for a variety of reasons. Holly was there this week with a food impaction. For others, it could be a pain flare or an asthma attack. [7:26] Holly asks how families can be prepared for medical bills related to emergency care. [7:40] Beth replies, You also have on that bill the ER doctor and the ambulance fee, including mileage, which must be accurate or rounded up to the next mile. Track the mileage in your car. [8:43] Who will be transporting you: volunteers from the fire department, a hospital ambulance, or an outside ambulance? Are you going under Basic Life Support or Advanced Life Support? [9:05] Once you get to the ER, have someone else with you who can advocate for you. Sometimes, staff will bring you forms to sign before they treat you. If you're in a lot of pain, you're not in your right mind to sign those forms; you're only thinking of your pain. [9:53] Ryan says a friend of his went to his doctor's office for a prescription refill. Typically, he pays a $25.00 copay per visit. This prescription refill visit was not covered in the same way as other visits, and he received a bill for over $200. The insurance company only covers maintenance appointments. [10:48] Beth says an Explanation of Benefits (EOB) comes from your insurance company. It shows what the doctor charged, what the insurance company paid, and what you owe. [11:07] A medical bill is what your provider sends you. Beth always asks the provider to send the bill after the insurance company has paid. That way, you know the insurance company has paid on the bill, and there are no surprises. [11:25] When the provider bills you, the insurance company may have paid something on it, or it may have applied the bill toward your deductible or copay. [11:44] When a patient receives a provider bill, Beth says they can go to a company called FAIR Health to see today's rates of what should be charged. Insurance companies negotiate rates with providers. [12:04] Beth says that an out-of-network provider of physical therapy can charge, for example, $160 a visit, and you have to pay out-of-pocket. They can send it to your insurance company, and the insurance company may only pay 30% of the charge. [12:20] Call the insurance company to ask questions about your insurance. Utilize the estimated costs feature on your insurance company's website. [12:32] Beth says she always keeps the page of her health insurance booklet that shows what a PCP office visit, or outpatient specialist visit, will cost. Most people get the book and toss it out, but that page is very helpful. [12:53] If you go into the emergency room, you might have a $300 copay just to be seen, but if you ask them to bill you after they bill your insurance company, most places should respect that. [13:11] Beth says that most of the time, the red flags that she looks for on medical bills are supply items. Most supply items are included in the cost of the hospital visit. She says a surgical hospital visit is like an oil change. [13:42] Beth compares a surgery to an oil and filter change. When you go in for surgery, the drape they put over you is included. You only pay for the supply items you walk out with. [15:15] Beth says, If there's something wrong on your medical bill, your insurance rep may not know the answer. Most insurance companies have outsourced their billing questions. Start with the billing department of the hospital. [15:35] Ask, "Why did you bill me for an X, Y, Z, when I didn't have an X, Y, Z? I had an A, B, C. Can we re-examine this, please?" Another thing is to go back to your provider. [15:52] The provider can request medical notes, which are part of your patient record, and you can look at them yourself. Beth says, for hospital stays, she always tells people to ask for a completely itemized bill. [16:12] Holly agrees. [16:20] Beth says you have to look at the itemized bill. Does something make sense to you? Does it look a little unreasonable? That's easy to see. [16:26] Ryan says when you call your insurance company, it can be time-consuming to reach the person who can answer your question, but it's important to do so, especially for expensive things like hospital stays. Doctor's office visits can also be expensive. [16:58] Something else that can be tricky is medications. Especially for those of us with chronic illnesses and the rare diseases that we work with here at APFED, costs can be quite high for some of the medications patients take. [17:20] Beth says, When you call the insurance company, ask for the name of the person you are talking to. Write down the name, date, and time that you spoke to the person. Ask them for a call reference number, where they are located, and what was discussed so you have record of that information. [18:04] For medications, you can look up prices through GoodRx or other prescription websites that might give you an estimate of what the possible cost could be. [18:20] If your provider states on the prescription, Do not substitute or give generics, you might be paying full price. Otherwise, most pharmacies will offer you the generics. [18:35] Holly asks, If someone feels overwhelmed by billing or insurance issues, where can they go for help? Are there resources that you recommend? [18:45] Beth says, There is a patient advocate group, with individuals across all 50 states, that will help you with medical bills and advise you on everything else. Your provider's office or the facility also might have someone who could help you. [19:11] Beth says she would look for patient advocates like social workers. Make sure whoever you work with has medical knowledge. [19:26] Ryan says, talking with the billing department can feel a little antagonistic, but they are there to help you. If you talk to the right people and ask the right questions, you can figure out what's going on and get some answers. [19:40] Beth