The CodeCast Podcast | Medical Billing & Coding Insights

The Business Side of Medicine ~ Coding, Reimbursement and Compliance for Physician Practices

National Speaker and Healthcare Consultant, Auditor and Educator, Terry Fletcher CPC, CCC, CEMC, CCS, CCS-P, CMC, CMSCS, CMCS, ACS-CA, SCP-CA, knows from over 25 years medical reimbursement industry experience that Coding, Billing and Compliance for physician practices and hospitals can be tough to navigate. Her CodeCast® Podcast series will share insights to current rules and regulations the Medicare payer requires, along with Commercial insurance plans’ rules and reimbursement challenges. Discover revenue opportunities to maximize reimbursement in your medical practice, focusing on different medical specialties and platforms each episode.

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Can you say that you take care of your medical practice health as well as your patient’s health? Isn’t it time for a checkup there as well?

For most provider groups the simple answer is, “yes”.

This week Terry dives into part one of a two-part series to give some serious insight as to the value of regular practice assessments. She will discuss how to stop and focus on the big picture, and really look to take the “business side of medicine to the next level” by giving you five easy steps that can validate if you are on the right track to meet or exceed benchmarks for success as well as for industry or market changes.

Learn some steps and further benefits to help you take a step back and easily and quickly assess your practice in the most pro-active and meaningful way.

Continuing with this month’s theme of revenue and where those sources can come from, Ms. Fletcher discusses the “Hidden Revenue” that already exists within your medical practice, and how coders, billers, administrators, and physicians can tape into these sources. Healthcare regulations continue to focus on ways to reduce costs and increase efficiency for both Providers and Health Plans, with a renewed emphasis on electronic payments. We will discuss the pitfalls of Healthcare Virtual Credit Cards, the benefits of EFT payments, and work through the Coding and Reimbursement challenges of claim denials.

This is a session you won’t want to miss for the financial health of your practice.

Happy New Year listeners. This week Terry rings in 2018 with some revenue opportunity gems, that many physician practices may not realize are billable services. With current reimbursements at a standstill, it is more important than ever to explore what revenue sources are available to physician practices with little or no cost to them to facilitate the service.

We will discuss Behavior Change Intervention codes, MNT codes, as well as home INR testing to name a few. Join us as the reimbursement process, in the Business of Medicine is taken to the next level with our CodeCast Podcast of the week.

This week Terry tackles the topic of current E/M guidelines and how CMS has opened up the lines for current discussions and dialogue to update these very dated services.

With the technological advancements of electronic medical record (EMR) and the administrative burden that goes with the current 1995 and 1997 documentation guidelines, Medicare is aware it’s time to make some changes.

Ms. Fletcher discusses how medical professionals and providers can make an impact on these discussions for change and what is on the horizon. Join us for this important discussion.

Physicians and mid-level providers are having some serious conversations with patients regarding their Advanced Care Planning, meaning the discussion of a serious illness and the next steps that they need to take regarding advanced directives, hospice, skilled nursing, pre and post-death arrangements, etc.

These discussions are now payable under most health insurance plans including Medicare, but you need to be walked through the steps of these important conversations first, then consider the options for coding, billing, and reimbursement. Most practices have been providing this important service for years but have never charged for it. Ms. Fletcher brings you the ACP directives and regulatory insight you need to get started. Join us for this important podcast. It could cost you thousands of dollars in lost revenue if you don’t listen in today.

The past three years has witnessed tremendous growth in the use of computer-assisted coding (CAC) systems. Many hospitals, physician practices, and health systems moved forward with CAC implementation after the ICD-10 rollout continued with delays. According to several, 2017 research reports, the CAC industry is expected to see continued adoption with the overall market rising to $5.1 billion by 2023.

What does this mean for the Coding professional moving to more automated coding? Many Coders recognize the benefits of automated coding systems, however, for the most part, the emotions on this discussion have been negative. In the fact, the perception is that upper management doesn’t understand the complexity of a coder’s job, that “the financial people just don’t get it”. Even though there is some wonder and excitement in response to the new technology, there is still the worry on behalf of coders, that the impact of technology on their job security would suggest the phasing out of a manual coder.

Ms. Fletcher talks through this perception and attempts to put the coder’s fears aside to reassure them that automated coding will not entirely replace coding professionals. Computers should be viewed as another tool to aid in the coding process, increase efficiency, and actually improve coding skills as we move toward these advancements.

Medical scribes can increase efficiency and the quality of chart documentation, and lessen audit exposure in most practices.

Terry discusses using medical scribes in a physician’s practice; how to calculate your ROI (return on investment) if you chose to use a scribe in your practice, and will outline not only their potential duties, but give you insight to what their qualifications should be and then the Joint Commission and CMS’ position and requirements for documentation, signatures, and authentication of their work.

Should you hire a scribe? Listen in to find out.

Terry takes the practical approach in discussing the frequent question of “Should physicians assign their own codes after a patient encounter?” Is the expense of hiring a coder worth the savings of having the physician provide the codes themselves or would this flag a practice for an audit? What are the pros and cons of hiring a certified coder versus having the physician use technological advancements to code?

Ms. Fletcher will address those issues, along with a discussion on practice revenue that is always impacted by the “coder” whomever that may be. Join us for this important practice discussion.

Telemedicine services and technologies are the current rage in the country. Terry brings her expertise in her podcast, this week on how to successfully adopt Telemedicine (Telehealth) into your practice, how to use this technology to potentially expand physician practice base, cut rising practice expense, and improve patient outreach while increasing revenues. Telemedicine can provide hard benefits of revenue improvement and efficiency, and the soft benefits of patient satisfaction and access to care if done right. To move forward in this ever-changing world of technology, this is a must listen Codecast Podcast.

Our CodeCast Podcast focuses on NPP’s this week. Terry Fletcher discusses the reasoning behind hiring a mid-level provider and the benefits to the physician practice as well as the particular services they can provide. It is all about the profit centers. Is your NP or PA a profit center for your practice? We discuss benchmarks to determine the answer to this question along with some compliance concerns and recommendations.