The Compliance Guy

Terry Fletcher joins Sean for the very first #TerryTuesday episode of 2023 to discuss the Medicare Fee Schedule Change and What it Really Means! As they say... watch out for the ole bait and switch! While Congress indicates a slight bump was given to the conversion factor the reality is, it was still an overall decrease. Terry and Sean explain it all in this episode.

The All Star Panel was back together for an outstanding first roundtable of the year! Sean was Joined by Terry, Christine, Scott, and Paul to discuss 2023 EM Services for the Inpatient setting, Split/Shared Services, Corporate Compliance Programs, HIPAA, and much more! 

In this episode Sean takes on H.R. 8800 (The Supporting Medicare providers Act of 2022)... Medicare Providers are facing a potential cut in reimbursement of up to 8.4%. However, if your contracts are paid at a % of Medicare your commercial contracts may be taking up to the same 8.4% cut.

H.R. 8800 was referred to the Subcommittee on Health back on September 14, 2022, but there’s been crickets ever since… the question is why and whether Congress (who by the way does not have to worry about healthcare in the same way civilians do) realizes that if these cuts hold up, there will be a mass exodus from the Medicare System. Providers will either retire early or shut their doors to Medicare and any insurance company that follows suit with reducing provider fees. The industry is already facing a crisis with respect to a shortage in physicians, couple that with what COVID-19 did to the industry with mandatory shutdowns and closures of surgery rooms and ASCs for elective surgeries and now a looming cut based on a reduction to the conversion factor and a PAYGO Sequestration cut, and you have a situation that the industry and patients may never recover from.

H.R. 8800 introduced by Congressmen Bera and Bucshon looks to amend title XVIII of the Social Security Act to extend certain increases in payments for physicians’ services under the Medicare program through 2023. “It is the sense of Congress that the Secretary of Health and Human Services, the House of Representatives, and the Senate should commit to take administrative and legislative actions to—

(1) ensure financial stability and predictability in the Medicare physician payment system;

(2) promote and reward value-based care innovation; and

(3) safeguard timely access to high-quality care by advancing health equity and reducing disparities”.

In this final #TerryTuesday episode, Sean and Terry tackle the OIG Report on improper payments for Co-Surgeons and assistants at surgery! Such an important topic to round out the year! 

It is that time of the year where we begin to wrap-up our current efforts and prepare for the year that awaits us!

Don't forget to check us out at www.thecomplianceguy.com or visit Terry at www.terryfletcher.net 

In this Episode the entire All-Star Panel is back together to discuss the latest most pressing coding and compliance issues healthcare organizations are facing! The panel takes on Computer Assisted Coding (CAC) and the problems that come with this technology as well as the significant differences between office, inpatient and facility coding when it comes to EM Guidelines. 

Such a great episode! Don't Miss This One! 

Shay Eskew joins #thecomplianceguy tomorrow at 11am right here on #linkedinlive for an insightful discussion on life, surviving, healthcare and so much more. PLEASE DO NOT MISS THIS ONE!!!

Shay is the CSO of CirclesX – a technology company & the Chief People Officer of Shay Eskew – Motivational Speaking and Consulting. He is an All-American & top 1% All World ranked #ironman triathlete, burn #survivor with scars over 65% of his body and a sought out international motivational #speaker. 

Despite being told he’d never compete in sports again at the age of 8, Shay is living testament to “Anything is Possible”: 45x IRONMAN finisher, 4x member of Team USA, and has competed in 12 triathlon world championships in 9 countries on 5 continents, including the IRONMAN World Championships in Kona, and most recently in Nice, France in 2019 – all of this despite not being able to sweat on 1/3 of his body due to his scars. 

His mantra has always been to not merely be a “finisher” but to be a “competitor.”

Shay is a healthcare disrupter, RCM strategist, Board Advisor, 6 Continent and 45x IRONMAN finisher, Medicare + Medicare Advantage Recovery, 5x Dad, Best Selling Author and Motivational Speaker

His Book: What the fire ignited – How life’s worst helped me achieve my best - the trials and tribulations he was forced to face while recovering from his burns and reclaiming his life as an athlete. (https://lnkd.in/dQm6DrWP)

The all star cast of characters is back as they join Sean to discuss 2023 em services and the impact changes have and will have on your coding and compliance!

Christine Hall CHC CPC , CPB, CPMA, CRC, CEMC, CPC-I / Scott Kraft Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM / Stephanie Allard, CPC, CEMA, RHIT / John Paul Spencer will join me to discuss how the AMA has added so much new instructional guidance in 2023 CPT® guidance (the green stuff) beyond the codes themselves. 

Many (most) coders or providers assigning codes, or worse the EMRs with NPL may not educate themselves on these priceless updates, especially if using an encoder or CACS. 

The panel will focus on Medicare because they are disagreeing on the AMA's position for #prolongedservices, also multiple same day #hospital visits for the same condition, when a patient goes from the ER or office to Inpatient. 

For more information on our cast visit them here: 

www.doctors-management.com 

www.terryfletcher.net 

www.stirlingglobalsolutions.com

www.namas.co

Terry joins Sean to discuss a variety of coding and compliance related topics including the critical importance of following instructions and complying with published guidance. The conversation also addresses the Clean Claims Payment (42 CFR 447.45), Christmas Trees and being a farmer... Enjoy! 

For more information on Terry and her service offerings visit her at www.terryfletcher.net