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

During the month of May, Terry was flooded with coding, billing, and reimbursement questions which came from all over the country. That can mean only one thing: it’s time for another Top 10 Tuesday Q&A!

Today’s episodes answer questions focused on Dermatology, Orthopedic Surgery, Cardiology, Vascular, General Practice and HIPAA, with a little ICD-10-CM thrown in.

She’ll also discuss some information that will help most practices deal with NPP reimbursement from a “certain commercial payer”.

There are also some special announcements you won’t want to miss.

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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/

Failing an audit?
Inaccurate scores?
Lower reimbursements?

Don’t worry! Terry has you covered on today’s episode, which gets into detail regarding the pitfalls of physician documentation. The discussion revolves around the lack of certain elements of the history, to include Chief Complaint and HPI, and how leaving out important elements of documentation could drastically change the level of service and loss of revenue if you are not accurate and careful.

Auditors are bound by documentation rules: physicians need to be aware those rules are not only for their patient’s protection but theirs as well.

Today’s show will help give you the insight needed to make sure you are audit-proof in your documentation efforts.

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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/

Our lives are becoming more and more remote controlled. You can now earn a degree online, shop with the click of a button, or manage other aspects of your life with the click of a button from computer or smartphone.

The same can now be said for our health. Managing your health from a distance is becoming increasingly popular.

Telehealth and Telemedicine is the process of managing health via telephone, video, email or any other technological option. Today’s podcast focuses on the advantages telemedicine services offer in 2018. Now more than ever these services can build a better practice and client base while attracting new patients.

This topic was discussed briefly in 2017, but nearly halfway through 2018, the concept of Telehealth is heating up all over the country. You do not want to be left behind!

Listen in for some tips on making informed decisions for implementing Telehealth services into your practice and reducing practice costs.

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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/

It’s time to have a PEP talk on today’s show!

A PEP (Physician Education Program) makes sure your physicians are meeting basic standards for Risk Adjustment Data Validation (RADV) process for Medicare.

RADV is the process of verifying that chronic diagnosis codes submitted for payment by the Medicare Advantage organizations are supported by medical record documentation for the patient.
Physicians may receive an audit of these records at any time.

With MIPS and MACRA (and the reporting which goes along with them) there is no time like the present to have a PEP talk with the physicians. Terry shares her expertise on these conversations, that you should be having NOW.

Today’s show will be your daily motivation to help build confidence as you prepare to speak to your physicians and clinicians about this important subject.

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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/

Our latest informative episode revisits coding and billing of services by mid-level providers and making sure physicians and medical practices are compliant with Medicare and third-party payer rules.

The “incident to” term is defined and discussed with examples to clarify if you are reporting these services correctly and would withstand an audit.

We’ll also discuss Shared Visits, as an extension of these services as well as supervision requirements.

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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/

In this session of the CodeCast Top 10 Tuesday Q&A, Terry tackles a flood of questions and answers focused on practice management:

– Deciding to opt in or opt out of insurance plans
– Should you have a practice website?
– What should be part of that website?
– How the new Medicare Card rollout impacts your practice
– Questions and answers for injection coding
– And much more!

It’s a jam-packed CodeCast this week, with a potpourri of topics to address to continue to “Take Your Business/Practice to the Next Level.”

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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/

In this week’s CodeCast Ms. Fletcher discusses the “art” of negotiating payer contracts. Whether you are a novice or a seasoned negotiator, payer contracts can be complicated.

In order to sustain viable revenue, it is prudent to analyze and effectively negotiate healthcare payer contracts. Today’s discussion turns to “cost analysis” and how to effectively negotiate contracts: not only for peace of mind that your revenue is protected but that your reimbursement also accurately reflects the market and your individual needs as a practice/provider.

Even if a practice is run efficiently, and has low overhead, if payer contracts are not properly negotiated or worded, it can result in a loss of revenue. This is “The Business of Medicine”. It is not personal, but it is your livelihood. That is why you must make sure that there are no payment inequities within your contracts, and that you have the tools to effectively negotiate with your insurance payers.

Join us as we continue to “Take your practice to the next level”.

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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/

Auditing physician’s practices for a living can be a tough job. It’s even tougher witnessing a continuing pattern of behavior in vital documentation with many physicians across the country.

In today’s CodeCast, Terry shares her auditing concerns and issues that have risen out of 1000’s of audits she has conducted over the years.

The discussion centers around the importance of passing or failing an audit, and avoiding being a red-flag to payers but will also show both sides of the process. It’s important to not only focus on documentation and coding failures, but also positive outcomes from a training discussion with the provider. Terry will also talk about tools to make the documentation process easier: think of this as your personal CDI discussion with some revenue opportunities mixed in!

Remember, this is about taking the “Business of Medicine” to the next level.

Your business. Your practice. Your peace of mind.

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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/

This week, Terry discusses the ever confusing topic of “New vs. Established” patient visit.

Billing and coding staff continue to have confusion over the question of “What is a New Patient?” However, it’s not only the billing office that needs clarification but physicians as well. Since new patient visits carry a higher Relative Value Unit (RVU, or “reimbursement”) they are always going to be under the watchful eye of payers.

Those payers are quick to deny any unsubstantiated claims, which means your E/M coding needs to hold up to claims review. Today’s CodeCast will give you the insight and guidelines for review while adding tips for capturing new patient revenue (when appropriate).

Bonus: At the end of the podcast Terry will also give her overview of the CMS listening call from 3/21 and the potential changes coming to the E/M services in 2019 and 2020.

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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/

It’s that time of the month again: it’s Top 10 Tuesday Q&A!

On the last Tuesday of each month, this ongoing series will address the top Coding, Billing and or Compliance questions Terry has received during the month.

Listen in to troubleshoot billing and coding issues with Terry today to make you a more efficient and informed coder, biller, collector or physician. You may not realize you had this question come up in your practice, or maybe you did and now we have the answers!

If you are an OnDemand Coding Corner member through Ms. Fletcher’s service, your questions may be asked and answered on air.

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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/