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.

 

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

Catherine Keegan, a seasoned professional with 34 years in the RCM space, shares her journey in academic healthcare and community medicine at East Carolina University. As the Director of Revenue Integrity, she discusses the vital role her team plays in revamping the revenue cycle process, ensuring compliance, and driving positive change appreciated by the entire community. Keegan's responsibilities include overseeing the Charge Description Master, fee schedules, charge reconciliation, and clinical denial management, showcasing her passion for making a difference in healthcare.

 

 

[00:02:57] Rural healthcare challenges.

[00:08:56] AI in healthcare billing.

[00:10:20] AI in healthcare revenue management.

[00:15:37] Be the unicorn.

[00:21:14] Exploring revenue cycle insights.

 

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

Drained by constant business travel, Heidi Ritton said enough was enough and formed her new business LLC on a layover in the Charlotte airport. Five years later Behavioral Health Billing Services is thriving. It wasn’t easy, but failure wasn’t an option with two small children and a husband who went back to school. In this episode, Heidi shares the tenacity it takes to be a successful entrepreneur and the tools and tricks she’s used to build her business.

 

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

In this insightful episode, we had the pleasure of speaking with Ken Hogue, a seasoned professional in revenue cycle management. Ken shared his deep-rooted connection to healthcare, influenced by his family's background in the field, and his passion for being a mediator and executive in the space.

Ken's journey began with a desire to improve the healthcare system without being directly involved in patient procedures. He has worked with notable organizations like Change Healthcare and Rochester Regional Health and is currently the Senior Director overseeing the entire revenue cycle for both hospital and physician sides.

During our conversation, Ken recounted the challenges of implementing Epic EMR during the pandemic and the transition to virtual operations. He emphasized the importance of advancing the organization in growth and proficiency, grooming future leaders, and ensuring financial success.

Ken manages a staggering $1.4 billion in revenue, five hospitals, hundreds of physician practices, and leads a team of 540 individuals. He discussed the evolving landscape of healthcare regulations and the need for effective communication and compliance to navigate these changes.

We delved into the intricacies of the No Surprises Act and price transparency, exploring how Ken's organization is publishing information online and providing patient estimates to meet compliance and improve patient engagement.

Ken also highlighted the role of business intelligence (BI), artificial intelligence (AI), and automation in healthcare. He shared success stories of increased efficiency and the importance of understanding workflows to ensure the effectiveness of automated processes.

 

 

[00:02:09] Implementing Epic during the pandemic.

[00:04:24] Administrative burdens and communication.

[00:08:35] Healthcare regulations and patient education.

[00:15:30] BI, AI, automation.

[00:18:39] Automation and workflow design.

[00:20:17] Success through automation.

[00:25:36] Implementing over 100 ideas.

[00:29:00] Creating a career ladder.

[00:32:30] Advancement and work-life balance.

[00:35:37] Career paths and mentorship.

 

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

In this solo episode of the Leaders in Medical Billing podcast, I reflect on the insights and lessons learned from the past two years of engaging with industry leaders. As we step into 2024, I aim to provide valuable takeaways for medical billing companies looking to strategize their growth in the coming years.

Key Themes from Past Episodes

• Delegation: A recurring topic has been the challenge of delegation. I shared my personal experience with Dan Sullivan's unique ability exercise, which helps identify tasks to delegate, allowing business owners to focus on their strengths.

• Decreasing Reimbursements: Many guests discussed the use of offshore labor to manage payroll expenses and the balance between onshore and offshore teams.

• Innovative Pricing Models: Robert Kowalik's approach to variable pricing based on claim processing time was highlighted as a creative solution to decreasing margins.

• Employee Growth: The importance of providing growth paths for billing staff was emphasized by guests like Gary Siano and Emily Ostek.

• Impact of Private Equity: The influx of private equity in healthcare and its implications were discussed, along with strategies for sales growth and acquisitions.

• Compliance and Transparency: Mark Haskelson spoke on compliance, and the challenges of price transparency and the No Surprises Act were addressed.

• Government Engagement: Andrew Graham and Matt Tamez shared their experiences with lobbying and advocating for change at the state level.

• Front Desk Efficiency: Robin Goldberg's strategies for addressing billing issues at the front desk were explored.

• Technology and Automation: The role of AI, RPAs, and machine learning in the future of medical billing was a significant focus, with the emphasis on the need for clean data.

