Leaders in Medical Billing

In this inspiring episode of Leaders in Medical Billing, Chanie Gluck sits down with Josh Fertel, owner of J3RCM, to discuss his remarkable journey into the medical billing industry. Pivoting from 30-years in the car business to founding his own medical billing company at the age of 57, Josh shares how personal challenges and a passion for learning led him to his career change. This episode explores the importance of networking, the role of communication in business success, and the entrepreneurial mindset that drives Josh's success. Tune in to hear his story and gain valuable insights for your business!

Timestamps

00:00:00 - Introduction and Host's Background 00:00:32 - Guest Introduction: Josh Fertel 00:00:47 - Josh's Career Transition to Medical Billing 00:01:42 - Overcoming Health Challenges 00:02:23 - Learning Medical Billing During Recovery 00:03:02 - Starting J3RCM and Early Success 00:03:32 - Challenges and Unique Perspective in Medical Billing 00:04:20 - Networking and Client Acquisition 00:05:16 - Building a Knowledgeable Team 00:05:49 - First Major Project: Chronic Care Management 00:06:46 - Launching the Angry Biller Podcast 00:07:01 - Frustrations with Physicians' Business Knowledge 00:08:48 - Enjoyment and Purpose of Podcasting 00:09:47 - Communication as a Key Business Focus 00:11:09 - Managing a Remote Team 00:12:45 - Networking and Learning from Industry Leaders 00:13:05 - Host's Business Journey and Offshoring 00:16:01 - Growth and Networking Strategies 00:17:05 - Client Referrals and Specialties 00:18:22 - Software Preferences and Challenges 00:19:13 - Future Goals and Success Metrics 00:20:04 - Planning for the Future 00:20:20 - Contact Information and Closing Remarks

In this episode of Leaders in Medical Billing, Chanie Gluck interviews Ashish Mandavia, a trained physician and now CEO and co-founder of Sohar Health. Ashish shares his journey from practicing psychiatry to becoming a healthcare tech entrepreneur, discussing the motivations behind his career shift and the challenges he faced in the process. He explores systemic issues in healthcare that motivated him to innovate, particularly focusing on revenue cycle management (RCM) and the need for better technology in this space. The conversation also delves into differences in healthcare systems between the U.S. and Europe, the impact of AI on healthcare, and the future of preventative care.

Timestamps:

• 00:00 - 02:00 - Introduction by Chanie Gluck, overview of the podcast.
• 02:01 - 05:00 - Introduction of guest Ashish Mandavia and his background.
• 05:01 - 10:00 - Ashish’s journey from practicing psychiatry to entering healthcare tech.
• 10:01 - 15:00 - Challenges in the U.S. healthcare system and Ashish's motivation to innovate.
• 15:01 - 20:00 - Discussion on revenue cycle management (RCM) and why physicians avoid taking insurance patients.
• 20:01 - 25:00 - Overview of Sohar Health’s solutions for automating RCM processes.
• 25:01 - 30:00 - Importance of accuracy in RCM and the role of AI in improving healthcare processes.
• 30:01 - 35:00 - Future of Sohar Health and broader healthcare industry trends.
• 35:01 - 40:00 - Ashish’s perspective on AI and preventative care in healthcare.
• 40:01 - 45:00 - Closing thoughts, upcoming conferences, and where to find Sohar Health.

In this episode of "Leaders in Medical Billing," the discussion focuses on the transformative impact of AI and automation within the medical billing industry. Key topics include:

1. AI and Automation Trends in Revenue Cycle Management (RCM):

   • Exploration of current trends in AI and automation.
   • The importance of incorporating automation to stay competitive in the industry.

2. Risks and Liabilities Associated with AI:

   • Analysis of the potential risks and legal liabilities of adopting AI technologies.
   • Guidance on performing due diligence when partnering with technology vendors.

3. Benefits of Automation in Medical Billing:

   • Practical examples of how automation can improve efficiency and revenue collection.
   • Insights into how automation can handle tasks like patient statements and follow-ups, resulting in higher collection rates.

4. Future of AI in RCM:

   • Discussion on the evolving role of AI, including its limitations and potential.
   • Predictions on how AI technologies will shape the future of medical billing and revenue cycle management.

5. Implementation Strategies:

   • Strategies for medical billing companies to integrate AI and automation into their existing workflows.
   • The importance of training staff to work alongside AI technologies to enhance operational efficiency.

6. Legal and Ethical Considerations:

   • Considerations for navigating the legal landscape as AI technologies continue to develop.
   • The importance of maintaining ethical standards while leveraging AI for business growth.

This episode provides valuable insights for medical billing companies looking to leverage AI and automation to improve their processes, enhance efficiency, and stay competitive in an evolving industry. For more in-depth discussions and specific takeaways, be sure to listen to the full episode.