agrees and says, Always write down your questions. Ryan adds, Always write down the answers and ask the name of the person you are talking to. Beth reminds you to ask for the call reference number. They keep a record of every call. [20:09] Beth's last words about medical billing: "The most important thing is keeping track of what's going on. I recommend using a calendar, like a planner, that you can write 'I saw Dr. J. Smith, EoE Specialist. Discussed flare-ups,' and the time and date." [20:30] "Keep a record. That way, in this planner, you can go back to it and match it up. If possible, have someone with you or on the phone with you when you talk with them. The other person can take notes, which is very important." [20:39] "You need to have the backup and the understanding. If you don't understand something, ask questions." Ryan says, Those are good tips for everyone. [21:14] For our listeners who would like to learn more about eosinophilic disorders, please visit apfed.org. [21:20] To learn more about navigating healthcare in the United States with eosinophilic disorders, please check out NavigateEOSCare.org. We'll include links to both of those in the show notes below. [21:29] Ryan thanks Beth Morgan for joining us today. This was an insightful conversation for everyone. Beth thanks Ryan and Holly for having her on. [21:35] Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode. Mentioned in This Episode: Beth Morgan, President & CEO of Medical Bill Detectives NavigateEOSCare.org Patient Advocate Foundation APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast Apfed.org apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda. Tweetables: "Medical insurance covers healthcare costs. It protects the patients and caregivers from very high expenses. It can also possibly help with the stress of navigating the healthcare systems." — Beth Morgan "Most people look at what insurance will cost them per month. They fail to look at what their yearly deductible might be, per person or per family." — Beth Morgan "Ask the doctor what the CPT code is. That's the code that describes the treatment. Then go to the insurance company's website. Most insurance plans have it. They will give you an estimated cost for that." — Beth Morgan "Keep a record. That way, in this planner, you can go back to it and match it up. If possible, have someone with you or on the phone with you when you talk with them. The other person can take notes, which is very important." — Beth Morgan "For hospital stays, I always tell people to ask for a completely itemized bill." — Beth Morgan "I would look for patient advocates like social workers. Make sure whoever you work with has medical knowledge." — Beth Morgan Guest Bio: Beth Morgan, President & CEO of Medical Bill Detectives, has been a Certified Professional Coder (CPC) and Compliance Specialist (MCS-P) since 2004. Over the past 20 years, she has worked in several areas of the medical profession, doing billing and coding for all sorts of providers. Her knowledge and expertise have enabled her to not only reduce providers' accounts receivable but also medical bills by 51%. She has access to a broad base of insurance company policy information and is an information contributor to radio and TV shows, as well as magazine articles. Medical Bill Detectives reviews medical bills for errors and overcharges, reducing them to Usual Reasonable and Customary charges, for negotiating discounts on medical bills. We are able to review bills for all 50 states. Aphadvocates.org/speakers/beth-morgan/ Seakexperts.com/members/7326-beth-morgan
Time-based coding can be a powerful, defensible approach for E/M services—when it's documented the right way. But vague or incomplete time notes can open the door to denials, audits, and compliance problems. In this episode, Terry breaks down the exact language, documentation elements, and inclusions you need to make time-based E/M coding hold up. She also covers Care Management Services, their time requirements, and how to avoid overlapping time pitfalls. Tune in for a clear, practical walkthrough. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Time Based EM and Care Management Compliance appeared first on Terry Fletcher Consulting, Inc..
Don't Offer Medical Billing Audits
Telehealth isn't going anywhere, but many practices still don't have a solid audit plan in place. With Medicare's proposed rules now finalized for 2026—and the added uncertainty of another potential government shutdown—it's easy to see why compliance teams are feeling the pressure. In this episode, Terry breaks down five practical tips to help you strengthen or update your telehealth audit plan, especially if you're providing office visits via telehealth through January 30, 2026. We also highlight insights from Sonal Patel and her excellent NAMAS article on this very topic. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Telehealth Compliance Tips for 2026 appeared first on Terry Fletcher Consulting, Inc..
Terry kicks off 2026 by clearing up a major misunderstanding in the provider and manufacturer community. Some believed that CMS's last‑minute withdrawal of the LCD for skin substitute products would delay or stop the 2026 reimbursement changes. That's not the case. The LCD withdrawal has no impact on the Final Rule, and the new 2026 reimbursement methodology for skin substitutes will move forward exactly as finalized, using an incident‑to payment structure. In this episode, Terry breaks down the difference between the policy halt and the reimbursement rules, and explains what providers need to know about the updated approach to skin substitutes and skin graft products and services. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Skin Substitutes and Grafts LCD vs Reimbursement 2026 appeared first on Terry Fletcher Consulting, Inc..
