“But That’s How We’ve Always Done It”: Dangerous Words in Compliance

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Hello, everybody.

 

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Welcome back to the Practice

 

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Perfect podcast.

 

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Another week,

 

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another chance to listen to

 

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the beautiful Maya Turner and myself.

 

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Welcome to the show, Maya.

 

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Hello, beautiful.

 

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It's Wednesday.

 

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Today is Wednesday.

 

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Today is Wednesday.

 

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It feels like a Wednesday.

 

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It really feels like a Wednesday.

 

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I don't know about you.

 

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It's like allergies in my voice.

 

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Just like...

 

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so many meetings today uh

 

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shout out to my amazing

 

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project manager our amazing

 

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project manager jessica

 

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haslett she keeps

 

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everything running and

 

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smooth oh man it's like

 

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it's nice to have somebody

 

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like her who is on it and

 

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keeps us on our toes

 

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reminds us when we forget

 

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to join the meeting it's

 

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been it's been what a week

 

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yes and she always reminds

 

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us to hydrate drink water

 

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I love it.

 

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I do love it.

 

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Yeah, I don't have mine with me.

 

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I'm like,

 

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I'm falling down on the job here.

 

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But no, yeah,

 

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I love how she puts in my

 

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calendar hydrate in between

 

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meetings because like I'm

 

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going to forget and I do forget.

 

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So I have the reminder, which is really,

 

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really great.

 

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So I'm excited for the rest of the week,

 

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you know, see what happens.

 

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But today we're really focused on

 

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Those seven words we loathe to hear.

 

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But that's how we've always done it.

 

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I mean, Maya, if you had to guess,

 

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how many times in your

 

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career have you heard those words?

 

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If you had to guess.

 

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Way too many.

 

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If I had a dollar for every

 

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time I heard it,

 

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I would really be a millionaire.

 

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And I've been in this field

 

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for thirty years.

 

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And it's just, it never stops.

 

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It never ceases to amaze me.

 

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Just because you've done it

 

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that way doesn't mean that

 

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you've done it right.

 

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And it just is a terrible thing to say,

 

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especially when you're

 

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dealing with coding and compliance.

 

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Yeah, it's true.

 

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Well,

 

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so my first experience with that was

 

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many years ago.

 

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And, you know,

 

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I work with physicians all

 

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the time and I never heard

 

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that from any of them.

 

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It was more about, hey,

 

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let's talk to Jennifer about it.

 

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That was the cool thing that

 

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I had with my surgeon I was

 

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with for so many years.

 

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And then when I ventured out on my own,

 

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started my own billing company,

 

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started to get into consulting,

 

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I had a surgeon.

 

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And that's the first time I heard it.

 

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And he was in ophthalmology.

 

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And he had practices before this one.

 

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And we were looking at some

 

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documentation and they had

 

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the templates, right?

 

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The surgical templates.

 

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And if I could show you this template,

 

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Maya, oh my goodness, it was like,

 

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so bare bones.

 

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And with some of like,

 

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I don't know if you know, ophthalmology,

 

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you know, yeah, you know, retina.

 

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So it was for an eye stent.

 

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And we know that those

 

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procedures require a

 

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certain level of medical

 

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necessity to be proven, right?

 

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You got to prove the medical necessity.

 

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And those specific codes,

 

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were, as we know,

 

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category three codes at the time.

 

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And so it's really, really, you know,

 

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specific.

 

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And so what we had to deal

 

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with a lot of was talking

 

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to some of the reps at those companies.

 

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And they would give us reimbursement,

 

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you know, information.

 

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We would look up the policies.

 

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And yeah,

 

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you had to be very specific about

 

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the glaucoma.

 

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And what did I get?

 

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Very unspecified glaucoma.

 

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Yep.

 

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Mm hmm.

 

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We always got paid.

 

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But did you?

 

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Not really.

 

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But did you?

 

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No, you didn't.

 

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Not really.