In this episode of "Leaders in Medical Billing," I had the pleasure of speaking with Jeff Robertson, the CEO of Nexsys Billing and Practice Management. Jeff brings a wealth of experience with 27 years in the industry, starting from owning a DME company to transitioning into revenue cycle management (RCM).

Jeff shared his journey, which began with selling EMR software and evolved into providing comprehensive RCM services. His company initially focused on primary care and expanded to various specialties, with significant operations in New York and California. Jeff's passion for problem-solving and helping physicians optimize their workflows was evident throughout our conversation.

We delved into the exciting advancements in healthcare technology, particularly in automation and AI. Jeff highlighted a standout tool, Raxia, which uses AI to optimize patient statement delivery, significantly improving payment collection rates. He also discussed the challenges of integrating new technologies and the importance of future-proofing businesses in the ever-evolving medical billing landscape.

One of the critical challenges Jeff mentioned is the high turnover and low skill level at the front desk of medical practices, which often leads to billing errors. To address this, Nexsys Billing is proactively verifying patient information before appointments to reduce claim denials.

Looking ahead, Jeff remains committed to staying at the forefront of technology and continuing to provide exceptional service to his clients. He emphasized the importance of maintaining a balanced life while navigating the dynamic healthcare industry.

For more insights and takeaways, visit leadersinmedicalbilling.com. This episode is sponsored by 4D Global, empowering medical billing companies to grow through offshore staffing. Visit them at 4DGlobalInc.com.

[00:02:32] Evolution from EMR to RCM.

[00:05:17] Workflow challenges in clinics.

[00:08:55] Sales team evolution.

[00:13:08] Patient statements using AI.

[00:15:36] Future of healthcare trends.

[00:20:26] Automation in healthcare billing.

[00:23:48] Front desk denials and training.

[00:26:13] Elevating the RCM profession.

In this insightful episode of "Leaders in Medical Billing," I had the pleasure of hosting Landon Tooke, the COO and Chief Compliance Officer at Impact Healthcare Solutions. Landon shared his unconventional journey from working in healthcare since 2001 to founding a rural health medical billing and consulting firm, and eventually pursuing a law degree to deepen his expertise in healthcare compliance and law.

Landon discussed the evolution of his career, highlighting his transition from clinical roles to founding Impact Healthcare Solutions in 2009. His firm specializes in rural hospital billing, and over the years, they have increasingly focused on compliance-related issues, prompting Landon to gain further qualifications in healthcare law.

A significant portion of our conversation delved into the pressing issues of cybersecurity and the legal implications of using artificial intelligence (AI) and automation in the medical billing industry. Landon emphasized the high value of medical records, making healthcare providers and RCM companies prime targets for cyberattacks. He stressed the importance of continuous education, robust cybersecurity measures, and the need for a proactive approach to protect sensitive data.

Furthermore, Landon provided a critical analysis of the current landscape of AI and automation in RCM, distinguishing between true AI and more common automation processes used today. He cautioned RCM companies about the potential legal liabilities when deploying these technologies, especially as they become more sophisticated and autonomous.

Listeners can find more about Landon and Impact Healthcare Solutions at their website or connect with him on LinkedIn for more updates on healthcare compliance and cybersecurity.

This episode is brought to you by 4D Global, which specializes in empowering medical billing companies to expand through offshore staffing solutions. For more episodes and insights, visit our podcast website at leadersinmedicalbilling.com.

00:00:00 - Introduction and Background Chanie introduces the podcast and her guest, Landon Tooke, discussing their backgrounds and the focus of the episode.

00:01:04 - Landon's Journey into Medical Billing and Law Landon shares his unconventional journey from healthcare to founding Impact Healthcare Solutions and eventually pursuing law.

00:04:00 - Legal Education and Compliance Expertise Landon discusses his legal education and how it complements his role in medical billing and compliance.

00:05:45 - Cybersecurity in Medical Billing The conversation shifts to the importance of cybersecurity in the medical billing industry, highlighting the threats and necessary precautions.

00:10:09 - Practical Cybersecurity Measures Landon provides practical advice on enhancing cybersecurity within medical billing companies.

00:15:45 - AI and Automation in Medical Billing Discussion on the role of AI and automation in medical billing, distinguishing between AI and other technologies like RPA.

00:22:16 - Legal Implications of AI in Healthcare Landon talks about the potential legal challenges and liabilities associated with deploying AI technologies in healthcare.

00:27:17 - Comparisons and Future of AI The conversation explores the future implications of AI in healthcare, comparing it to other industries like autonomous vehicles.

