PREFLIGHT BLOG FOR HOSPITAL REVENUE CYCLE PROFESSIONALS
Briefings on topics we think about and think you should think about...
Wiser Wednesday Podcasts now produced by Brian Cui from MedicalCodingGeek.com
Portions of the No Surprises Act Regulations Have Been Invalidated
How Surprising:
Portions of the No Surprises Act Regulations Have Been Invalidated
The No Surprises Act (the Act) continues to bump through its initial implementation phase. We've seen plenty of discussion elsewhere about how out-of-network physicians and facilities (OON Providers), and their allies, are pushing back against portions of the recently issued interim final rule with comment period (the Interim Rule). Most recently, they succeeded in doing so when the Texas Medical Association, a trade association representing more than 55,000 physicians, and Dr. Adam Corley filed and won a lawsuit against the Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management (collectively, the Departments). The plaintiffs successfully argued that the Interim Rule unfairly protects group health plans and health insurance issuers (collectively, Plans) to the detriment of patients and OON Providers.
On February 23, 2022, Judge Jeremy D....
Wiser Wednesdsay - Experience Speaks: John Zelem, MD, FACS and Joe Crea, DO
John Zelem, MD, FACS is the president and owner of Streamline Solutions Consulting, Inc. He is a Board-Certified general surgeon with more than 25 years of clinical experience, has transitioned out of clinical practice into Healthcare Executive Leadership. Dr. Zelem is a renowned industry author who has published many books and is a well-known motivational speaker and presents often to professional and public/patient audiences on health and wellness, personal development, and leadership and success. Joe Crea, DO is the medical director for Advisory Services for Sound Physicians. He brings a decade of physician advisory experience to this position as well as extensive experience in both clinical and academic settings. He holds a Health Care Quality & Management Physician Advisor certification. Dr. Crea considers himself an "amateur chef," and loves to cook in his spare time. He is an avid traveler who loves to experience new places and is looking forward to becoming a part of...
Wiser Wednesdsay - Experience Speaks: Eric Rubenstein
Eric Rubenstein is a seasoned federal law enforcement officer (25 years), specializing in white-collar crime investigations. Wide-ranging experience involving federal healthcare programs, with an emphasis on crimes involving the Medicare and Medicaid programs by health care providers, including physicians, pharmacies and health care entities. He is currently the Director of Litigation Fraud Waste and Abuse Support for Advize Health.
Eric Rubenstein on LinkedIn: https://www.linkedin.com/in/eric-rubenstein-oig/
Glenn Krauss on LinkedIn: https://www.linkedin.com/in/glenn-krauss-93521a19/
Core-CDI: CDI Consulting: https://www.core-cdi.com/
Top Gun Audit School: http://www.topgunauditschool.com/
This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com
Wiser Wednesdsay - Experience Speaks: Mary-Claire Cotner
Mary-Claire is dedicated to her passion for health care & medicine. She has a unique background in health care. Over the years, she has contributed to clinical research & assumed leadership roles. She is currently completing her graduate medical education. Here she aims to obtain excellent medical & professional competencies. She considers herself a lifelong learner & is committed to engendering a culture of excellence wherever she goes.
Mary-Claire Cotner on LinkedIn: https://www.linkedin.com/in/maryclairecotner/
Glenn Krauss on LinkedIn: https://www.linkedin.com/in/glenn-krauss-93521a19/
Core-CDI: CDI Consulting: https://www.core-cdi.com/
Top Gun Audit School: http://www.topgunauditschool.com/
This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com
Wiser Wednesdsay - Experience Speaks: Noelle Dale-Brown
Noelle Dale-Brown is an experienced RHIA and RMA in both post-acute and acute care. She is Scrum Master/Lean Six Sigma Green Belt certified, and skilled in record management workflow assessment and redesign using methodologies to achieve productivity and efficiency.
Noelle Dale-Brown on LinkedIn: https://www.linkedin.com/in/noelle-dale-brown-bshiim-rma-rhia-smc%C2%AE-a15a73132/
Core-CDI: CDI Consulting: https://www.core-cdi.com/
Top Gun Audit School: http://www.topgunauditschool.com/
This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com
Wiser Wednesdsay - Experience Speaks: Sonal Patel and Toni Elhoms
Sonal Patel, CPMA, CPC, CMC is the healthcare coding and compliance consultant at the law firm of Nexsen Pruet, LLC. She has over 10 years of experience in multi-specialty healthcare coding, auditing and compliance. She provides reimbursement investigations for Parts A and B providers. Ms. Patel delivers healthcare lawyers with strategies and analyses to overturn denials with private and government payers. She is a member of the AAPC Northbrook, Ill., local chapter, AMBA (American Medical Billing Association), PMI (Practice Management Institute), and NCMGMA (North Carolina Medical Group Management Association). Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy...
Wiser Wednesdsay - Experience Speaks: Candice Faison
Candice is an innovative, results-oriented, and experienced healthcare administrative professional with more than 13 years of successful experience in various aspects of revenue cycle and health information management. Candice is a graduate from Franklin University where she obtained her MS degree in Healthcare Administration and BS in Allied Healthcare Management. She is also a graduate of Sinclair Community College with an A.A.S in Health Information Management and a Registered Health Information Technician certified through AHIMA. She is currently the manager of clinical documentation and coding quality for Premier Health Partners.
Candice on LinkedIn: https://www.linkedin.com/in/cnfaison1/
Core-CDI: CDI Consulting: https://www.core-cdi.com/
Top Gun Audit School: http://www.topgunauditschool.com/
This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com
Wiser Wednesday: Melissa Rodriguez
Melissa Rodriguez, CCS, CCS-P, CDIP, CPMA works for Salem Health as documentation and coding specialist, where her role is to provide education for both the coding and CDI team. She works in clinical validation denials and deals with varying audit functions such as queries and coding. She strives to continually educated herself and her team on the latest coding and clinical validation guidance. Since her time at Salem Health, she has helped implement a query policy and a regular audit schedule for both the coding and CDI teams. She has implemented a denials tracking method that highlights high risk areas with solutions to minimize risk. Melissa is an avid motorcyclist and a kayaker.
Melissa Rodriguez on LinkedIn: https://www.linkedin.com/in/melissa-rodriguez-ccs/
Core-CDI: CDI Consulting: https://www.core-cdi.com/
Top Gun Audit School: http://www.topgunauditschool.com/
This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com
Wiser Wednesday: Dr. Tisha Titus & Dr. Paula Wineland on Better Documentation
Physician Challenges to Good Documentation with Tisha Titus, MD, MPH and Paula Wineland, MD, FACP.
Core-CDI: CDI Consulting: https://www.core-cdi.com/
Top Gun Audit School: http://www.topgunauditschool.com/
This podcast was edited and mixed by Brian Cui from MedicalCodingGeek.com