Terry closes out the year with a deep dive into Medicare's newly permanent “Virtual Supervision” rule taking effect in 2026, along with a refresher on the current requirements for reporting services under a physician's NPI versus an NPP's NPI. She urges listeners to approach this shift carefully, outlining the risks tied to non‑compliance, malpractice exposure, and whether patient‑safety concerns outweigh any potential financial upside. Tune in to get the context you need before jumping into this virtual model. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Is Virtual Supervision a Good Idea for 2026? appeared first on Terry Fletcher Consulting, Inc..
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 16th Season starts up and Episode 17 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on podiatry practices' evaluation and management services with modifier 25.Spark inspires us all to reflect on resilience based on the inspirational words of Winston Churchill.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
2026 is coming in fast, and with it comes a fresh wave of CPT code changes that every healthcare professional needs to be ready for. On today's episode of the CodeCast podcast, we break down the newest updates impacting Cardiology, Peripheral Vascular services, and several other key specialties. From what's changing to why it matters, we'll walk through the revisions, additions, and potential pitfalls so you can stay compliant and ahead of the curve as the new year approaches. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post 2026 CPT Code Changes Are Coming Fast appeared first on Terry Fletcher Consulting, Inc..
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 16 features a Newsworthy update on the PEPPER program. It's back.Sonal's Trusty Tip and compliance recommendations focus on skin substitutes and the upcoming LCDs.Spark inspires us all to reflect on resilience based on the inspirational words of Thomas Edison.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Auditing split/shared encounters can become confusing when providers, auditors, and coders are not aligned. CPT and CMS have both issued guidance to help clarify how these services should be billed. In this episode of the CodeCast podcast, Terry breaks down where to begin when auditing and educating on Split/Shared visits, what payers are currently saying, and how to maintain compliance for physicians and NPPs to prevent payer audits or confidently address them when they occur. She also gives a shout out to Sonda Kunzi, CPC, for her NAMAS article referenced during the discussion. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post Audit Tips For Split/Shared Visits appeared first on Terry Fletcher Consulting, Inc..
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 15 features a Newsworthy update on the OIG Work Plan for November 2025.Sonal's Trusty Tip and compliance recommendations focus on chronic care management documentation.Spark inspires us all to reflect on resilience based on the inspirational words of Edmund Hillary.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
In this episode of Leaders in Medical Billing, Chanie Gluck sits down with Randi Tapio, a seasoned revenue cycle management (RCM) leader whose career spans hands-on billing, consulting, and building high-performance teams. Randi shares her journey from working the front desk of a doctor's office to running her own billing center, exiting it, and ultimately launching MedCycle Solutions, now in hyper-growth mode. She opens up about the realities of staffing in RCM, explaining why maintaining a strong team is one of the industry's biggest challenges: "We have to hire three people to keep one — and interview six to hire those three." Randi discusses how she builds and manages a fully remote U.S.-based team, the importance of trust-driven culture, and why strategic hiring and leadership are essential for sustainable revenue cycle performance. This episode offers valuable insights for RCM leaders navigating growth, workforce challenges, and the evolving balance between human expertise and emerging technology. This episode is sponsored by 4D Global, empowering medical billing companies through offshore staffing.
When auditing risk of management in an E/M note, how are over-the-counter (OTC) medications scored? Under the 1995/1997 guidelines, they were categorized in the “low” risk row. However, the 2021 guidelines provide no examples under minimal or low risk, relying instead on AMA and Medicare guidance. Terry explains this distinction and highlights the difference between an acute uncomplicated illness and an acute illness with systemic symptoms. Take a listen. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post “Risk” E/M Element OTC Medications appeared first on Terry Fletcher Consulting, Inc..
Why do so many people fear AI being used in their medical billing?
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 16th Season starts up and Episode 14 features a Newsworthy update on World AIDS Day.Sonal's Trusty Tip and compliance recommendations focus on a new Medicare hospice outpatient services edit.Spark inspires us all to reflect on resilience based on the inspirational words of Marcus Aurelius.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Medical record signatures are more than the macro “electronically signed by Dr. Jack Jones.” A provider's signature is a legal attestation that the physician or provider performed, reviewed, and/or agreed with the documentation. Is this actually true, or are your EMR auto-signatures taking over? Terry discusses this critical aspect of medical record documentation compliance, with a shout-out to NAMAS for an article that also addresses the topic. Plus, a bonus update on the G0136 add-on code for 2026. Subscribe and Listen You can subscribe to our podcasts via: Apple Podcasts – https://podcasts.apple.com/us/podcast/codecast-medical-billing-coding-insights/id1305926627 Spotify – https://open.spotify.com/show/1lA69Q7EnjSMuVr3sXVWlX TuneIn – https://tunein.com/radio/CodeCast–Medical-Billing-p1056702/ YouTube – https://www.youtube.com/channel/UCoNm5vs6PFMIEDa5Undidlg YouTube Music – https://www.youtube.com/playlist?list=PLQ8tk23yZroZslhtTVe-PEIjQsAoJZJIQ Pandora – https://www.pandora.com/podcast/codecast-medical-billing-and-coding-insights/PC:1000156874 Amazon Podcasts – https://music.amazon.com/podcasts/c9d8dc99-fced-45a2-82b4-0efdf144c897/CodeCast-Medical-Billing-and-Coding-Insights iHeart Radio – https://www.iheart.com/podcast/256-codecast-medical-billing-a-31135434/ The post MR Signature Compliance appeared first on Terry Fletcher Consulting, Inc..
