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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Ms. Fletcher shares her responses and insights to some frequently asked questions while assisting coding and billing staff in their coding processes with advice on certain ICD-10-CM codes.

Some of these codes can be tough to navigate through. CPT codes for GI Screening, Pacemaker Device checks, and Transitional Care Management services code choices can be confusing.

Today, Terry takes some of her most frequently asked questions from her onDemand Coding Corner Service Membership to help clear up some of that confusion.

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Every practice at one time or another has at some point needed to do without their employed physician on a temporary basis. Whether it be for a sabbatical, vacation, maternity leave or any other reason, physicians do take time off.

When a practice cannot “cover” internally for the physician needing an extended amount of time off, one option is to hire a Locum Tenens physician. When you hire and bill for an LT physician, you are billing for a substitute, or covering physician as if they were the regular physician who is not available.

The following podcast will give you insight on what the experience has been by physicians who have been there, how the experience should be should you are one of your physicians want to take this on, and lastly, as this is a CodeCast, Terry will give you her expertise on the coding process so that you don’t miss a beat when billing for Locum Tenens physician services. (And also how long this can be available to your practice.)

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

Breaking News! The Modifier 25 may not be the revenue “protection” modifier it once was known as for many physician’s practices. Terry dives right in this week to the recent headlines from payers like Anthem Blue Cross, and Independence Blue Cross Blue Shield, and their new 2018 policy amendments:

  • When a minor surgical procedure code (0 or 10-day global period) is reported on the same day as an E/M code by the same physician, payment for the E/M code will be reduced by 50 percent.
  • When a preventative/wellness exam and a problem-oriented E/M are billed during the same encounter, payment for the problem-oriented E/M code will be reduced by 50 percent.

CMA and AMA were able to scale back Anthem’s policy to 25% but you will continue to have an uphill battle as this new policy may become the new norm. You don’t want to miss this important news update and solution packed Podcast on how to fight back.”

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Episode 15 of the CodeCast Podcast takes the topic of Medical Practice Collections and Appeals to the next level… literally. Terry discusses level 1, 2 and yes, a level 3 appeal, in the process of collecting and protecting your money. Her approach in the appeals process gives insight into a work product that is often negative in the medical industry but makes it a positive project-oriented task.

Claim denials cost the medical industry over $1 million annually. How much of that is coming from your practice? Do you have an appeals process in place?

Claim denials will happen. It’s inevitable. This podcast will discuss working through those challenges with smart solutions to assist in your success in your relationships not only with payers but also with patients, the practice, and the insurance industry as a whole.

It’s time to be a force in the reimbursement process. It’s your money. Protect it!

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

Terry continues her theme with medical practices making sure they have done their due diligence to keep their practices healthy, in giving you a checklist for Billing Service Outsourcing. Are you considering outsourcing your billing and coding? Do you have a billing company in mind? What questions do you need to ask to make sure you are making the right decision the first time as to not interrupt your cash flow?

Terry goes into detail with this list, also offering her commentary on why you need to ask certain questions and her insight from when she owned her own billing company for over 20 years. Join us for this important discussion before you hire a company. Be prepared.

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If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

Continuing our discussion of the importance of a practice assessment and checkup, Ms. Fletcher gets into part two of this two-part series, to discuss industry benchmarks, the importance of crunching financial numbers and how to consider the culture in your practice as an invaluable investment in your medical practice’s success.

By learning what inefficient processes, people, and other factors may be holding back your practice, a medical practice assessment can uncover the underlying problems and empower you to make informed decisions: decisions that will position you and your patients for success now and in the years ahead.

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You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

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.