00:30:45 - Impact Healthcare Solutions Services Landon details the services offered by Impact Healthcare Solutions, emphasizing their consulting and compliance capabilities.

00:32:26 - Closing Remarks and Contact Information The episode wraps up with thanks to Landon and information on how to connect with him and Impact Healthcare Solutions.

In this insightful episode of the Leaders in Medical Billing podcast, host Chanie Gluck talks with Matt Riter, Principal at Capitol Associates, about key changes in healthcare legislation affecting the revenue cycle management (RCM) industry. They delve into critical provisions of the No Surprises Act and the challenges arising from recent cyberattacks affecting healthcare providers.

Key Topics Covered:

1. Change Healthcare Cyberattack (02:15): Matt provides an overview of the Change Healthcare cyberattack, its impact on UnitedHealthcare services, and the challenges faced by providers in accessing payment and data.

2. No Surprises Act Updates (18:45): Discusses the Advanced Explanation of Benefits (AEOB) and Good Faith Estimate (GFE) provisions, emphasizing the importance of preventing surprise medical bills and promoting transparency.

3. Medicare Reimbursement Challenges (32:20): Insights into the complexities of Medicare reimbursement, upcoming payment cuts, and how providers are affected by shifting policies.

4. Legislation & Advocacy (45:30): Matt discusses pending bills in Congress addressing payment issues, virtual credit card fees, and EFT charges to support healthcare providers.

5. FTC Antitrust Investigation (58:10): An analysis of the Federal Trade Commission’s investigation into UnitedHealthcare’s market dominance and the implications for the healthcare sector.

Below you will find the bills referenced in the episode

H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which permanently ties annual Medicare reimbursement updates to MEI.

H.R. 6371, the Provider Reimbursement Stability Act of 2023, which reforms how CMS budget neutrality adjustments are calculated.

H.R.6487/S.3805, the No Fees for EFTs Act, which closes the loophole that payment vendors exploit to charge EFT transaction fees.

Join Chanie Gluck as she navigates the complex aftermath of the Change Healthcare cyberattack alongside Landon Tooke, COO and Chief Compliance Officer at Impact Healthcare Solutions. In this insightful episode, they discuss the latest developments and strategies for strengthening cybersecurity in the healthcare sector.

•  Chanie sets the stage, discussing her experience and the focus of today’s episode—the Change Healthcare cyberattack.
•  Landon, a seasoned healthcare attorney, gives an update on the current situation regarding Change Healthcare, explaining the sequence of events that led to the recent data breaches and the implications for healthcare providers and revenue cycle management (RCM) companies.
• Detailed breakdown of the cyberattacks by Black Cat, subsequent responses by Change Healthcare, and the emergence of Ransom Hub, a new threat actor claiming possession of sensitive data.
•  Discussion on how the breach has sparked debates over healthcare data security, antitrust concerns, and the potential reevaluation of large healthcare mergers.
• [Cybersecurity Focus]: Emphasis on the importance of maintaining cybersecurity vigilance, investing in protective measures, and considering cybersecurity insurance as essential parts of healthcare operations.
• Conclusion: Chanie and Landon reflect on the broader implications of the cyberattack and stress the need for continuous improvement in cybersecurity strategies within the healthcare industry.

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We're thrilled to announce that "Leaders in Medical Billing" has been recognized by Feedspot as one of the Top 15 Medical Billing and Coding Podcasts on the web, currently ranking in 5th place! Learn more about this honor here https://podcasts.feedspot.com/medical_billing_and_coding_podcasts/

In this enlightening episode, Benjamin Riegel, founder and host of the Revenue Cycle podcast "My Good Friends" and CEO of Tarpon Health, takes us through his journey from co-founding Health Rise Consulting Firm to establishing a unique community that fosters innovation and support among healthcare leaders. With a wealth of experience in enhancing healthcare systems and a deep dive into the complexities of healthcare changes, Benjamin shares his insights on the importance of community, the power of learning from failures, and the impact of technology in healthcare. Join us as we explore the evolution of healthcare through the lens of a seasoned expert who believes in the power of collaboration and innovation to drive positive change.

Benjamin Reigle, founder and host of the Revenue Cycle podcast "My Good Friends," shares his extensive experience in the healthcare industry, including co-founding Health Rise Consulting Firm and leading initiatives at companies like McKinsey & Company and Accredited Health (now R1). He is also the CEO of Tarpon Health, a community driving automation for healthcare providers. In this episode, Benjamin dives into the topic of healthcare change, emphasizing the importance of understanding industry shifts. Stay tuned to gain insights into the evolving landscape of healthcare.

The Change Healthcare breach, as discussed in the podcast episode with Benjamin Reigle, has had a profound impact on the healthcare industry. The breach resulted in challenges with claim submission, cash flow, and data security, affecting not only the operations of Change Healthcare but also having a ripple effect on healthcare providers, payers, and patients.

