Auditing Antics: Navigating Medical Coding and Auditing
by Stephanie Allard Consulting, LLC
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On the show
Recent episodes
When Coding Quality Starts to Slip
Jul 15, 2026
Unknown duration
E/M Q&A on Documentation MDM and Time
Jul 8, 2026
Unknown duration
Summer Burnout in Healthcare Compliance and Affordable Ways to Recharge
Jul 1, 2026
Unknown duration
Why the Back of the CMS-1500 Matters More Than You Think
Jun 24, 2026
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Location, Location, Location: The Overlooked Telehealth Requirement
Jun 17, 2026
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| Date | Episode | Description | Length | ||||||
|---|---|---|---|---|---|---|---|---|---|
| 7/15/26 | When Coding Quality Starts to Slip | Coders are the last line of defense before a claim is submitted, yet audit after audit continues to reveal fundamental coding and documentation errors that should have been identified long before billing. In this episode of Auditing Antics, we're discussing why coding quality appears to be slipping and the growing impact it's having on compliance, reimbursement, and audit risk. We'll explore how inadequate training, production pressures, overreliance on technology, and limited quality oversight are contributing to these issues, while reinforcing that coders have a professional responsibility to recognize documentation deficiencies, apply coding guidelines correctly, and question records that do not support the codes being assigned. Coding is more than selecting codes from a note. It requires critical thinking, regulatory knowledge, and accountability. Join us as we discuss the trends we're seeing in real-world audits, why these mistakes continue to occur, and what organizations can do to strengthen coding quality before payers and auditors find the errors first.#AuditingAntics #MedicalCoding #CodingQuality #MedicalAudits #HealthcareCompliance #CodingEducation #MedicalBilling #ClinicalDocumentation #RevenueCycle #DocumentationIntegrity #ComplianceMatters #HealthcareLeadership #RiskManagement #ProviderEducation #HealthcarePodcast | — | ||||||
| 7/8/26 | E/M Q&A on Documentation MDM and Time | Join us for an E/M Q&A on Documentation, MDM, and Time as we answer some of the most common questions providers, coders, billers, and compliance professionals face. From selecting the correct E/M level to understanding medical decision making requirements and time-based billing rules, we'll break down real-world scenarios, audit risks, and documentation tips to help you improve compliance and coding accuracy. #EMCoding #EvaluationAndManagement #MedicalCoding #HealthcareCompliance #MedicalAuditing #CodingAudit #AuditReady #MedicalDocumentation #MDM #HealthcareBilling #RevenueCycleManagement #HealthcareConsulting #ProviderEducation #CodingEducation #HealthcareAdministration #RiskManagement #AuditingAntics #CodingCommunity #MedicalCoder #ComplianceMatters | — | ||||||
| 7/1/26 | Summer Burnout in Healthcare Compliance and Affordable Ways to Recharge | Summer can be one of the busiest times of year for healthcare coding, billing, auditing, and compliance professionals, making it easy to overlook the signs of burnout. In this episode of Auditing Antics, Stephanie and Michele discuss the realities of summer burnout in healthcare compliance and share affordable, practical ways to recharge without spending thousands on a vacation. From staycations and local adventures to setting boundaries, unplugging from work, and making time for yourself, we'll explore how small changes can have a big impact on your well-being, productivity, and long-term career success. #AuditingAntics #HealthcareCompliance #MedicalCoding #MedicalBilling #RevenueCycleManagement #HealthcareAudit #HealthcareConsulting #ComplianceProfessional #HealthcareLeadership #BurnoutPrevention #WorkLifeBalance #RevenueIntegrity #HealthcareOperations #MedicalAuditing #HealthcareEducation #HealthcarePodcast #CodingLife #ComplianceMatters #SummerBurnout #SelfCare | — | ||||||
| 6/24/26 | Why the Back of the CMS-1500 Matters More Than You Think | In this episode of Auditing Antics, Stephanie Allard and Michele Strickland discuss one of the most overlooked compliance resources in healthcare, the back of the CMS-1500 claim form. Every claim submitted includes certifications related to medical necessity, supervision, billing accuracy, and regulatory compliance, making it clear that compliance extends far beyond documentation. Join us as we explore how workflow failures involving telehealth, incident-to billing, credentialing, supervision, and revenue cycle processes can create audit risk even when the medical record appears complete, and why true compliance requires both strong documentation and operational controls.#AuditingAntics #HealthcareCompliance #MedicalCoding #MedicalBilling #RevenueCycleManagement #RCM #HealthcareAudit #CodingCompliance #ComplianceOfficer #HealthcareLeadership #PracticeManagement #RevenueIntegrity #DocumentationIntegrity #MedicalNecessity #IncidentToBilling #TelehealthCompliance #ProviderEnrollment #Credentialing #InternalAudit #HealthcareOperations #RiskManagement #ClaimsReview #ClaimsAuditing #MedicareCompliance #MedicaidCompliance #HealthcareConsulting #AuditReadiness #ProviderEducation #MedicalPracticeManagement #HealthcareAdministration #HealthcareRegulations #ComplianceTraining #FraudWasteAndAbuse #MedicalClaims #HealthcarePodcast #StephanieAllard #MicheleStrickland #AuditingAnticsPodcast | — | ||||||
