A Slice of Healthcare podcast co-hosted by Taya Moheiser, CMPE, CMOM & Kem Tolliver, CMPE, CPC, CMOM. #revenuecyclemanagement #medicalbilling #RCM
Welcome back to RevDive! Listen to hear Charles Gellman, CEO and Chief Patient Advocate of HIDO Health as they talk about AI-assisted robotics, remote patient montoring, and tech that can reshape the healthcare system.
What you’ll get out of this episode:
Learn more about HiDO Health here: https://us.hidohealth.com/
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Welcome back to RevDive! Listen to hear Russ Thomas, Chief Executive Officer at Availity discuss proactive revenue cycle management, reducing denials and overpayments, and the critical importance of payer-provider collaboration in healthcare
What you’ll get out of this episode:
Learn more about Availity here: https://www.availity.com/
And make sure to subscribe to the Slice of Healthcare Network:
/ @sliceofhealthcare
Welcome back to RevDive! Listen to hear Ed Marx, Chief Executive Officer at Marx Advisory discuss healthcare technology advancements and philanthropy.
What you'll get out of this episode:
Learn more about Ed Marx here: https://www.marxadvisory.com/
And make sure to subscribe to the Slice of Healthcare Network:
/ @sliceofhealthcare
Welcome back to RevDive! Listen to hear Andrew Lockhart, Co-Founder and CEO at Fathom Health discuss AI and it's implications in the coding world.
What you'll get out of this episode:
To learn more about Andrew Lockhart please use the link below:
- LinkedIn
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Taya https://www.linkedin.com/in/tayagordon/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Welcome back to RevDive! Listen to hear Matthew McCreith, Strategic Partner at Schooley Mitchel discusses how organizations can save money and address overlooked costs.
What you'll get out of this episode:
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- LinkedIn
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Taya https://www.linkedin.com/in/tayagordon/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Welcome back to RevDive! Join as Claire Ernst, JD, Director of Government Affairs at MGMA joins RevDive to give another Spill from the Hill.
The healthcare industry awaits publication of the 2023 CMS Final Rule later this year. As we await what's to come, our guest sheds light on anticipated changes expected within the payment formula which will impact reimbursement to healthcare organizations and providers dependent upon CMS for funding.
In this episode, we also discuss recent Presidential comments made regarding the national perception of our Public Health Emergency; which leaves many stakeholders scratching their heads and others bracing for current 1135 waivers to come to an end.
Not only are we thrilled to have Claire share her unique "crystal ball" projections for CMS' activities next year, we're excited to bring her back to unpack the 2023 CMS Final Rule after its publication later this year.
What you’ll get out of this episode:
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Taya https://www.linkedin.com/in/tayagordon/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Episode Details:
Join in as Rae Jimenez discusses important updates to coding, effective in 2023. Say goodbye to components of 1995 and 1997 documentation guidelines, and say hello to standardized documentation.
Rae expresses that an important metric for efficiency and quality of care is the proper understanding and application of coding guidelines. We discuss the importance of becoming familiar with 2023's guideline modifications.
Coding has evolved into the vast pool of data analytics, in which we can gain accurate information and branch into unique career trajectories. Rae, working for AAPC for 15 years, shares takeaways from her career. Starting off as a clinic assistant, she conveys that an important mindset for healthcare career longevity is that, “there is no small job”.
What you’ll get out of this episode:
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Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Learn More About Our Guest
Rae Jimenez - AAPC Website - AAPC LinkedIn
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is answering a question directly from our RevDivers!
Julie Collins, Innovation Consultant & Lead Faculty for National Science Foundation (NSF) & National Institutes of Health (NIH). Join in as Julie tells our RevDivers how to get into an innovative mindset, what customer discovery means, and how to learn more about the Innovation Corps at NIH where many revenue cycle product leaders got the foundation to succeed. We encourage you to apply these strategies to your process improvements, revenue cycle integrity programs, and general professional outlook.
What You’ll get out of this episode:
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Julie Collins
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Scott Becker of Becker’s Healthcare and McGuire Woods, LLP. Join in as healthcare celebrity Scott Becker talks about how he and his team created the Becker's Health universe, trends he is seeing in the industry today, and the achievements and failures he navigated on his road to success.