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 years on Feedspot.Sonal's 16th Season starts up and Episode 13 features Newsworthy updates on the month's fraud, waste, and abuse cases. Sonal's Trusty Tip and compliance recommendations focus on a Medicare telehealth update.Spark inspires us all to reflect on resilience based on the inspirational words of Dalai Lama.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
In this episode of Disruption/Interruption, host KJ interviews Matt Seefeld, CEO at MedEvolve, about the chaos and inefficiencies in the US healthcare revenue cycle. Matt shares how generative AI and a focus on human accountability can help providers achieve "zero touch" claims, reduce waste, and improve access to care, especially for small and rural hospitals. Four Key Takeaways: The Real Cost of Healthcare is Obscured (3:00)The US healthcare system lacks alignment between consumers, providers, and payers, making it nearly impossible to know the true cost of care. Administrative Waste is a Billion-Dollar Problem (04:01)Most providers touch claims multiple times, with 63% of those touches being wasted effort due to system inefficiencies and payer games. AI is a Tool, Not a Cure-All (31:50)While AI can automate and improve processes, more than half of claim errors still require human intervention, and technology alone won't solve systemic issues. Access to Care is Shrinking for Many Americans (24:00, 27:00)As costs rise and reimbursements fall, small and rural hospitals are closing, and more Americans are forced to seek care through emergency services or go without. Quote of the Show (31:50):"More than half—53%—of the errors that we see that humans have to get involved with come from AI solutions, so they're not smart enough yet." - Matt Seefeld Join our Anti-PR newsletter where we’re keeping a watchful and clever eye on PR trends, PR fails, and interesting news in tech so you don't have to. You're welcome. Want PR that actually matters? Get 30 minutes of expert advice in a fast-paced, zero-nonsense session from Karla Jo Helms, a veteran Crisis PR and Anti-PR Strategist who knows how to tell your story in the best possible light and get the exposure you need to disrupt your industry. Click here to book your call: https://info.jotopr.com/free-anti-pr-eval Ways to connect with Matt Seefeld: LinkedIn: https://www.linkedin.com/in/matt-seefeld-521319/ Company Website: https://medevolve.com How to get more Disruption/Interruption: Amazon Music - https://music.amazon.com/podcasts/eccda84d-4d5b-4c52-ba54-7fd8af3cbe87/disruption-interruption Apple Podcast - https://podcasts.apple.com/us/podcast/disruption-interruption/id1581985755 Spotify - https://open.spotify.com/show/6yGSwcSp8J354awJkCmJlDSee omnystudio.com/listener for privacy information.
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 12 features a Newsworthy update on RAC audits for 2025.Sonal's Trusty Tip and compliance recommendations focus on specific RAC audits for 2025.Spark inspires us all to reflect on resilience based on the inspirational words of Isabel Allende.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM.Thanks to all of you for making this a Top 15 Medical Billing & Coding Podcast for 5 Years on Feedspot. Sonal's 16th Season starts up and Episode 11 features a Newsworthy update on the OIG Work Plan for October 2025.Sonal's Trusty Tip and compliance recommendations focus on another claims processing update from Medicare.Spark inspires us all to reflect on resilience based on the inspirational words of Ernest Hemingway.Paint The Medical Picture Podcast now on:Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3XApple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcastFind Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7AFind Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/And checkout the website: https://paintthemedicalpicturepodcast.com/If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com
In this episode of "Leaders in Medical Billing," host Chanie Gluck welcomes Matt Seefeld, CEO of MedEvolve, to discuss his extensive experience in the healthcare industry. With over 24 years in management consulting, Matt shares insights into process improvement and technology development across the revenue cycle. He reflects on his journey from his early career at StockAmp and Associates to leadership roles at PricewaterhouseCoopers, Deloitte, and InterPoint Partners. Matt also discusses the transition from consulting to building a technology company, and the lessons he's learned along the way. Tune in to discover valuable takeaways for medical billing professionals and insights into the evolving landscape of healthcare technology. This episode is sponsored by 4D Global, empowering medical billing companies through offshore staffing. [00:02:07] Measuring healthcare administrative performance. [00:06:39] Tech bubble in healthcare. [00:08:47] Complexity of healthcare revenue cycle. [00:11:35] AI and coding denials feedback. [00:15:19] Agentic automation in revenue cycles. [00:19:40] Waste in healthcare processes. [00:22:49] AI in patient engagement solutions. [00:27:32] Importance of data transparency. [00:29:11] AI automation and benchmarks. [00:33:06] Social issues in healthcare.