| 6/17/26 | Location, Location, Location: The Overlooked Telehealth Requirement | Telehealth has become a routine part of healthcare delivery, but one of the most important compliance requirements is often overlooked: location.In this episode of Auditing Antics, Stephanie and Michele discuss why the physical location of both the patient and the provider matters during a telehealth encounter. From state licensure requirements and payer policies to documentation expectations and audit risk, knowing where care is being delivered can have significant compliance implications. | — | ||||||
| 6/10/26 | The Reality of AI and the Future of Healthcare Coding | Artificial intelligence is no longer a future concept in healthcare. It is already impacting documentation, coding, auditing, revenue cycle operations, and compliance. The question is no longer whether AI will affect healthcare coding, but how quickly the industry will change and what professionals can do to prepare.In this episode of Auditing Antics, Stephanie Allard and Michele Strickland take an honest look at the realities of AI in healthcare coding. They discuss where AI is already being used, the opportunities and risks it creates, and why simply collecting credentials may not be enough to remain competitive in the years ahead.Join us as we explore how coders, auditors, consultants, and compliance professionals can adapt, build valuable skills, and position themselves for long term success in an evolving healthcare landscape. This is a practical conversation about career growth, professional relevance, and preparing for a future that is arriving faster than many realize. | — | ||||||
| 6/3/26 | The Credential Conversation: Coding Certifications and Real Career Impact | For this episode of Auditing Antics, we are diving into one of the biggest misconceptions in the healthcare coding and compliance industry: credentials alone do not automatically advance your career. While certifications can open doors, true career growth often comes from how you apply your knowledge, build experience, develop professional relationships, and navigate opportunities throughout your journey.We will discuss how coders, auditors, and compliance professionals can strategically choose certifications that align with their goals instead of collecting credentials without direction. This episode explores the real-world impact of experience, mentorship, communication skills, specialty knowledge, leadership, and adaptability in an industry that continues to evolve rapidly. Whether you are new to healthcare coding or looking to expand into auditing, consulting, education, or leadership roles, this conversation will help you think beyond the letters after your name and focus on building a sustainable and meaningful career path. | — | ||||||
| 5/27/26 | Behavioral Health Q&A: Documentation, Billing, and Audit Risk | As Mental Health Awareness Month comes to a close, this episode of Auditing Antics: Navigating Medical Coding and Auditing focuses on one of the most questioned areas in healthcare today: behavioral health documentation, billing, and audit risk. Stephanie and Michele answer real world questions surrounding psychotherapy documentation, E/M with therapy services, time based coding, telehealth requirements, medical necessity, and common behavioral health audit findings.The discussion also explores the growing compliance challenges organizations face when balancing insurance billing, self pay models, and increasing payer scrutiny. Whether you are a coder, auditor, provider, biller, compliance professional, or practice leader, this Q&A episode provides practical insight into reducing risk, improving documentation clarity, and supporting accurate reimbursement in behavioral health services. | — | ||||||
| 5/20/26 | Psych and Neuropsych Testing Services: Documentation, Coding Accuracy and Compliance | In this episode of Auditing Antics, we break down the complex world of psychological and neuropsychological testing services from the perspective of documentation, coding accuracy, reimbursement, and compliance risk. We discuss the differences between psych and neuropsych testing, how time and testing components should be documented, common coding and billing mistakes, and the audit vulnerabilities organizations are facing with these high risk services. This episode also explores medical necessity, interpretation and reporting requirements, technician versus provider roles, and the growing scrutiny surrounding testing services by both commercial and government payers. Whether you are a provider, coder, auditor, biller, or compliance professional, this conversation highlights the areas that can quickly lead to denials, recoupments, and audit exposure if not properly supported in the documentation. | — | ||||||
