In today's episode, we have a captivating discussion about a groundbreaking book that turns our understanding of healthcare as we know it today. Joining us is the esteemed Dr. Henry Buchwald, a seasoned healthcare professional who has witnessed the transformation of healthcare over the past 50 years. Drawing from his vast experience and keen observations, Dr. Buchwald offers a unique perspective on the current state of healthcare in the United States. Dr. Buchwald unveils a startling...

In this episode we delve into the critical issue of healthcare cybersecurity and its increasingly vital role in protecting sensitive patient data. As digital transformation accelerates within the healthcare industry, the risks and challenges associated with cybersecurity have become more pronounced. Join our expert guest, Britton Burton with Corl Technologies. Britton is a cybersecurity specialist in the healthcare sector. He shares invaluable insights and practical advice on fortifying...

In this captivating episode, we delve into the realm of digital transformation in healthcare and explore its profound impact on patient care. Our expert guest in digital transformation Unmesh Srivastava, will shed light on various facets of this transformation, including the adoption of value-based care, harnessing the power of AI technology, and the crucial aspect of cultural sensitivity. Join us as we uncover how healthcare providers are redefining their practices to prioritize...

This episode will discuss how to build meaningful relationships with patients, caregivers, and healthcare professionals. You will learn to build strong relationships with your teams, peers and external stakeholders. We will provide insights on how to build and maintain relationships that are beneficial to the organization as a whole. We will interview Jennifer Krippner Chief Experience Officer at the Institute for Healthcare Excellence Developing trust, communication, accountability,...

In this podcast episode, we sit down with Joey Dizenhouse, an expert in pharmacy benefit management (PBM). We explore the latest data trends in the PBM market, including rising healthcare costs. We also delve into the growing importance of data analytics and technology in managing pharmacy benefits and improving patient outcomes. Throughout the episode, Joey shares his experiences and observations from his work in the PBM industry and as a patient advocate, offering valuable insights into...

In this episode, we are showing our support for primary care physicians and how we can help them improve documentation.Primary care physicians are the backbone of our healthcare system. They provide comprehensive health care services to patients and serve as the first line of defense against illness and disease. Unfortunately, primary care physicians often struggle to keep up with the mountain of documentation requirements required which means that their time spent with patients is...

The documentation of the chief complaint is a crucial part of a patient's medical record. The chief complaint is the primary reason a patient seeks medical attention, and it is important to document it accurately to ensure proper diagnosis and treatment. In this episode, we will discuss Documentation vs Guidelines What the payers are saying There is a level of critical thinking needed by coders and auditors. Our advisors will discuss these areas in detail Let's tune in to our...

In this episode, we are joined by our friend Glenn Krauss from CORE-CDI. Glenn and I had the opportunity to sit down and review the CDI programs for Inpatient and Outpatient and how important CDI is to the healthcare industry. We will discuss the following: The medical record as a communication tool versus a reimbursement tool Physician documentation improvement must be physician-centric and physician driven Compliance and ethics in Physician Documentation Improvement must be an...

In the second installment of our series on Evaluation and Management, we dive into the importance of two keys areas Prescription Drug Management Major vs Minor surgery There is a level of critical thinking needed by coders and auditors. Our advisors will discuss these areas in detail Let's tune in to our advisors Jennifer McNamara CCS,CPC,CPMA,CRC,CGSC,COPC AAPC Approved Instructor Email Jennifer at [email protected] Visit her website: https://www.sparkadvise.com Hear her speak...

The world of healthcare is in a state of chaos. With the rising costs of medical care, the increasing complexity of healthcare systems, and the changing landscape of insurance and payment options, it can be difficult for patients and providers to navigate the system. While there are some efforts to organize healthcare chaos, there is still much work to be done. In this episode, we sit down with Healthcare data and expert Jordan Johnson, MSHA, iMPaCT to discuss: Staff Shortages ️SDOH ...

In this exciting three-part series we will hear from our advisors all about how to unravel the E/M guidelines and how to interpret areas of documentation. In this episode, we will look at how to interpret some key definitions in the MDM  that affect a patient's condition. The meaning of acute vs chronic Exacerbated conditions vs severe exacerbations Complicated vs uncomplicated conditions There are many areas to dissect and you simply cannot do it without research, communication, and a...

In our first episode of Season two, we start out with a very important topic that affects all in healthcare-Compliance! It's more than understanding what it is, but also how we view it and how we navigate the many levels.  Today we sit down and chat with Compliance and Legal expert Susan Walberg JD, a consultant, and writer in all things compliance.   Susan will tell us all about her latest Compliance Books and Non-Fiction books that are designed to shed light on meeting industry standards...