The breach led to issues with claim submission, as some payers who relied solely on Change as their intermediary were unable to process claims. This created a backlog of claims and disrupted the revenue cycle for many healthcare organizations. Some providers resorted to manual processes, such as printing and mailing claims, which added complexity and delays to the billing process.

Cash flow was significantly impacted by the breach, especially for smaller healthcare entities like physician groups and community hospitals. With claims not being processed efficiently, these organizations faced financial strain due to delayed payments and uncertainty about when the situation would be resolved. The lack of cash flow threatened the financial stability of these smaller entities, highlighting the importance of having contingency plans and backup systems in place.

Data security concerns arose as a result of the breach, with questions about the extent of the data compromised and the potential implications for patient privacy. The breach raised questions about the adequacy of security measures in place and the vulnerability of healthcare systems to cyber threats. The need for enhanced data security protocols and proactive measures to prevent future breaches became a pressing issue for healthcare organizations.

Experian Health Client Communication

February 23, 2024

Experian Health is aware of Change Healthcare’s (Optum’s) announcement on February 21 about a cybersecurity incident affecting its systems. Experian’s Cyber Incident Response team and Cyber Threat Intelligence teams have been engaged and are closely monitoring the situation. We have not seen evidence of a threat to Experian. Out of an abundance of caution and consistent with Experian’s security practices, Experian has temporarily severed connectivity to Change Healthcare. During the period of this severed connectivity, there will be an impact to batch and EDI authorizations, claims and remits, claim status, eligibility, and notice of care transactions that Experian Health sends to Change Healthcare. Experian will resume connectivity to Change when it receives assurances from Change Healthcare that it has adequately contained the threat. Payers work with a variety of clearinghouses to process data. In many cases, multiple payer connections are available although sometimes payer connectivity may be limited or even exclusive to a single clearinghouse. In the majority of cases, transactions from Experian Health route directly to the requestedpayer.