| 5/13/26 | Let’s Break Down Psychotherapy Billing From an Auditor’s Perspective | Psychotherapy services continue to be a major focus in behavioral health audits, payer reviews, and documentation denials. In this episode of Auditing Antics, we break down psychotherapy billing from an auditor’s perspective, including what documentation actually supports the service billed, how time based services are reviewed, and the common red flags that trigger denials and compliance concerns. We will discuss medical necessity, psychotherapy time requirements, add on codes, and the difference between psychotherapy documentation and E/M documentation. We also explore the growing conversation around whether practices should continue billing insurance or consider developing self pay models due to increasing audit pressure, reimbursement challenges, and administrative burden. Whether you are a provider, coder, auditor, or compliance professional, this episode focuses on the real world risks practices are facing and the steps that can help support cleaner claims, stronger documentation, and more sustainable practice operations. | — | ||||||
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| 5/6/26 | Mental Health Awareness Month: The Conversations We Need to Start Having | Substance Abuse and Mental Health Services Administration (SAMHSA) https://www.samhsa.gov/find-helpMay is Mental Health Awareness Month, and this episode of Auditing Antics focuses on the conversations our industry avoids. Medical coding, auditing, and compliance demand constant accuracy and productivity, but rarely address the mental toll behind that work. From audit pressure and denials to decision fatigue and burnout, many professionals are carrying more than they show while still expected to perform at a high level. If the work feels heavy, you are not alone. It is time to acknowledge it, talk about it, and start changing the conversation. | — | ||||||
| 4/29/26 | The Compliance Risk of Billing Under the Wrong Provider | This episode takes a closer look at one of the most common and dangerous billing issues in healthcare operations: reporting services under the wrong provider’s NPI. What may seem like a simple administrative shortcut can quickly turn into a significant compliance problem when the documentation, supervision, credentialing, or actual rendering practitioner do not match the claim. In this episode, I break down why billing under the wrong provider creates exposure far beyond a claim correction, including audit risk, overpayment liability, false claim concerns, and payer scrutiny around who actually performed and supervised the service. I also walk through the operational habits that often lead to these errors, how organizations confuse billing rules with staffing convenience, and what practices should be reviewing now to make sure their claims accurately reflect the practitioner who performed the work. | — | ||||||
| 4/22/26 | Telehealth Q&A: What You’re Still Getting Wrong in 2026 | A focused episode answering the most common and highest-risk telehealth questions coming in right now. This episode cuts through confusion around what is actually allowed versus what is temporarily permitted, and where organizations are making assumptions that are leading to denials and audit exposure. Expect clear answers on documentation requirements, place of service selection, modifier usage, audio only limitations, consent, and how virtual supervision impacts compliance. This is a real-time breakdown of what is being questioned by payers today and what needs to change now before it turns into recoupments. | — | ||||||
| 4/15/26 | The Mental Load and Stress of Medical Coding, Billing, and Compliance | In this episode of Auditing Antics, we recognize Stress Awareness Month with an honest conversation about the mental load and stress that comes with working in medical coding, billing, and compliance, where there is constant pressure to be accurate, meet productivity expectations, stay current with changing guidelines, and navigate audit risk while knowing that even small mistakes can have significant consequences. We discuss the realities many professionals experience but do not always say out loud, including second guessing decisions, balancing speed with accuracy, managing provider expectations, and carrying the weight of compliance responsibility, and this episode is not just about acknowledging that stress but understanding where it comes from, how it impacts your work, and why it matters, especially if you have ever felt overwhelmed trying to get it right while everything around you keeps changing because this conversation reinforces that you are not alone and that the pressure you feel is real.