CodeCast | Medical Billing and Coding Insights

Terry is back with another Top Ten Tuesday discussion.

In this episode, she discusses front desk to billing office workflow mistakes, looking at patient demographics, insurance information, HMO referrals, PA’s, and data backups.

Tune in to reset your RCM workflows.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post Top 10 Tuesday Q&A – RCM Workflow Mistakes appeared first on Terry Fletcher Consulting, Inc..

Today on the CodeCast podcast, Terry discusses best practices for the -25 Modifier, where to find her latest blog on the AAPC website, and what the MAHA (Make America Healthy Again) movement means to our country.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post The 25 Modifier and More appeared first on Terry Fletcher Consulting, Inc..

CMS published the 2025 Final Rule on November 1st. Terry breaks down the highlights and gives you the facts on the Telehealth “mess” that could have 85% of Medicare patients without access to virtual care.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post CMS final rule is out and Telehealth is an issue appeared first on Terry Fletcher Consulting, Inc..

Many practices have engaged in coding for TCM (Transitional Care Management) services but are finding that they are receiving more denials than payments.

Terry breaks down why that is, and sheds light on what is needed to qualify billing for these services.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post Why are TCM services receiving more denials than payments? appeared first on Terry Fletcher Consulting, Inc..

Artificial intelligence (AI) has the potential to make substantial progress toward the goal of making healthcare more personalized, predictive, preventative, and interactive.

However, AI-based systems raise concerns regarding data security and privacy. Because health records are important and vulnerable, hackers often target them during data breaches. The absence of standard guidelines for the moral use of AI and ML (machine learning) in healthcare has only worsened the situation.

There is debate about how far artificial intelligence (AI) may be utilized ethically in healthcare settings since there are no universal guidelines for its use. Therefore, maintaining the confidentiality of medical records is crucial.

Terry scratches the surface and discusses some concerns about AI in healthcare predictive models and what to also look for as we continue to use AI scribes.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post AI in Medical Coding: What’s the Reality? appeared first on Terry Fletcher Consulting, Inc..

HIPAA has many privacy issues that most practices have in their HIPAA compliance manuals. However, current HIPAA violations are coming to light when employees purposefully search patient PHI for personal use or curiosity. This is not only a violation of privacy laws but could have a cascading effect if not stopped in its tracks.

In this episode, Terry discusses these issues at length and what safeguards to take in this political climate.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post HIPAA violations your organizations should avoid appeared first on Terry Fletcher Consulting, Inc..

In this edition of the CodeCast podcast, Terry discusses the “subtle changes” to look for in the ICD-10-CM updates effective October 1st.

Also, Terry clears up understanding the UHC Gold Card Program, and what CMS looks at when they send you a denial.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post RCM Updates for 4th Quarter appeared first on Terry Fletcher Consulting, Inc..

According to the AMA, most physicians lack training in “webside manner.” Researchers from the University of Michigan Medical School and the Veterans Affairs Ann Arbor Healthcare System surveyed 1,213 patients from their respective institutions to measure preferences regarding the visual background seen during a video visit.

Today’s CodeCast podcast brings you the survey results, with some surprising details. Also, Terry gives her insights on how to prepare for virtual visits.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post Telemedicine “Webside Manner” appeared first on Terry Fletcher Consulting, Inc..

Many practices offer cash payment options to avoid insurance billing, hoping to reduce administrative burden or boost revenue.

However, this practice of charging cash for services that could be billed to and covered by a patient’s insurance plan raises serious compliance concerns. Federal law and insurance contracts generally prohibit this practice because it undermines the healthcare payment system and can lead to regulatory violations.

Terry discusses the compliance ramifications of this policy with a little health from a NAMAS article.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post Charging patients cash for “insurance covered” services appeared first on Terry Fletcher Consulting, Inc..

Sometimes there are coding, compliance, and billing questions that we struggle to find answers to in any published guidance or specific regulatory rules.

This week on the CodeCast podcast, Terry brings up three specific questions that we are always hunting for answers to and the best way to deal with them.

You can subscribe to our podcasts via:

If you’d like to become a sponsor of the CodeCast podcast please contact us directly for pricing: https://www.terryfletcher.net/contact/

The post Sometimes the rules are as “clear as mud” appeared first on Terry Fletcher Consulting, Inc..