When connectivity is limited or certain routes are unavailable, however, it is common to route traffic through another clearinghouse. Below is a list of potentially impacted payers. Our teams are actively evaluating and rerouting transactions when an alternative route is available and will provide an update to this list as soon as possible. BCBS-MA Blue Cross Blue Shield of Massachusetts Claims 13162 1199 National Benefit Fund 93044 A & I Benefit Plan Administrators 37283 AAG-American Administravie Group 72467 ACS Benefit Services Inc. © Experian Health, Inc. Experian Confidential Information Page 2 of 28 83077 Advantek Benefit Administrators CB159 Advisory Health Administrators 65093 Advocate Physician Partners CB637 Aegis Administrative Services 128CA Aetna Better Health of California 128FL Aetna Better Health of Florida 68024 Aetna Better Health of Illinois 128KS Aetna Better Health of Kansas 128KY Aetna Better Health of Kentucky 128LA Aetna Better Health of Louisiana 128MD Aetna Better Health of Maryland 128MI Aetna Better Health of Michigan 46320 Aetna Better Health of New Jersey 34734 Aetna Better Health of New York 50023 Aetna Better Health of Ohio 23228 Aetna Better Health of Pennsylvania 38692 Aetna Better Health of Texas (Medicaid & CHIP) 128VA Aetna Better Health of Virginia 128WV Aetna Better Health of West Virginia 26337 Aetna Better Health Premier Plan MMAI 45221 Aetna OhioRISE 13334 Affinity Health Plan 46594 AFFINITY MEDICAL GROUP 37280 AGA 20048 Agate Resources Inc. (LIPA) 64158 Agency Services Inc ARA01 AgeRight Advantage AWNY6 Agewell New York 95422 AIDS Healthcare Foundation 12K01 Alabama Medicaid 91136 Alaska Carpenters Trust 44423 Alexian Brothers Community Services of TN 13550 ALICARE AHCA1 Alignment Healthcare 26160 AllCare Advantage 58234 Alliant Health Plans of Georgia 50749 Allianz Global Assistance 37308 Allied Benefit Systems A0701 Alta Bates Medical Group RP016 Alterwood Advantage 13343 Amalgamated Life - PA / Alicare 75137 AmeriBen Solutions Inc. TH095 American Family Insurance 62030 American General © Experian Health, Inc. Experian Confidential Information Page 3 of 28 31135 American Health Advantage of Mississippi 31125 American Health Advantage of Oklahoma 31130 American Health Advantage of Tennessee 31155 American Health Advantage of Texas 1066 American Healthcare Alliance 74048 American National Ins. Co. (ANICO) 44444 American Postal Workers Union Health Plan 48055 American Progressive Life and Health Insurance Company 56195 American Trust Administrators Inc. 54763 AmeriHealth Administrators 77799 AmeriHealth Caritas Delaware 77003 AmeriHealth Caritas Florida 27357 Amerihealth Caritas Louisiana (LACare) 47073 AmeriHealth Caritas Next - A Product of AmeriHealth Caritas VIP Next, Inc. 45408 AmeriHealth Caritas Next A Product of AmeriHealth Caritas Florida, Inc. 83148 AmeriHealth Caritas Next North Carolina 81671 AmeriHealth Caritas North Carolina 84243 AmeriHealth Caritas Ohio 22248 AmeriHealth Caritas Pennsylvania 77062 AmeriHealth Caritas VIP Care 87406 AmeriHealth Caritas VIP Care - Delaware DSNP 77013 AmeriHealth Caritus VIP Care Plus (Michigan) 77002 Amerihealth District of Columbia 77001 AmeriHealth NorthEast 64090 AmFirst Insurance Company (payer only accepts Secondary claims) 24818 Amida Care 79966 Amida Care Medicare 37105 Amita Health Medical Care Group 34192 Antares Management Solutions 29370 Anthem Ohio Medicaid 34196 Apex Benefit Services 83112 Apex Health 11081 Arcadia Healthcare Solutions - IPG 36364 Arcadia Healthcare Solutions - NPA 39185 ARISE 61184 Arkansas Superior Select 6603 ASAGEHA AAMG1 Asian American Medical Group 46156 Aspire Health Plan 36483 Aspirus Medicare Advantage 75068 Assurant Health Self Funded 74240 Assured Benefits Administrators 84320 Astiva Health 87020 Atlantic Coast Life © Experian Health, Inc. Experian Confidential Information Page 4 of 28 AVA01 Avalon Administrative Services 46045 Avera Health Plans 87098 Avesis (Vision) 59274 AvMed Inc. 65101 AXA Assistance_USA 77005 Bakersfield Family Medical Group 12X42 Banner Health SX145 Banner Health AZ 84323 Banner Medicare Advantage Prime HMO 81079 BayCare Select Health Plans 63100 Behavioral Health Systems 99320 Benefit & Risk Management Services 48611 Benefit Management Inc. of KS 37212 Benefit Management Systems Inc 88052 Benefit Plan Administrators 39081 Benefit Plan Administrators Co. (Eau Claire WI) 38238 BeneSys, Inc. 95606 Berkshire Lehigh Partners 62183 Better Health Plans Inc. CB987 Black Hawk 3036 Blue Benefit Administrators of MA 12B54 Blue Cross Blue Shield of Alabama 77078 Blue Cross Blue Shield of Arizona