Dr. Wilner would love your feedback! Click here to send a text! Thanks!Many thanks to Heather Signorelli, DO, for joining me on The Art of Medicine with Dr. Andrew Wilner. Heather is a practicing pathologist and owner of a medical billing company. Heather's interest in medicine and business began at an early age. Her father was an obstetrician for his entire career, and her mother was involved in hospital management.At medical conferences, physicians who struggled with running their offices frequently asked Heather for help and inspired her to start her company. Heather began her medical billing business with her husband five years ago. Currently, she supervises 70 employees and assists 200 physician practices in collecting payments for their services. The current complexity of the number of carriers, plans, and rules conspires to prevent physicians from receiving prompt reimbursement for their services. The industry average is 40 days to get paid, although Heather's company tries to shorten this considerably. Heather explained the top 3 things that physicians can do to improve collections. During our 30-minute discussion, we explored the growing concept of the Concierge Practice, which is a cash-based model. We also addressed the role of AI in streamlining office procedures and controlling overhead.Micro-practices, as presented on this program by Kara Pepper, MD, on August 31, 2025, are another option to traditional insurance-based practices. Both Dr. Pepper and Dr. Signorelli have studied with business guru and pediatrician Please click "Fanmail" and share your feedback!If you enjoy an episode, please share with friends and colleagues. "The Art of Medicine with Dr. Andrew Wilner" is now available on Alexa! Just say, "Play podcast The Art of Medicine with Dr. Andrew Wilner!" To never miss a program, subscribe at www.andrewwilner.com. Follow me on Instagram: @andrewwilnermd X: @drwilner linkedin.com/in/drwilner Please rate and review each episode. To contact Dr. Wilner or to join the mailing list: www.andrewwilner.com This production has been made possible in part by support from “The Art of Medicine's” wonderful sponsor, Locumstory.com, a resource where providers can get real, unbiased answers about locum tenens. If you are interested in locum tenens, or considering a new full-time position, please go to Locumstory.com. Or paste this link into your browser: https://locumstory.com/?source=DSP_directbuy_drwil...
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-legacy-protection
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-legacy-protection
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-empowerment-through-opportunity-for-women-everywhere
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-empowerment-through-opportunity-for-women-everywhere
If you've ever felt overwhelmed by a medical bill, this episode is for you. Jules Nowak—NICU parent and founder of The Medical Bill Academy—talks about the often-overlooked financial side of a NICU stay. From surprise bills to navigating insurance denials, Jules shares her personal journey through a 73-day NICU experience and the lessons that inspired her to help other families protect their financial health.
Dental hygienists are transforming dentistry by bridging clinical care and medical billing, boosting patient outcomes, reducing write-offs, and strengthening practice profitability through comprehensive assessments and codiscovery. Kandra Sellers, BA, RDH Read by Jackie Sanders https://www.rdhmag.com/career-profession/insurance/article/55311212/why-dental-hygienists-are-essential-for-codiscovery-and-medical-billing-in-dentistry
Daylight Savings Time changeover health myths busted; A doctor breaks her ankle and is billed $64,000 in uncovered expenses; Vitamin D shields life-prolonging telomeres, may help depression; The vaunted DASH Diet for hypertension faces off against low-carb alternative; The critical first 1000 days after conception—early life sugar avoidance yields major later life health dividends; Do you really need hot water to disinfect your hands?