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Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
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Scott Becker
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is James Lineberger, Executive Director for Anesthesia Associates of Boise. Join in as James talks about the top four pitfalls that leaders fall into when assessing data and transforming internal processes.
What You’ll get out of this episode:
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Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
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James Lineberger
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Kevin Mulcahy, Senior Director of Payer Relations, Special Billing & Provider Enrollment for Mass General Physician Organization. Kevin discusses the trickle-down effect Provider Enrollment and Payer Contract management plays in the overall Revenue Cycle.
What You’ll get out of this episode:
· Remote Central Business Office workforce optimization best practices
· National trends and solutions to address provider enrollment delays
· Incorporating provider enrollment and payer contracting compliance standards into RCM workflows
· Cross-functional knowledge sharing to avoid loss of information in the midst of workforce turnover
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
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Kevin Mulcahy
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Kevin Dedner, Founder and CEO of Hurdle Health. Mr. Dedner talks about the revolutions his company has been making in virtual therapy services, publishing “The Joy of the Disinherited-Essays on Trauma, Oppression and Black Mental Health.”, how new CMS policies will impact the future behavioral health landscape, and how to lead multi-faceted teams.
What you’ll get out of this episode
Quotables
“For the people who we wanted to serve, there were a lot of barriers that we needed to overcome. The ability for insurance to be accepted, I saw as a critical point for us.”
“The hard truth is that the mental healthcare system is not designed for everyone. We have a system that was really designed for one segment of our population. For far too long, mental health has been a luxury and a privilege.”
“Teletherapy and telehealth are here to stay. If you start to think about work supply shortages and geographical shortages. There are real solutions in telehealth, particularly in the mental health field.”
Recommended Resources
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
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Kevin Dedner https://www.linkedin.com/in/kevin-dedner-mph-/
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Amy Weiser, lead project coordinator at Quality Insights for the QPP service project. Ms. Weiser explains what a Quality Improvement Organization (QIOs) is and how they support other organizations. Additionally, she explains pressing CMS MIPS updates to help keep listeners up to date.
What you’ll get out of this episode
Quotables
“We collaborate with providers, communities, and people with Medicare through data driven initiatives.”
“[To improve quality] Selecting measures that are meaningful to your practice is the first thing.”
“In a nutshell, the MIPS Value Pathway program, is designed to reduce provider burden.”
Recommended Resources
Sponsored by: Inovalon
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Alexandra Pecci, freelance writer for Health Leader Media and other top health news outlets. Ms. Pecci takes her experience from interviewing health industry leaders at every-level and gives us the ins and outs of revenue cycle management from the perspective of an outsider.
What you’ll get out of this episode
Quotables
“You have to make sure you’re not giving bad information...If I point them in the wrong direction or at the wrong regulation, it can have some really serious consequences.”
“I’m not an expert. I interview experts and then share what they have to say with other people who care about it.”
“…payers make the rules and break the rules, and then seemingly make them up as they go along, and change them without telling you."
Recommended Resources
Sponsored by: Inovalon
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Follow our hosts on LinkedIn:
Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
What you’ll get out of this episode:
Quotables
“Bad Actors are targeting healthcare providers and systems because they know it has a bigger impact than targeting just one organization”
“The general rule of thumb for liability, is that whoever collects the data is responsible to protect the data. So it’s really important that you have a vendor management process”
“Carriers have really evolved into taking a more proactive, pre-breach stance, in protecting their insureds. There are a lot of resources they offer now to help you prevent breaches”
Today's guest: Jenny Jacobsen: https://www.linkedin.com/in/jenny-jacobsen-3b624082/
Recommended Resources
Sponsored by: Inovalon
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Chances are, like the rest of the industry, you are seeing significant payer delays. In this episode, Sharon Smith, Practice Manager at Virginia Beach Surgery explains the impact of payer delays and how to tackle these issues with payers.