Personal Advice and Future Plans

• Customer Engagement: I advise engaging with clients to understand their concerns, opportunities, and strengths. This understanding can lead to creating more value and avoiding commoditization.

• Education and Networking: Staying informed through industry conferences, publications, and other resources is crucial for success.

• Upcoming Guests: We look forward to featuring guests who are not only identifying problems but also offering solutions and success stories.

This episode is sponsored by 4D Global. Visit them at 4dglobalinc.com.

 

[00:01:46] Delegation challenges and solutions.

[00:05:08] Price transparency and education.

[00:09:03] Understanding client's pain.

[00:11:52] A prosperous and successful 2024.

 

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

In this episode of Leaders in Medical Billing, our guest Robert Kowalik shares his unique journey from being a physical therapist to transitioning into the billing side. With experience in running a private practice and managing a billing team, Robert saw an opportunity to help other physical therapy practices with their billing needs. He started by focusing on accounts receivable conversion and gradually evolved his approach to a specialty-focused, parallel process billing system. Tune in to learn more about Robert's insights and experiences in the medical billing industry.   Time stamps [00:00:13] Transition from physical therapy [00:07:26] The biggest time inflator. [00:09:41] Variable rate structure for billing. [00:16:38] The black hole concept. [00:17:14] Turning billing into business intelligence. [ 00:23:44] The focus needs to be on the other side of the scale. [00:26:03] Converting billing team to BI team.     For more insights and takeaways, visit www.leadersinmedicalbilling.com. This episode is sponsored by 4D Global, empowering medical billing companies to grow through offshore staffing. Visit them at www.4DGlobalInc.com

In this episode of Leaders in Medical Billing, our guest Christopher Turner shares his journey with implementing the Entrepreneurial Operating System (EOS) in his company. Christopher explains how he transitioned from being a founder to a CEO and the role that EOS played in transforming his business. He discusses his experiences with Vistage, a peer advisory group, and how he learned to manage and run a business. Christopher also shares his initial confusion when asked about his company's operating system and how he discovered the benefits of EOS through another member's success story. Tune in to learn more about the impact of EOS on company culture and Christopher's journey as a leader in the medical billing space.   Timestamps [00:00:25] Implementing EOS and transforming companies. [00:04:34] Replicating and scaling a business. [00:09:31] Culture and company success. [00:12:28] Investing in meaningful benefits. [00:19:30] Billing issues in healthcare. [00:21:19] Pervasive issues in medical billing. [00:26:39] Confusion with medical billing. [00:29:43] Future of humanity.   For more insights and takeaways, visit www.leadersinmedicalbilling.com. This episode is sponsored by 4D Global, empowering medical billing companies to grow through offshore staffing. Visit them at www.4DGlobalInc.com

In this podcast, Denise Corbisiero, the COO of Integrity Billing, shares her personal journey into the mental health and substance abuse treatment industry. Denise started her career running a call center before transitioning into treatment, which fueled her passion for helping facilities and substance abuse facilities succeed financially. She has been in healthcare since the mid-nineties and has observed several changes and challenges in the field, including changes in healthcare providers' practices and an increase in insurance companies' control over treatment procedures. Denise also highlights how technology, such as AI, is enhancing the industry by easing employee workload and has hopes to further automate processes like the appeals procedure. Beyond automation, Denise stresses the importance of personal relationships with customers as a critical factor in success in the industry. She touched on the success of their SaaS product that verifies benefits in seconds, proving to be quite popular with clients.   #MentalHealthAdvocacy #SubstanceAbuseRecovery #HealthcareInnovation   Timestamps

• [00:00:02] Introducing Denise Corbisiero, COO of Integrity Billing
• [00:00:20] Choosing Mental Health Industry: Challenges & Struggles
• [00:08:10] Tough Recovery & Insurances Hurdles
• [00:11:34] Embracing Change: AI’s Role in Reducing Workload
• [00:13:38] Underlining Customer Relationships: Turnover and Internalization
• [00:16:00] Accelerating Benefit Verification: Leveraging SaaS
• [00:19:21] Future of Automation: Streamlining the Appeals Process
• [00:21:54] Preferred Systems for Behavioral Health
• [00:23:21] Defining Success and Making Connections

 