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-asset-management-for-the-working-class
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-asset-management-for-the-working-class
Last month, the "Billing Boys"—Chris Jones and Phil Rodgers—joined the GeriPal podcast to demystify medical billing and coding in palliative care. This month, we're back with part two, shifting the focus to geriatrics. While billing and coding may not be the most exciting topic, they're essential for ensuring fair reimbursement for the complex care we provide and for supporting the work of our interprofessional teams, many of whom can't bill directly for their services. When we underbill or leave money on the table, we not only shortchange ourselves but also devalue the critical role of geriatrics in the healthcare system. This time, we're joined by experts Peter Hollmann, Ken Koncilja, and Audrey Chun to dive into key questions: Why does billing matter, and who does it benefit? What's the difference between CPT, E&M, and ICD-10 codes (if you need a refresher, check out our chat with the Billing Boys here)? We explore how to think about billing for complexity versus time, and unpack new and impactful codes like the Cognitive Assessment and Care Plan Services code (99483), advance care planning (ACP) billing codes, and G2211, which acknowledges the added work of managing patients with chronic conditions. We also highlight the new APCM G-codes for 2025, a set of HCPCS codes that could provide substantial financial support for interdisciplinary teams in geriatrics. Finally, we discuss the advocacy behind these codes. The American Geriatrics Society (AGS) plays a vital role on the AMA's RUC committee, helping to improve reimbursement for the complex care of older adults. Tune in to this week's GeriPal podcast for expert advice, practical strategies, and insights that will help you optimize your billing practices and sustain the future of geriatrics! Here are some of the resources we also talked about: The physician fee schedule look up tool Wwere you can find out CMS expected charge based off where you practice AGS's annual coding update Geriatrics at Your Fingertips, which has a one-pager on billing Medicare Claims Processing Manual
SummaryIn this episode of the Compliance Guy podcast, Sean M Weiss welcomes Don Self, a veteran in the medical billing industry, to discuss his extensive experience and insights. They explore Don's two recent books, touching on topics such as medical office management, evaluation and management services, and the importance of understanding ERISA. The conversation highlights the challenges faced by healthcare providers in documentation and billing, as well as the need for better practices in the industry. Personal anecdotes and reflections on mentorship add depth to the discussion, making it both informative and engaging.TakeawaysDon Self has over 40 years of experience in the medical billing industry.The importance of mentorship in professional growth is emphasized.Don's books are accessible and filled with practical advice.Evaluation and management services continue to challenge providers.Documentation practices have become more complex and subjective.Healthcare systems in other countries can offer valuable lessons.Local coverage determinations are crucial for understanding payment policies.ERISA provides significant protections for employees and providers.Many providers are unaware of their rights under ERISA.The conversation encourages proactive engagement with insurance carriers.
Send us a textIn this quick-tip episode, Brandon Seigel breaks down the benefits and limitations of AI in medical billing, highlighting how artificial intelligence can streamline claim accuracy, reduce denials, and automate repetitive tasks while still requiring expert oversight. He emphasizes the importance of checks and balances, clean data, and payer compliance to avoid costly errors, noting that while AI can replace 50–70% of processes today, it cannot fully substitute human expertise. From improving denial prediction and underpayment recovery to enhancing patient collections and staff productivity, Brandon explores how AI-powered billing tools can optimize efficiency, scalability, and revenue for private practices—when implemented with careful auditing and accountability.Welcome to Private Practice Survival Guide Podcast hosted by Brandon Seigel! Brandon Seigel, President of Wellness Works Management Partners, is an internationally known private practice consultant with over fifteen years of executive leadership experience. Seigel's book "The Private Practice Survival Guide" takes private practice entrepreneurs on a journey to unlocking key strategies for surviving―and thriving―in today's business environment. Now Brandon Seigel goes beyond the book and brings the same great tips, tricks, and anecdotes to improve your private practice in this companion podcast. Get In Touch With MePodcast Website: https://www.privatepracticesurvivalguide.com/LinkedIn: https://www.linkedin.com/in/brandonseigel/Instagram: https://www.instagram.com/brandonseigel/https://wellnessworksmedicalbilling.com/Private Practice Survival Guide Book
Send us a textIn this episode, Brandon dives deep into the most common medical billing mistakes in private practice and how they directly impact profitability, compliance, and patient trust. From benefit analysis errors and upcoding without documentation, to missed NCCI edits, weak authorization management, and delayed claim submissions, he highlights the critical pitfalls that cost practices thousands each year. Brandon stresses that medical billing is not data entry—it's a science requiring skill, strategy, and accountability. By prioritizing daily billing, accurate documentation, denial management, and upfront patient collections, private practice owners can protect cash flow, stay compliant, and create sustainable growth. This episode is a must-listen for any healthcare entrepreneur looking to optimize their revenue cycle management (RCM) and avoid the costly errors that derail so many practices. Welcome to Private Practice Survival Guide Podcast hosted by Brandon Seigel! Brandon Seigel, President of Wellness Works Management Partners, is an internationally known private practice consultant with over fifteen years of executive leadership experience. Seigel's book "The Private Practice Survival Guide" takes private practice entrepreneurs on a journey to unlocking key strategies for surviving―and thriving―in today's business environment. Now Brandon Seigel goes beyond the book and brings the same great tips, tricks, and anecdotes to improve your private practice in this companion podcast. Get In Touch With MePodcast Website: https://www.privatepracticesurvivalguide.com/LinkedIn: https://www.linkedin.com/in/brandonseigel/Instagram: https://www.instagram.com/brandonseigel/https://wellnessworksmedicalbilling.com/Private Practice Survival Guide Book
In this special episode of Leaders in Medical Billing, host Chanie Gluck is joined by 4D Global CTO Nishant Mathew to explore how AI is reshaping the revenue cycle. Together, they break down the difference between deterministic and non-deterministic frameworks, discuss the levels of AI maturity in healthcare, and tackle some of the toughest challenges in medical coding. Whether you're evaluating new tools, leading a billing team, or simply curious about what AI can and cannot do, this episode gives you a clear and practical view of where the industry is headed.
