In this solo episode of Behind The Scenes, Sonda gives an overview of why you need a compliance plan for Medicare/Medicaid enrollment. This episode dives into the risks associated with operating a business without a compliance plan in place. Sonda describes the implications of healthcare relationships that seem harmless but could implicate the provider when compliance isn’t top of mind.

In this episode, Sonda discusses:
• Vendor offerings within the healthcare organization
• The False Claims Act and self-disclosure
• How to create a strong compliance plan and mitigate risks

Allow Sonda to help you understand auditing with ease!

Link to OIG Compliance Guidance https://oig.hhs.gov/compliance/general-compliance-program-guidance

Until next time, stay curious, inspired and keep learning!

Sonda's Links For You:
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In this episode of Behind The Scenes, Sonda is joined by Shelly Baer and Christie Armstrong. The group discusses the therapists’ interpretation of how difficult it can be to maneuver and navigate the insurance space and how this can be turned into making a larger impact. The trio has meaningful conversations about unique guidelines that are in place for different insurance carriers, as well as about Shelly and Christie’s plethora of industry experience in the mental healthcare field. 

In this episode, the group discusses:
• The unique needs of individuals in therapy and the ways in which their cases are recorded.
• The stressors associated with billing in the therapy field.
• The differentiators between clinical and mental health.

Let’s forge a pathway to wellness together. Check out this episode!

Until next time, stay curious, inspired and keep learning!

Shelly's Links:
Shelly’s Instagram
Shelly’s Website

Sonda's Links For You:
• Website
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• Facebook
• LinkedIn

Welcome to our first episode of 2024! In this solo episode of Behind The Scenes, Sonda dives into the changes to behavioral health for 2024. She shares that marriage and family therapists will now be able to get contracted with Medicare. Sonda explains that with some of the changes at hand, individuals may be confused as to whether or not they qualify. She talks about who is considered to be a mental health practitioner in 2024 (including addiction counselors), and helps to mitigate any confusion that may come as a result of the changes. 

In this episode, Sonda discusses:
• The qualifications and certifications required to be considered a mental health practitioner.
• Intensive outpatient procedures.
• Required training for auxiliary personnel.

Stay in the know for 2024. Check out this episode!

Until next time, stay curious, inspired and keep learning!

Sonda's Links For You:
• Website
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• LinkedIn

In this solo episode of Behind The Scenes, Sonda dives into the challenges of payer ghosting. She explores the portals, processes, and protocols that contribute to the payer ghosting problem. She talks about the importance of looking at your billing partner and ensuring that everyone works on your claims in a way that is supportive and won’t take a denial at face value. In this episode, Sonda discusses:

• The importance of working with providers to foster a proactive approach.
• The provider/payer relationship.
• Returning to contracts and requirements.

Let’s all fight against payer ghosting. It’s time to become more diligent! Check out this episode!

Until next time, stay curious, inspired and keep learning!

Sonda's Links For You:
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• LinkedIn

In this episode of Behind The Scenes, Sonda is joined by Rachel Woodward to discuss behavioral health billing. Rachel is the CEO of Datapro Billing, based out of Southern California. She is passionate about serving this industry and has found great purpose in helping providers. The pair focus on the differences between east coast and west coast practices and services.  Join the women as they talk about:

• Working with a behavioral health billing partner.
• Pre-payment and post-payment review.
• Unexpected medical billing and patient finances.
• Training internal staff on payment plans.

Let’s dive into the ways in which behavioral health billing partnerships are progressing. Check out this episode!

Until next time, stay curious, inspired and keep learning!

Rachel’s Links:
Datapro Billing Instagram

Sonda's Links For You:
• Website
• Instagram
• Facebook
• LinkedIn

In this episode of Behind The Scenes, Sonda is joined by Ray Dalessandro to discuss the value of partnership in business. Ray is part of a clearing house called Etactics and in this episode, he brings his knowledge to the table. The pair focus on working across agencies, honing in on challenges that partners face, and adding value in working relationships. Join Sonda and Ray as they talk about:

• Working with partners who add and share value.
• Open, transparents communication with clients.
• Showcasing your knowledge and understanding during onboarding.
• Using resources and showing true care.