What you’ll get out of this episode:
Quotables
“Practices need to understand what their contractual obligations are as well as state regulations. One thing that is a frustration is that there are so many caveats in the legislation that allow carriers to bypass”
“Payers should be mandated to say whether or not they are subject to the state regulations to give the claims processor and the practice an indication of whether they can be held accountable”
“Provider reps used to come to the office, we used to actually have reps assigned that we could communicate trends to. With the ways the world has changed we don’t have those deep relationships anymore with provider reps and that adds to the challenge”
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Sponsored by: ABILITY Network
This episode is for revenue cycle leaders, operational leaders and those looking for ways to innovatively approach denial management and operational challenges. In this episode we talk to Lamont Louis, Chief Operating Officer for Physician Services for Einstein Physicians at Jefferson Medical Group in Philadelphia, PA. Mr. Louis talks about identifying financial variances, using the FORM approach to team success, and how to identify critical KPIs from an operational perspective.
What you’ll get out of this episode:
Quotables
“When I arrived 40 years ago, the only metrics I saw were patient visits, and dollar signs. ”
“If we are two years in, and we are still at a loss, then we need to change that dynamic.”
“Don’t be afraid to say, this is not acceptable and we need to be better. It comes with the responsibility of always pushing yourself and your teams to be better”
Recommended Resources
“Proactive to Reactive” by Lamont Louis, MGMA Article https://lnkd.in/e4XJzUpG
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Sponsored by: ABILITY Network
All practices, hospitals, and health systems this is a critical and timely episode. Claire Ernst, Director of Government Affairs breaks down the legislation passed last night by Congress which waived and delayed several looming cuts to Medicare reimbursement for 2022. She covers the PAYGO 4% cuts, conversion factor changes, sequester delays and phased reinstitution, telehealth coverage for 2022 and more! Tune in for essential updates to your 2022 reimbursement outlook!
What you’ll get out of this episode:
Quotables
“Statutory PAYGO has actually never been triggered before for Medicare…we were getting down to the wire and it wasn’t getting done” @ClaireErnstJD
“Anyone who has a physician office lab would want to pay attention to this, the protecting access to medicare act (PAMA) passed in 2014 basically redid the formula for data reporting and coming up with the calculation for reimbursing labs which led certain labs to face up to 15% in cuts…many of those cuts were delayed for a year by the CURES Act through the end of this year”@ClaireErnstJD
“We went from expecting 9.75% cuts in Medicare reimbursement to removing 9% of those cuts” @ClaireErnstJD
“There is momentum [regarding audio only telehealth] if it’s something that’s important to you and your practice, especially if you are in a rural area, get in contact with your members of congress and provide them that data or those anecdotes you may have” @ClaireErnstJD
Recommended Resources
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Taya https://www.linkedin.com/in/tayamoheiser/
Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/
Sponsored by: ABILITY Network
Details:
Listen in as we hear from Physician and Attorney Reza Ghafoorian on strategies to minimize alarm fatigue while remaining compliant with not so obvious threats that may leave healthcare providers vulnerable to cyberattacks. Our guest gives insight on industry best practices to remain vigilant in protecting your brand and Protected Health Information.
Interviewee:
Reza Ghafforian, MD, Esq, Principal Attorney at G2Z Law Group, PLLC
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: ABILITY Network
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Details:
Luigi Leblanc joins us for a discussion right at the intersection of public health and technology. How can we optimize use of technology, how is technology being used for niche services, how are programs changing to drive reimbursement for these? Find out the answers to these and more in this episode of RevDive!
Interviewee:
Luigi Leblanc, VP of Technology at Zane Networks
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: ABILITY Network
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Details:
Hi there RevDivers, join us as we learn how to become more brave as leaders with the help of Master Hudson Coach, Nicole Bianchi, author of Small Brave Moves.
Interviewee:
Nicole Bianchi, Partner at Bravium and author of Small Brave Moves
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: ABILITY Network
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Details:
Hi there RevDivers, join us as we chat about engaging physicians in RCM discussions with Jill Arena, noted author of Physician Heal Thy Financial Self & CEO & Founder of Health e Practices.
Interviewee:
Jill Arena, CEO & Founder of Health e Practices
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: ABILITY Network
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Details:
Hi there RevDivers, listen in as Dawn Lunde shares her experience in improving the patient payment experience while integrating patient engagement and health literacy into RCM to develop an informed consumer.