Advantage SB580 Blue Cross Blue Shield of District of Columbia (Carefirst) 12000 Blue Cross Blue Shield of District of Columbia (Carefirst) SB971 Blue Cross Blue Shield of Hawaii (HMSA) SB690 Blue Cross Blue Shield of Maryland (Carefirst) 12011 Blue Cross Blue Shield of Maryland (Carefirst) 12B15 Blue Cross Blue Shield of Missouri (Blue Cross) BCSVT Blue Cross Blue Shield of Vermont BOONG Boon Administrative Services 22286 BritCay 35182 Brodart 51037 Brokerage Concepts 94316 Brown & Toland Medical Group BTHS1 Brown and Toland Health Services 42020 Buckeye Ohio Medicaid 42150 Butler Benefit 23708 C&O Employees Hospital Association CAIPA California IPA 71057 Cannon Cochran Management Services Inc. Metairie LA 95399 CAP Management Systems 12X03 Capital District Physicians Health Plan 95112 Capital Health Plan © Experian Health, Inc. Experian Confidential Information Page 5 of 28 68011 Capitol Administrators 12K89 Care Access Health Plan (CAHP) 77082 Care Improvement Plus 66010 Care N' Care 57116 Care1st Health Plan of Arizona - Medicaid (DOS < 11/30/22) 11345 CareCentrix 14182 CareCore National 14180 CareCore National LLC (Oxford Radiology Claims) 14188 CareCore/WCNY RAD 75191 CareFirst Administrators/NCAS (Charlotte, NC) 75190 CareFirst Administrators/NCAS (Fairfax, VA) 93975 CareOregon Inc. 16307 CarePartners of Connecticut 31500 CareSource Ohio Medicaid 65391 CBHNP - HealthChoices 95167 Cedars-Sinai Medical Network Services 68063 Celtic Insurance 99111 Cencal Health 94312 Center for Elders Independence 13360 CenterLight Healthcare 23626 Central Pennsylvania Teamsters Fund 13193 Central Reserve Life Ins Co-Medicare Supplement 36215 Central States Health & Welfare Funds 84146 CHAMPVA - HAC CHERO Cherokee Nation Comprehensive Care Agency 34154 Chesterfield Resources Inc. 80141 Childhealth Plus by Healthfirst (CHP) 94321 Children First Medical Group 33065 CHOC - Children's Hospital Of Orange County Health Alliance 38308 Christian Brothers Services 59355 Christian Care Ministries 10629 Christus Health Medicare Advantage 52106 Christus Health TX HIX 38219 ClaimChoice Administrators (DOS >1.1.21) 11752 ClaimsBridge HPN 85468 Clear Spring Heath 13285 Clover Health 51579 Coastal Communities Physician Network 42049 Cofinity - Group Resources 22284 Colonial Medical 88091 Commercial Travelers/PHX 14315 Commonwealth Care Alliance 14316 Commonwealth Care Alliance - Medicare Advantage 60995 Community Care Inc. - Family Care (Wisconsin) © Experian Health, Inc. Experian Confidential Information Page 6 of 28 73143 Community Care Managed Health Care Plans of Oklahoma 35193 Community Health Alliance 48145 Community Health Choice 75261 Community Health Electronic Claims/CHEC/webTPA 37322 Companion Life 37363 Compsych 6105 ConnectiCare Inc 75284 Consolidated Associates Railroad 87843 Consolidated Health Plans 45321 Consumers Choice Health SC 99433 Contessa Health 46478 Continuum (formerly Marrick WRx) 55544 Conversion Plan-APWU THCP9 Cook Children STAR Plan 58231 Core Administrative Services 43160 Corizon Inc. 35202 Cornerstone Benefit Adminstrators CB268 Cornerstone Preferred Resources CMSP1 County Services Medical Program 58102 Covenant Administrators, Inc. 64068 Creative Medical Systems CC304 Curaechoice 38261 Dell Children's Health Plan (DCHP) 63740 DentaQuest Vision 84133 Denver Health and Hospital Authority DESRT Desert Medical Group 44006 Desert Oasis Healthcare 27133 Dignity Health MSO 12001 District of Columbia Medicaid 6102 Diversified Administration Corporation 74284 Driscoll Children's Health Plan 35186 Dunn and Associates Benefits Administrators Inc. TH084 Early Intervention Central 66122 Eastland Medical Group 31074 EBMC 31625 ElderPlan Inc. 4326 Element Care Inc. EMP01 Empire Physician's Medical Group 42149 Employee Benefit Systems 35112 Employee Plans LLC 20818 Essence Healthcare RP037 Eternal Health 35605 Everence I & P 32052 Everpointe © Experian Health, Inc. Experian Confidential Information Page 7 of 28 62160 eviCore 59313 Evolutions Healthcare Systems (New Port Richey FL) 22344 Exceedent LLC 12B38 Excellus - BCBS Utica Watertown 12B40 Excellus - Blue Cross Blue Shield Rochester Area 71412 ExclusiCare 22254 Fallon Community Health Plan 88055 First Agency FCC01 First Carolina Care 91131 First Choice Health Administrators 57103 First Choice Next (SC) 32456 First Choice VIP Care (SC - DSNP) 77009 First Choice VIP Care Plus by Select Health of South Carolina 59322 Florida Health Care Plan 48116 Florida Hospital Waterman 48117 FMH Benefit Services Inc. 64069 Fox-Everett Inc. 99660 Fresno PACE 34171 FrontPath Health Coalition 25169 Gateway Health Plan