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 4/8/26 | Questions Every Practice Should Ask About Their Risk Adjustment Process | In this episode of Auditing Antics, we ask the questions every practice should be asking, but many are not, when it comes to their risk adjustment and HCC coding processes. Are your workflows built around accuracy and clinical integrity or are they driven by capture and convenience? We walk through the critical questions that uncover gaps in documentation, coding practices, provider involvement, and compliance oversight, including reliance on problem lists, pre populated diagnoses, the role of MEAT criteria, and internal audit processes. This episode highlights where risk adjustment workflows commonly break down and what that means for audit exposure. If your organization is focused on HCC recapture, vendor tools, or productivity driven coding, this conversation will challenge you to step back and evaluate whether your process truly reflects the patient’s current condition and meets compliance expectations, because this is not just about getting the codes right, it is about making sure your process can stand up to scrutiny.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 4/1/26 | Are You Ready for the UnitedHealthcare Radiology Change Effective April 1, 2026? | This is not just a policy update, it is a shift in workflow. In this episode of Auditing Antics, we break down what UnitedHealthcare (UHC) is really changing and why so many providers are at risk without realizing it. If you are reviewing imaging on the same date as an E M service, that work may no longer be separately reimbursed unless it meets strict interpretation and reporting requirements. We walk through what qualifies as a true interpretation versus a simple review, why global billing is now under increased scrutiny, and how payer edits and documentation expectations will directly impact your claims. This is not just about radiology, it reflects where payer enforcement is going and how quickly reimbursement can shift when workflows and documentation do not align. If your workflow has not changed, your revenue likely will.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 3/25/26 | Taking Coding Skills to the Next Level Through Auditing | In this episode of Auditing Antics, we explore how coding skills evolve through auditing and what it really means to take your knowledge to the next level. While coding provides the foundation, auditing requires a broader focus on documentation integrity, medical necessity, and compliance risk. We break down the key mindset shifts and practical skills needed to move beyond code selection and into analyzing the full clinical picture, helping you strengthen your approach and grow with confidence in a more advanced, compliance focused role.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 3/18/26 | Spravato® Workflow: What Actually Has to Happen Clinical vs Billing | Visit the etsy shop at sallardconsulting.etsy.comSpravato treatment includes a required two-hour observation period, but many clinics are unclear about what that time should actually involve. In this episode, we explore what needs to happen during the monitoring period and how clinical care responsibilities differ from billing and compliance expectations. We discuss patient monitoring, staff roles, physician involvement, and documentation, along with common workflow approaches that can unintentionally create compliance or billing risk for practices.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 3/11/26 | It Paid for Years… Until It Didn’t | Go to https://www.stephanieallardconsulting.com/online-shop/p/peripheral-vascular-lower-extremity-interventions-coding-and-compliance-essentials-1 and use code VASC15 at checkout for a discount on the upcoming Peripheral Vascular Lower Extremity Interventions: Coding and Compliance Essentials Event!There’s a phrase in compliance that should make every practice pause:“We’ve always done it this way.”In this episode of Auditing Antics, Stephanie and Michele unpack one of the most dangerous patterns in healthcare billing — the normalization of deviance. A coding practice that started small. A billing habit no one questioned. Claims that paid for years without issue. Until one denial. One probe. One data review changed everything.We walk through how long-standing habits become compliance blind spots, why teams genuinely believe they’re doing it right, and how the math of recoupments can unravel years of “routine” billing in a matter of months.Because payment history is not proof of compliance.And comfort is not a compliance strategy.If you’ve ever heard “but it’s always paid,” this episode is for you.