Interviewee:
Dawn Lunde, Senior Director, Sales Strategy Ability Network
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Hi there RevDivers, join us as we interview Doral Jacobsen, founding partner at Prosper Beyond and co-author of MGMA’s “Transitioning to Alternative Payment Models” guidebook. Doral chats with us about the importance of payer contracting and provides some great tips and tricks for when you reach out to negotiate those agreements!
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Today's Guest:
Craig Wiberg, Senior Editor at MGMA
Hi there RevDivers, join us as we interview Craig Wiberg, the legend behind MGMA’s excellent educational content! The October MGMA conference will look very different this year and Craig takes us through all the key things attendees can expect from this in person event!
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Today's Guest:
Susan Childs, Founder & Healthcare Practice Advisor at Evolution Healthcare Consulting
Hi there RevDivers, join us as we interview Susan Childs, author of Common Nonsense and national practice management consultant. Susan is an expert on revenue cycle, emotional intelligence, and all areas of practice operations.
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Today's Guest:
Laurie Baedke. A noted speaker for Harvard Medical School and Cleveland Clinic, author of the Emerging Healthcare Leader, Growth/Edge Podcast Host and Assistant Dean of Physician Leadership Education and Director of Healthcare Leadership Programs at Creighton University.
Hi there RevDivers, join us as we interview Laurie Baedke. As a powerhouse speaker, author, and educator dedicated to healthcare leadership she provides expert guidance on everything from imposter syndrome to dealing with burnout.
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Our Guest:
Eric Bricker, MD, Chief Medical Officer at First Stop Health
Details:
Hi there RevDivers, we had the extreme pleasure of chatting with Dr. Eric Bricker, or as he is better know the Whiteboard Doctor! Dr. Bricker talks everything from price transparency to the importance of objectivity. Fun fact, Dr. Bricker started his career in revenue cycle support and is a huge advocate of all of our RevDivers listening in. Listen into our lively discussion with Dr. Bricker and check out his educational series on YouTube “AHealthcareZ”!
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Join us as Claire Ernst, JD shares legislative updates on the recently announced CMS 2022 Proposed Rule that includes proposed changes to the Medicare Physician Fee Schedule, Telehealth and Congressional updates.
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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Hi there RevDivers, join Taya for a super speedy review of four proposed rules dropped by CMS in July. Changes to payments, documentation, telehealth services, rural hospitals and more, in this quick and informative recap.
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC
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The public health emergency has created new opportunities to buy and sell medical practices. Today we’ll discuss factors to consider on both sides of this type of transaction. Today's guest, Stephen Kaufman, Esq., Partner at Wright, Constable & Skeen, LLP has seen it all and shares some best practices for buying and selling medical practices in this episode of the podcast.
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Join us today as we take a look at the interim surprise billing rule issued July 2, 2021 and OSHA’s Emergency Temporary Standard on COVID-19. Both would be mandatory once finalized and both require significant changes to practice workflows.
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Join us as we chat with Lucien Roberts and gain valuable insights on the challenges facing practices seeking prior authorization and gold-card status. Lucien is the lively practice administrator at Gastrointestinal Specialists in Virginia, former president of the Virginia MGMA chapter, Legislative Advocate Award winner, writer and speaker for Physicians Practice and the AMA.
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
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Join us as legislative and regulatory expert Claire Ernst provides the current Spill from the Hill discussing hot topics in congress including:
Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.
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This episode is a continuation of episode #2, part 1, that focused on activities that may be included in time-based scoring of evaluation and management codes (E & M). We discuss the recent E & M clarifications published by the American Medical Association (AMA) that provide further guidance on the use of Medical Decision Making as a factor for leveling E & M services.
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In this part 1 episode, Taya Moheiser and Kem Tolliver dive into the changes related to time-based coding of evaluation and management codes.
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In this episode, Taya Moheiser and Kem Tolliver discuss the recent vote by Congress to extend the moratorium on the two percent sequestration cuts to Medicare programs. CMS put a hold on payments in anticipation of the delay and it was approved.
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