Let’s dive into the ways in which we can build meaningful partnerships. Check out this episode!

Until next time, stay curious, inspired and keep learning! 

Ray's Links:
LinkedIn - https://www.linkedin.com/in/ray-d-1417ba8

Sonda's Links For You:
• Website
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• Facebook
• LinkedIn

In this episode of Behind The Scenes, Sonda is joined by Gary Humble, who has been in the healthcare field for 42 years and leads G&M Consulting as its President. Sonda and Gary discuss credentialing and dive into the review process and the importance of keeping track of all the moving pieces. Join Sonda and Gary to learn more about:

• The difficulties associated with billing when being the “last touch” of a claim.
• Determining the type of contract being dealt with and the services being offered. 
• Filling client gaps and missing details on the revenue side. 
• Advice for agencies to get paid correctly.

Contracts can be tricky. Let’s dive into the credentialing world together.  Sonda and Gary are here to help!

If you enjoyed this episode, we would appreciate it if you could share, rate, review and drop us a note for subjects about the business of medicine you would like to hear! There is a lot to share and we want to know what would be most impactful for you!

Until next time, stay curious, inspired and keep learning! 

Gary’s Links:
Website: https://gmbhconsulting.net
Twitter/X: @ghrecon

Sonda's Links For You:
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In this episode of Behind The Scenes, Sonda discusses physician office notes and the ways in which auditors and coders are challenged by reviewing them. She focuses on “note bloat”, which refers to notes that contain an excess of cloudy information. Join Sonda as she discusses:

• The transition from physical physician notes to digital records.
• The supportive partnership between auditors and physicians.
• The use of legacy templates for documentation.
• The importance of training and record review for physicians.

Let’s dive into the complexity of physician documentation together. Want to help eradicate the note bloat? Check out this episode!

Until next time, stay curious, inspired and keep learning! 

Sonda's Links For You:
• Website
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• Facebook
• LinkedIn

In this episode of Behind The Scenes, Sonda is joined by Chris Smalley, the owner of Pivot BH Consulting. Chris gives us a rundown of her transition from special education to this area of work. She is now a specialist in consultation and accreditation! In this conversation, we expand upon the importance of training in the mental health space and client care. Join Sonda and Chris as they discuss:

• New certification and accreditation for Ohio.
• Clinical competencies and proactivity in clinical reviews.
• “The Golden Thread” and how it all ties together.
• Agencies that are pushing the boundaries for revenue, rather than displaying client care.
• Qualified mental health specialists and standardized training.

Let’s dive into the nuances of medical records from a billing and clinical standpoint. Curious to learn more? Check out this episode!

Until next time, stay curious, inspired and keep learning! 

Chris's Links:
Website: https://pivotbhc.com
LinkedIn: https://www.linkedin.com/in/christine-smalley/

Sonda's Links For You:
• Website
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• Facebook
• LinkedIn

In this episode of Behind The Scenes, Sonda will be discussing the challenges that come with remote teams. This seems to be the way of the working future as more and more people have shifted their priorities to be focused upon work-life balance. People are striving for the freedom associated with remote work, so let’s talk about managing them! Join Sonda as she discusses:

• Key performance indicators must be measured to analyze outcomes of employees. 
• Team recognition is essential to celebrate those doing great work.
• Understanding the accountability and experience levels of employees is necessary.
• Participation in on-camera meetings must be encouraged by managers.

Let’s tackle the remote working world with confidence and ease. We are in fact, managing the future!

Until next time, stay curious, inspired and keep learning! 

Sonda's Links For You:
• Website
• Instagram
• Facebook
• LinkedIn