Medicaid PA 75273 Geisinger Health Plan 31140 Georgia Health Advantage 7205 Gilsbar Inc. 7689 Global Care Inc. GEM01 Global Excel Management GHOKC Global Health GMICC Global Medical Management 47083 GMS Inc. 76923 Good Shephard Hospice Inc. 45235 Government Employees Health Association (Multiplan) GRV01 Gravie Inc. 36338 Group Administrators Ltd. CB951 Group Benefit Services Inc. 39167 Group Health Cooperative of South Central Wisconsin 64246 Guardian Life Insurance Company of America 47738 Hamaspik Choice 59143 Harrington Health Non-EPO 62061 Harrington Health-Kansas (formerly known as Fiserv Health-Kansas) 4245 Harvard Community Health Plan 4271 Harvard Pilgrim 12K62 Hawaii Medicaid 62180 Health Change Pathway 62179 Health Choice Arizona 46221 Health Choice Insurance Co © Experian Health, Inc. Experian Confidential Information Page 8 of 28 62111 Health Cost Solutions 34158 Health Design Plus (Hudson OH) RP039 Health First Health Plans TH049 Health Management Administrators (HMA) 4286 Health New England SX030 Health Options Inc (FL - BCBS HMO) 80142 Health Partners of Philadelphia 20270 Health Payment Systems Inc. 83253 Health Plan of Michigan 68035 Health Plan of San Joaquin 44273 Health Plans Inc. 37290 Health Services for Children with Special Needs HCH01 Healthcare Highways 56731 Healthcare Resources NW 73147 Healthcare Solutions Group 71064 HealthChoice Oklahoma 85729 Healthcomp Inc. 56144 Healthgram Inc. 55204 Healthnow Division 94267 Healthpartners 59140 HealthPlan Services 75237 Healthsmart Accel 37272 HealthSmart Benefit Solutions 87815 HealthSmart Benefit Solutions fka Wells Fargo TPA.Inc. 75250 HealthSmart Preferred Care Inc. 60058 Hennepin Health 30862 Heritage Victor Valley Medical Group 95393 High Desert Medical Group 95461 Highmark Senior Solutions (WV) 46 Hill Physicians Medical Group HPIPA Hispanic Physicians IPA (Encounters Only) 12T11 HMA - Health Management Admin 86066 HMA Hawaii 75318 HMC HealthWorks aka Health Management Co 84555 HMO Louisiana Inc 91164 HMSO-Highline Medical Service Organization HLSTA Holista (Novant Health Direct to Employer) 88023 Hometown Health Plan Nevada 37224 HSBS Memphis 37256 HSBS Oklahoma City 31172 HSBS World Trade Center Health Program 37137 HSHS Medical Group IPA 61103 Humana Ohio Medicaid 94154 Humboldt-Del Norte Foundation for Medical Care © Experian Health, Inc. Experian Confidential Information Page 9 of 28 54750 Huron PACE 37279 IAA 19028 IBM Business Transformation Outsourcing Insurance Services Corporate 26054 iCare Health Solutions 97661 IEC Group - AmeriBen 41600 I'Mcare 40585 INDECS Corporation TA720 Independence Administrators MHM01 Independence Medical Group 12X01 Independent Health SX073 Independent Health INDPM Independent Physicians at Mercy 12X75 Indian Health Services SX171 Indian Health Services 35600 Indiana Childrens Special Health Care Services 35107 Indiana Teamsters Health Benefits Fund (Indianapolis IN) 95444 Indiana University Health Plan 26212 Indiana University Health Plan (Commercial) 30360 Individual Assurance Company 31053 Individual Health Insurance Companies 43471 Inetico Inc. 52196 Informed LLC 38343 Ingham Health Plan Corporation 31182 InnovAge TH012 Insurance Services of Lubbock 39182 InsuranceTPA.com 86304 Insurers Administrative Corp. 51020 Integra Administrative Group (Seaford DE) 31127 Integra Group 20050 Integrated Medical Solutions LLC 23287 Intergroup Services Corporation 93116 Interlink 11329 International Benefit Administrator RP075 Iowa Health Advantage 47262 IU Health Transplant Evaluation Program JLSFE JLS Family Enterprises 38310 JOHN MORRELL COMPANY CO. - AHPBA 68036 John Muir Mt. Diablo Health System 66003 Johns Hopkins Health Advantage 52189 Johns Hopkins Healthcare (EHP/PP) 52123 Johns Hopkins Healthcare (USFHP) 43178 Joplin Claims / Benefit Management Inc 34136 JP Farley Corporation 91617 Kaiser Foundation Health Plan of Colorado © Experian Health, Inc. Experian Confidential Information Page 10 of 28 94123 Kaiser Foundation Health Plan of Hawaii 94135 Kaiser Foundation Health Plan of Northern CA Region 52095 Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. 