A podcast on medical billing and coding??? Ok, hear us out as we were skeptical too. We've invited the Billing Boys, Chris Jones and Phil Rodgers, who convinced us of the following: Billing is complicated, but it isn't hard. Effectively billing helps pay for the interprofessional team members who often can't bill We should know our worth and bill for it. Just because a visit didn't feel HARD to a well-trained provider doesn't mean it wasn't complex or valuable. Many of us have long suffered from low professional self-esteem when it comes to money, and it's high time we stop that. While exclusively billing on time may have been right 20 years ago, we must now understand complexity and advance care planning (ACP). We can't cover everything in the 45 minutes we are together, so here are some of the resources we reference in the podcast: Chris's and Phil's consulting contact info via Lightning Bolt Partners CAPC resources: CAPC's Billing and Coding Toolkit CAPC's Monthly office hours in Inpatient and Community-Based PC Billing and Coding run by Andy Esch, Phil Santa Emma, and Chris Jones CAPC's 2025 Annual Billing and Coding Update done by Phil and Chris each year Advance Care Planning resource from the Medicare Learning Network Top Ten Tips for Using Advance Care Planning Codes CPT 2025 Professional Edition. This is the book that has the Complexity Grid in it. The answers are all here! And your coders will likely share.
Welcome back to Ditch the Lab Coat! In this episode, host Dr. Mark Bonta sits down with Dr. William Cherniak, an emergency physician, global health leader, and CEO of Rocket Doctor—a Canadian tech company on a mission to shake up how we access healthcare. As the world continues to grapple with the lessons learned from COVID-19, Dr. Cherniak and Dr. Bonta dive deep into the evolution of virtual care and its role in both episodic and chronic healthcare.Together, they challenge the misconceptions around virtual medicine, exploring how digital innovation is not just a convenient alternative but often a superior solution for patients who need fast, efficient, and ongoing medical attention. From navigating Canada's complex healthcare policies to leveraging AI and Bluetooth-enabled devices, Dr. Cherniak shares his journey as a physician-entrepreneur working to make healthcare more accessible—whether you're managing blood pressure from your living room or urgently treating poison ivy without a trip across town.Tune in as we unravel the myths of hands-on-only healthcare, the future possibilities of remote diagnostics and procedures, and what it will take for medicine to truly enter the 21st century. If you're curious about how virtual care is changing the patient-doctor relationship, cutting through red tape, and building a compassionate, tech-savvy future, this is an episode you can't miss.(https://www.linkedin.com)(http://rocketdoctor.io/)Episode Lessons 1 – Virtual Care Is Effective – Virtual healthcare can match or even surpass in-person care for many conditions, especially when accessibility is an issue.2 – Breaking Down Healthcare Barriers – Virtual care improves access for patients struggling with long waits or limited transportation to clinics.3 – Episodic vs. Chronic Care Needs – Healthcare isn't just for chronic patients; episodic care can be efficiently managed through modern virtual models.4 – Innovation Born From Necessity – Rocket Doctor's creation was driven by gaps in primary care, especially for those without family doctors.5 – Team-Based Medical Support – Virtual platforms enable teams of physicians to support each other, ensuring continuity even when one doctor is away.6 – Navigating Bureaucracy and Policy – Different provinces and health systems determine how virtual care can be provided and reimbursed, affecting implementation.7 – Seeing Beyond Clinic Walls – Virtual visits provide unique insights into patients' home and social environments, revealing valuable context for care.8 – Tech Empowers Doctors and Patients – Electronic records, AI tools, and Bluetooth devices streamline tasks, allowing more focus on patient care and faster follow-up.9 – Busting Medical Tradition Myths – Not every visit needs physical examination; much required care can be accurately delivered without in-person touch.10 – Envisioning Healthcare's Future – Real integration of AI, seamless records sharing, and patient-driven portals will further revolutionize how care is delivered virtually.Want me to bold all the lesson titles for consistency, or keep only the last one bold as the highlight?Episode Timestamps00:00 – Medical Podcast Disclaimer 05:28 – Reimagining Virtual Care in Canada 08:04 – Canadian Tech-Driven Medical Practice 11:54 – Bureaucratic Challenges in Healthcare 13:39 – Embracing Virtual Healthcare 19:53 – Virtual Care: Beneficial vs. In-Person 20:54 – Canada's Acute vs. Preventative Care 26:14 – Virtual Care Evolution 2019 30:08 – Healthcare Innovation and Streamlining 32:59 – Home Ultrasound Study for Pneumonia 35:40 – Virtual Care: Medicine's Evolution 37:42 – Science Skepticism Podcast Promo DISCLAMER >>>>>> The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions. >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests. Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.