In this final episode of 2022, we are bringing back a fan favorite and a very important topic. We must continue advocating for improved access to care, a better quality of care, and better patient rights and protections. We sat down with Jared Walker the Founder of Dollar For and we dig into the importance of hospitals being transparent about their charity programs and empowering patients to take control of their healthcare Dollar For is a program that provides financial assistance to...

Do you communicate effectively with your patients? Is your business staff up to the challenge of the necessary communication needed to keep your patients happy? Let's chat about necessary conversations that require communication Explaining Financial responsibility Communication regarding Prior Authorizations Effectively communicating prior to the patient appointment Legal requirements for Copays Join us fo the RevCycle Symposium February 23, 2023 Online and On Demand  --- Send in a...

In this episode I had the privilege of interviewing my friend Dr. Michael Cross. Conversation with a Surgeon: Does your patient come first? -Unique challenges in Breast Oncology -Burdens physicians face -Communication with teams -Patient education -Preventative measures and cost --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode we discuss Diabetes. November is Diabetes awareness month and we want to understand the impact on patient care and reimbursement and the cost of treating the condition.  How Diabetes affects Cost in Value-Based Care ICD10-CM Coding Guidelines Documentation and Risk Learn more by scheduling an onsite review and education session with your physicians - Contact our Advisory Network  --- Send in a voice message: https://anchor.fm/healthcrossroads/message

We have a bonus episode this week, to take a look at how we portray ourselves on Linkedin. Do we understand the proper etiquette? Have we made our profile attractive to a future or current employer? Let's take a break and get Linkedin Savvy! --- Send in a voice message: https://anchor.fm/healthcrossroads/message

In this episode we discuss the importance developing a Value Based Care Mindset.  What can we do to improve in documentation in light of the new EM Revisions for 2023 that now encompasses Hospital Charges? Do we understand basic definitions and how they will affect Value Based Care payments? Do we understand basic documentation guidelines? Contact [email protected] to schedule your physicians annual Value Based Care training.  --- Send in a voice message:...

In this episode I invite my special guest Christine Hall CHC (AAPC Instructor) CPC , CPB, CPMA, CRC, CEMC, CPC-I  to discuss the Global Package. We will discuss the proposed revisions by CMS and the history of it since 1992. Are we ready for a revision? Let's find out What changes have technology and advances in medicine brought us? Are you getting involved and sharing what challenges your practice is facing? Specialty Specific Global Care for Orthopedics and Dermatology Is your EMR...

In this episode, we sit down with my friend and fellow podcaster Terry Fletcher and discuss the relationship between Physicians and coders. This is a significant relationship that helps utilize both the clinical and business sides of medicine. This partnership ensures compliance, and accurate revenue and allows the physician to focus on patient care while enabling the coder to make sure the revenue is solid. When physicians keep their hard-earned income, the practice can flourish and patients...

Are you feeling burdened down with the Prior Authorization processes? You are not alone. In this episode we will chat with Manish Jain, Co-Founder and VP, Business Development of Oncospark and get his insights. We will answer: Why do insurance companies require authorization? Are internal process issues delaying treatment? Tips for organization, demographic errors, treatment changes and miscommunication in scheduling vs approval Can you truly automate the authorization process? We...

Join me and special guest Betty Hovey, BSHAM CCS-P CDIP CPC COC CPMA CPCD CPB CPCI as we look "Behind the curtain with an Auditor"   What is behind more audits in 2022?  What does a lack of Audits say about your organization?  Is Compliance your priority?  What does an Auditor do?  Why are Auditors vital in Healthcare? Schedule your next audit by emailing [email protected] --- Send in a voice message: https://anchor.fm/healthcrossroads/message

Check out me with my friend Pam Vanderbilt as we talk about Medicare and Modifiers. We will discuss the MPFS Indicators and why all in the Revenue Cycle need to know how Medicare processes claims, because Guess What? "Coding can change based on these Indicators" --- Send in a voice message: https://anchor.fm/healthcrossroads/message

Join me and my special guest Leslie Boles, BA, CCS, CPC, CPMA, CHC, CPC-I, CRC as we discuss the shift that needs to happen in the Business of Healthcare. As the Co-Owner & President at Revu Healthcare Leslie and her team offer comprehensive regulatory compliance solutions to healthcare providers, hospitals, health systems, physician groups, and other healthcare entities. In the past 10-15 years there has been a progression of gaps in communication between physicians and coders. Has...