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 3/4/26 | The Algorithm Already Saw You: Audit Triggers Hidden in Your Data | Most audits don’t start with a complaint.They start with a pattern.Long before a human reviewer opens a chart, payer analytics are scanning utilization trends, benchmarking providers against peers, and flagging statistical outliers. Sudden shifts in coding levels. High-frequency services. Modifier usage patterns. Even documentation that looks too consistent.In this episode of Auditing Antics, Stephanie and Michele break down how data science drives audit selection and why many providers are flagged without ever realizing their billing trends stand out. We’ll talk about outlier patterns, utilization spikes, and the quiet metrics payers monitor behind the scenes.Because in today’s compliance environment, you’re not just being reviewed by auditors. You’re being watched by the numbers. If you’ve ever thought an audit felt random . This episode will change how you look at your data.Reach Out For Compliance Help Now!https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 2/25/26 | Physician vs. Medical Coding Auditor: Different Minds, Same Medical Record | Physicians document to reflect clinical care. Auditors review to validate compliance and billing accuracy. Same chart with a completely different lens.In this episode of Auditing Antics, we break down the mindset gap between providers and medical coding auditors. Why does something that feels clinically obvious sometimes fail an audit? Why does intent not always translate to compliant documentation? And what are auditors actually trained to look for that providers may not realize?We’ll explore how clinical thinking and compliance thinking intersect, and where they often disconnect, plus practical ways to bridge that gap. In compliance, it is not about questioning care but instead discussing what the record supports.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com | — | ||||||
| 2/18/26 | From Burnout to Billing Errors: Protecting Performance Under Pressure | Burnout impacts morale and accuracy.In this episode of Auditing Antics, Stephanie and Michele unpack how exhaustion, staffing strain, and constant regulatory shifts quietly increase compliance risk. When teams are stretched thin coding patterns may change. Small oversights turn into denials, downcoding, or audit findings.We’re connecting the dots between human fatigue and operational exposure because compliance mistakes can happen when energy is depleted and teams are struggling to focus.Reach Out For Compliance Help Now!https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry!https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our online shop here! https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com | — | ||||||
| 2/11/26 | Auditing Antics Q&A: Real-Time Healthcare Coding & Billing Answers | Find the Medical Coding Workroom Here!https://www.stephanieallardconsulting.com/medical-coding-workroom-1Find the Membership (that includes the Medical Coding Workroom) Here! Use code AUDITINGANTICS26 for a 26% discounthttps://www.stephanieallardconsulting.com/membershipGot coding questions you’ve been sitting on because the answer isn’t quite clear? This live Auditing Antics Q&A is where real-world healthcare coding and billing questions get real-time, audit-focused answers. We’re breaking down E/M leveling, documentation defensibility, payer downcoding, modifier misuse, and high-risk billing patterns before they turn into denials, takebacks, or audit findings. | — | ||||||
| 2/4/26 | No Vaccine Given, Still Billable? Immunization Counseling Explained | What happens when a vaccine visit ends with education, but no immunization is administered? In this episode, we break down when immunization counseling may be reportable, what documentation is required, and the audit risks when vaccines are refused or deferred. Join us to learn about the new 2026 vaccine counseling codes.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact Sign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our online shop here! https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com | — | ||||||
| 1/29/26 | E/M Levels Under Fire: The Rise of Automatic Downcoding | Automatic E/M downcoding has become an increasingly common, and often unquestioned, practice in payer reviews and internal audits. In this episode of Auditing Antics, we break down what automatic downcoding is, why it happens, and when it crosses the line from compliance review into improper reimbursement reduction. We discuss how payers apply internal “rules” that override documented medical decision-making, the compliance risks this creates for providers, and how organizations can identify, challenge, and defend against inappropriate downcoding. If you’ve ever seen well-supported E/M services reduced without explanation, this episode will help you understand what’s happening and what to do next.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact Sign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our online shop here! https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com | — | ||||||
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