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

In this insightful podcast episode, we speak to Ryan O'Hara, an experienced healthcare professional currently working at Acclara, an RCM company. Ryan outlines his stress over the U.S. healthcare system, particularly the 22% GDP spending on healthcare despite having some of the worst outcomes. He acknowledges the need for a unique approach to address these inefficiencies, especially in the RCM space.   Ryan details the adversarial relationship between revenue cycle professionals and insurance companies, emphasizing the potential for improved cooperation through data-driven dialogue. He suggests that showing insurance companies potential benefits can encourage them to be proactive in providing remedies. Discussing administrative inefficiencies, Ryan underlines the significance of talent identification and nurturing within the healthcare sector. Interestingly, he boils talent down to four characteristics: happiness, hard work, empathy, and being a team player.   Discussing the subject of insurance and healthcare providers, Royal emphasizes the need for creating financial incentives for health capital, thus shifting the focus from making people better when they're sick to keeping them healthy. Ryan concurs, expressing his aspiration to act as a peacemaker between insurance companies and health systems.   Lastly, Ryan proposes a revised approach to measuring KPI's in the healthcare sector. Rather than the common practice of tracking numerous metrics, Ryan advises focusing on five things: cash versus a goal, AR measurement, agings by the payer, cost tracking and managing vendors to optimize spending.   Website: https://www.acclara.com/ LinkedIn: https://www.linkedin.com/in/ryan-o-hara-920b3623b/   For more insights and takeaways, visit www.leadersinmedicalbilling.com. This episode is sponsored by 4D Global, empowering medical billing companies to grow through offshore staffing. Visit them at www.4DGlobalInc.com   Timestamps

• [00:00:03] Introduction to Ryan O'Hara and Acclara
• [00:00:27] Discussing Healthcare Costs and Outcomes
• [00:02:04] Tackling Adversarial Relations in Revenue Cycle
• [00:05:06] Power of Data in Healthcare Conversations
• [00:08:07] Identifying Talents to Improve Healthcare Practices
• [00:14:15] Essential Traits for Leadership in Healthcare Sector
• [00:16:40] Advocating for Better Patient Centric Healthcare
• [00:24:00] Ryan's Vision for Bridging the Gap between Insurance and Health Systems
• [00:30:37] Key Performance Indicators in Healthcare, A New Perspective
• [00:32:30] Critique on AR Days and Measuring Absolute Revenue Returns
• [00:33:47] Importance of Measuring Aging by Payer
• [00:35:25] Monitoring Costs in Healthcare Sector and Vendor Management.

Frank Corcino, has been in healthcare for the past 38 years. Starting in the healthcare debt collection business, he made a strategic shift into cash acceleration with early-age receivables. Currently Frank serves as a National Market Leader for Financial Operations in OnPoint Healthcare Partners, a boutique consulting firm in Texas. He acknowledged the ongoing struggles of hospitals with expense management, automation, and the need for a hybrid model of operations. As hospital operating incomes are at an all-time low and claim denials are growing, Frank sees technological solutions such as AI and NLP as vital to streamlining processes and reducing issues in revenue cycles. He mentions the successful use of software programs like OnPoint's virtual assistant in transcribing clinical notes for doctors, saving valuable hours each day. The episode ended with Frank discussing how he sees the future of healthcare, the likelihood of more outsourcing in the future.

 

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

 

Show notes

• [00:00:00] Introduction: Frank's 38 Years of Healthcare Experience
• [00:00:17] Early Career: From Collections to Cash Acceleration
• [00:02:34] Current Role: National Market Leader at OnPoint Healthcare Partners
• [00:04:09] Challenges in Healthcare: Seeking Efficiency amidst Struggling Automation
• [00:06:23] Solutions to Cash Flow Issues: Better Management of CDM
• [00:08:52] Staff Shortage: Transition towards Younger, Low-cost Managers
• [00:10:27] Addressing Hospital Financial Struggles: The Role of Technology
• [00:14:07] Streamlining Process: The Impact of Robotics and OCR Scanning
• [00:16:56] Impact of AI and NLP: Accurate Clinical Notes for a Smooth Revenue Cycle
• [00:18:51] Patient-Physician Separation: Unique Technologies to Enhance Care and Payments
• [00:24:22] Future in Healthcare: Openness to Alternative Solutions
• [00:26:00] OnPoint's Virtual Assistant Tool
• [00:28:50] Frank's Future Plans

IRIS - https://info.onpointhealthcarepartners.com/iris-virtual-clinical-assistant-0