21313 Kaiser Permanente of Georgia 94320 Kaiser Self Funded 40137 Kalos Heath KCIPA Kane County BCBS 71066 Kansas Superior Select 95279 Keenan Associates (CA) 73100 Kempton Company 77039 Kern Health Systems 37217 Key Benefit Administrators (Indianapolis IN) 37321 Key Select 37323 Key Solution 23284 Keystone First 42344 Keystone First Community HealthChoices 77741 Keystone First VIP Choice 34145 Klais & Company KPS01 KPS-Kitsap Physician Services 72107 LA Blue Advantage Louisiana LACAR LA Care Health Plan 37116 Lake County Physicians Association 66125 Lakeside Medical Group LNDMK Landmark Healthcare Inc 52193 LBA Health Plans 37316 Leon Medical Center Health Plan LIB01 Liberty Advantage Health Plan (HMO SNP) 87071 Liberty Health Advantage 37281 Liberty Union 25181 LIFE Pittsburgh 41136 Life Trac 71498 LifeCircles PACE 76870 LifePath Hospice Inc LWA01 Lifeworks Advantage CB752 Lockard & Williams 37267 Loma Linda University Adventist Health Sciences Center Employee Health Plan 33036 Loma Linda University Healthcare SKLA2 Louisiana Medicaid - Ambulance claims 37175 Loyola Physician Partners 88056 Lucent Health Solutions 82694 Lucentis Copay Program 35183 Luminare Health (CoreSource OH) 35187 Luminare Health Internal (CoreSource-Internal) © Experian Health, Inc. Experian Confidential Information Page 11 of 28 75136 Luminare Health Little Rock (CoreSource Little Rock) 36334 MacNeal Health Providers- CHS 56139 Maestro Health Plan MCC01 Magellan Complete Care of Arizona MCC02 Magellan Complete Care of Virginia 1260 Magellan Health Services 11303 Magnacare 45341 Maine Community Health Options 35162 Managed Care Services LLC 52461 March Vision Care Inc. 53275 MARTINS POINT HEALTH CARE 83269 Mary Washington Health Plan 37121 Mashantucket Pequot Tribal Nation 86220 Mass Advantage 12T52 Masters Mates and Pilots Program TH111 Masters Mates and Pilots Program 88090 Mayo Clinic FL/GA 83028 MBA Benefit Administrators Inc (Salt Lake UT) 25160 MCA ADMINISTRATORS 88058 MED PAY 74323 MedBen (Newark OH) 56821 Medcost Benefit Services Bundled Billing 78857 Medica HealthCare Plan of Florida MAHC1 MEDICAL ASSOCIATES HEALTH PLAN L0170 Medical Card System ( MCS ) 62177 Medical Reimbursements of America L0210 Medicare y Mucho Mas ( MMM ) 95655 MediGold 35205 MedPartners Administrative Services RP062 Medstar Family Choice, Inc (DC) RP063 Medstar Family Choice, Inc (MD) 37050 Mental Health Consultants Inc. 86087 Merchants Benefit Administration 86052 Mercy Care Plan (AHCCCS) 33628 Mercy Maricopa Integrated Care 41124 Meritain Health Minneapolis 13265 MetroPlus Health Plan 23550 MFC & HealthPlus Peoria 47080 Midlands Choice Inc. 76079 Midwest Health Partners SKMS0 Mississippi Medicaid 12K17 Mississippi Medicaid SKMS1 Mississippi Medicaid 12K18 Mississippi Medicaid © Experian Health, Inc. Experian Confidential Information Page 12 of 28 64084 Mississippi Physicians Care Network 37233 Mississippi Public Entity Employee Benefit Trust MMS01 Missouri Medicare Select 13350 Moda Health 12X09 Molina Healthcare 38333 Molina Healthcare of California 51062 Molina Healthcare of Florida 61799 Molina Healthcare of Idaho 20934 Molina Healthcare of Illinois 38334 Molina Healthcare of Michigan 77010 Molina Healthcare of Mississippi MLNNV Molina Healthcare of Nevada 9824 Molina Healthcare of New Mexico - Salud 20149 Molina Healthcare of Ohio 46299 Molina Healthcare of South Carolina SX109 Molina Healthcare of Utah (aka American Family Care) 38336 Molina Healthcare of Washington ABRI1 Molina Healthcare of Wisconsin 73160 Molina Ohio Medicaid 7316V Molina Ohio Medicaid Vision 12M77 Montana Medicare 13174 Montefiore Contract Management Organization TLINS Monumental Life Insurance Company (AR) TRCLF Monumental Life Insurance Company (IA) TRP1E Monumental Life Insurance Company (IA, MD, PA) TRLTC Monumental Life Insurance Company (TX) SB941 Mountain State Blue Cross Blue Shield of West Virginia 20572 MSA Care Guard 80019 MSC (Medical Service Company) Group, Inc. 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[00:01:15] Change in healthcare industry.

[00:04:42] Cybersecurity breach at Change.

[00:08:55] Cash flow challenges for healthcare groups.

[00:13:37] Major issues in healthcare cybersecurity.

[00:16:28] Hackers demanding ransom for data.

[00:20:45] Cybersecurity threats in healthcare.

[00:24:40] Healthcare system vulnerabilities.

[00:29:53] Lack of transparency in communication.

In this insightful episode, we dive into the heart of medical billing and coding with Beth Schleeper, CEO and founder of TNT Consulting and Advanced Coding Services. Beth shares her inspiring journey from starting a billing service as a new mother to fulfilling her dream of opening a coding school. Along the way, Beth emphasizes the importance of community, trust, and continuous learning in the healthcare industry. She also touches on the challenges and triumphs of acquiring billing companies and the evolving landscape of healthcare technology. Through her story, Beth illustrates the power of determination, innovation, and giving back to the industry that has shaped her career.