NSCHBC Edge Podcast

Automating medical coding presents significant challenges due to the intricate nature of health information management, particularly medical records, which form the bedrock of healthcare coding and billing. Protected Health Information (PHI) exists in various formats, including handwritten notes, patient intake forms, and dictated lab reports. This lack of standardization poses a considerable hurdle for AI systems.Revenue Cycle Management (RCM) professionals—such as coders, billers, and auditors—possess the contextual understanding necessary to interpret and extract crucial information from diverse and sometimes illegible records. The complexity of abstracting documentation is further compounded by ambiguous acronyms, localized jargon, and specialized medical language. Additionally, a substantial portion of the information provided to coders is subjective, demanding a level of interpretation that current AI technology may not yet possess.For AI to acquire these essential skills, medical coders will need to train the systems, and auditors will be responsible for verifying their accuracy. This technological shift is inevitable, so RCM professionals should consider developing these skills to remain competitive in the evolving IT landscape.Join us as host Terry Fletcher welcomes Sirisha Bommireddipalli to the show for an insightful discussion on this important topic.

In the context of medical and/or dental insurance, ADR refers to Additional Documentation Request. This is a request from an insurance payer (like Medicare) for additional records to support a claim. It's not a sign of wrongdoing, but rather a way to ensure compliance with policies and verify the validity of claims. Ignoring these requests, or failure to meet their deadlines, can result in a loss of revenue and trigger additional payers' audits and ADR’s. Terry outlines the ADRs and best practices to make sure your staff is on top of these requests, which helps save your revenue.

On this edition of the Edge Podcast, Terry welcomes Healthcare Compliance Consultant, Stephanie Allard. The hosts discuss objectives when hiring an external consultant, such as budgets, objectives, outcomes, expectations, and more.Tune into this important and informative episode to make sure you are prepared

This month on the NSCHBC Edge Podcast, Terry welcomes back, NSCHBC member, Merikay Hunt CHBC, to discuss the pros and cons of a remote versus in-person versus hybrid workforce. When comparing corporate and healthcare sectors, remote work generally tends to be a better option for corporate roles due to the nature of many corporate jobs being more easily adaptable to digital platforms. However, healthcare often requires in-person patient interaction, making remote work less feasible in most cases. The best choice depends on the specific role and individual needs within each sector.

CPA versus bookkeeper: what is the role comparison in Healthcare, and medical practices? What does a physician or a physician practice need and why?A bookkeeper, although helpful for day-to-day accounting, payroll, and expenditures accounting. When the medical provider needs tax breaks information, provider relief funding accounting and deadlines, and retirement planning, what’s the better option and why?Terry talks with Healthcare CPA and NSCHBC President Shane Pickett on the best option for success.

The NSCHBC Edge Podcast welcomes fellow NSCHBC member, Rozmin Bapat to the show to discuss remote workers.Rozmin joins us from CodeRite Healthcare Consulting, based in Allen, TX. They are a billing, consulting and RCM company specializing in physician billing services.Terry and Rozmin define what it means to be a remote worker.What are some of the pros and cons of remote work and managing it. Also, how does remote work compare versus bringing everyone back in-person either hybrid or full-time?Healthcare jobs can be tricky in this sense. This episode will provide insights on how to make remote employees a success.

Healthcare policies, Medicare cuts, and election year promises and rhetoric all affect how a patient will receive or not receive benefits. We have so many Congressional policy rules on the table that will impact not only Medicare patients, but all patients as we may get a new HHS director as well when the presidency changes. Listen to this episode of the Edge podcast to know what is real and what is noise, as Terry Fletcher and Sean Weiss discuss healthcare and politics in 2024.

In the setting of AI - Artificial Intelligence - Healthcare is running head first into possible risk. In this month’s episode of the NSCHBC Edge Podcast Terry and Vinny Sankaran tackle the PROS and CONS of AI in Healthcare.Data suggests AI helps health providers practice their profession and invest their time in engaging with patients rather than spending time on transcribing notes and administrative work. Also, when used safely and appropriately, this could exponentially expand evidence-based medicine to improve health outcomes and people-centered care.However, there are some CONS. Risks from AI include poor outcomes from algorithms (due to bias, low-quality data, lack of transparency, or usage in inappropriate contexts) which is a concern. HIPAA issues are a concern as well as cyber-hackers. We look at the current and future landscape of AI in Healthcare.