This week, official MDIB member Dr. Tontra Lowe, Founder of Professional Auxiliary Training, shares insights on how medical billing can create new opportunities for dentists and patients. She explains why accessing medical benefits is crucial, how it impacts patient care and practice growth, and why training the entire team is essential for success. Episode 323 is available for download now on all of the top podcast platforms or listen now by clicking the player above! Episode highlights: Why medical billing matters for dentists and the value it brings to a practice Which dental procedures may qualify for medical billing and expected payment timelines Patient and team benefits of integrating medical billing into a dental practice How Dr. Lowe's training program equips entire dental teams to implement medical billing successfully Ready to thrive as a dentist and a mom? Join a supportive community of like-minded professionals at Mommy Dentists in Business. Whether you're looking to grow your practice, find balance, or connect with others who understand your journey, MDIB is here to help. Visit mommydibs.com to learn more and become a part of this empowering network today!
Chanie Gluck is the Founder and CEO of 4D Global, a medical billing and healthcare outsourcing company specializing in Revenue Cycle Management (RCM). 4D Global helps US-based medical billing companies scale by providing experienced offshore teams based in India, delivering cost-effective and efficient solutions. She has over two decades of experience in the industry, has led two successful companies, and has been recognized by the Titan 100, Forbes Next 1000, and Enterprising Women of the Year awards. Chanie is also the host of the Leaders in Medical Billing podcast and a respected voice in RCM innovation and AI integration. In this episode… Starting and scaling a business is tough — doing it while raising four children is even tougher. Entrepreneurs in demanding industries often face isolation, overwhelm, and uncertainty around how to grow sustainably while balancing personal responsibilities. So how do you create a thriving, people-first company that scales globally without sacrificing your family or sanity? Chanie Gluck offers an inspiring answer. With nearly 30 years of experience in the medical billing field, she shares her playbook for solving these challenges. Chanie emphasizes the importance of curiosity, problem-solving, and self-education — crediting her early library deep dives on sales and operations as foundational. She discusses how taking bold risks, like pitching herself to doctors and embracing offshoring in India years before it was trendy, enabled her to scale with efficiency. Chanie also stresses building trust with clients through free value-added services and fostering community among introverted industry professionals through podcasts and webinars. Tune in to this episode of the Smart Business Revolution Podcast as John Corcoran interviews Chanie Gluck, CEO of 4D Global, about scaling a medical billing business while raising a family. Chanie shares how she transitioned from local services to global operations, along with insights on offshoring, thought leadership, and adapting to AI in healthcare. Listeners will also learn why podcasts are powerful marketing tools and the importance of community-driven leadership.
Welcome to the Sustainable Clinical Medicine Podcast! In this episode, Dr. Sarah Smith is joined by Dr. Heather Signorelli—pathologist, business leader, and founder of a medical billing company—to dive into the practical side of billing, optimizing clinical workflows, and turning inefficiency into sustainability. Together, they tackle one of medicine's most vexing issues: how to make sure you're getting paid for the important work you do—all while reducing frustration and freeing up more time for life outside medicine. Dr. Signorelli shares her journey from clinical pathology to the business end of healthcare, drawing on years of experience in workflow optimization and billing stewardship across the U.S. and Canada. Tune in as they break down key points about revenue cycles, documentation, avoiding common billing mistakes, tackling administrative burdens, and leveraging teamwork for better compliance and less personal stress. Whether you're struggling to keep up with billing, navigating complex healthcare systems, or just looking for actionable tips to make your practice more efficient and financially sustainable, this conversation is packed with real-world insights and resources. Here are 3 key takeaways from this episode: Understand the "Language" of Billing: Mastering billing is about learning a new language that isn't taught in medical school, but is essential for ensuring you're paid appropriately for your work—whether salaried or fee-for-service. Optimize Workflow and Delegate: Sustainable and efficient practices rely on setting clear priorities, leveraging team members' strengths, and building strong processes—especially for things like data collection, documentation, and patient billing. Audit and Education Matter: Regular internal audits and ongoing education around coding, compliance, and payer rules can save you from costly errors, denials, or paybacks—and reduce the administrative overwhelm over time. Meet Dr. Heather Signorelli: Dr. Heather Signorelli is a board-certified pathologist and physician executive with over a decade of experience leading healthcare teams. She co-founded NatRevMD, a physician-led medical billing company that's been in business for 3 years, now supporting 26 practices with a team of over 65 billing and coding experts. NatRevMD helps private practices increase revenue by 25–30% through smart, data-driven billing, coding, and operations support. -------------- *** Learn more about Dr. Signorelli at https://natrevmd.com/ **** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine. Learn more at https://www.chartingcoach.ca **** Enjoying this podcast? Please share it with someone who would benefit. Also, don't forget to hit “follow” so you get all the new episodes as soon as they are released. **** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life. **** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.
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