 

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All those surgeries are they got billed,

 

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but they didn't get paid.

 

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So I think, you know,

 

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and especially with dealing

 

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with retina and I dealt

 

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specifically with macular

 

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degeneration and those

 

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types of diseases where, you know,

 

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in order for you to do the angiogram,

 

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you still had to get

 

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special approval because of the eye.

 

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And especially if they had, you know,

 

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the senile glaucoma.

 

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And they had to prove that.

 

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And one story,

 

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they didn't check all of the allergies.

 

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And one of the patients

 

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expired on the table,

 

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because they had an allergic reaction,

 

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allergic reaction to the eye.

 

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Yeah, yeah.

 

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So sad.

 

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Yeah.

 

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So I mean, that's why the

 

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you do those types of things

 

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to make sure that someone

 

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reviews the medical

 

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necessity and all of the

 

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dot i's are dotted and the

 

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t's are crossed to make

 

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sure that they are capable

 

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right of withstanding that

 

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type of surgery but in that

 

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particular instance yeah

 

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the patient expired on the

 

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table during an angiogram

 

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yep wow that is so I mean

 

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that really really makes

 

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you think about how

 

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important our jobs are to

 

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You know, earlier today,

 

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I was presenting for McVeigh seminars,

 

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shout out to McVeigh seminars,

 

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on my quarterly ENT

 

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presentation that I do every quarter.

 

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And one of the things I mentioned,

 

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I like to mention all the

 

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specialties I do, you know,

 

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updates for is where we're at with,

 

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you know, AI and different things.

 

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And one of the things that

 

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you and I have been talking

 

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a lot about with our externs,

 

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our extern group, is understanding that

 

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AI is not going to be able

 

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to be effective without

 

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good documentation.

 

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So we always use that term garbage in,

 

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garbage out.

 

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It's only going to be able

 

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to pull information from

 

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the record that is accurate,

 

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and it's going to be able

 

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to translate from that information.

 

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It can't just make stuff up, right?

 

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Exactly.

 

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It's going to pull data

 

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that's actually there.

 

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So when we look at, you know,

 

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trying to train coders and, you know,

 

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auditors is that you have

 

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to be able to find these things,

 

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even if they're not reimbursement related,

 

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these are things that

 

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affect the patient's life

 

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and their compliance from a

 

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medical record standpoint.

 

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And it may not even have to

 

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do with billing, but if you see something,

 

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say something.

 

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Yes.

 

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Yes.

 

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You know,

 

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could have been caught hopefully

 

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if someone had paid attention.

 

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Yeah, I mean, and I always say, I mean,

 

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even when you're dealing with AI, right?

 

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And I say this all day, every day,

 

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and my words twice on Sunday,

 

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is that AI is supposed to

 

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augment the services of the

 

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biller and the doctor.

 

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It should never automate.

 

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it should augmentate but

 

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never automate and I was

 

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just speaking with one of

 

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our colleagues I was just

 

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talking to lady and she

 

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says that they're using a

 

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new system and they're

 

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suggesting right but again

 

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they can only suggest but

 

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if the code doesn't support

 

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what they're suggesting

 

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because they're only

 

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pulling key terms that

 

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could be interrelated with

 

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something else that might

 

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not be as specific you could be in turn

 

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billing for a wrong service

 

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that may have already been

 

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pre-authorized and then

 

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you're going to cause a

 

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denial because that's not

 

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what they authorized for

 

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and that's not what the

 

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documentation is supporting

 

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so I mean just because

 

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we've already authorized it

 

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or we've already done that

 

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or we've always done that

 

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doesn't mean that it's

 

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always going to be

 

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supported when you bill it

 

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and that goes back to quite

 

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a bit of things that we've

 

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talked about before

 

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Absolutely.

 

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Well, you know, I had a doctor come to me.

 

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We were having not a disagreement,

 

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but just a conversation

 

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about the proper code for a

 

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certain procedure.

 

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And, you know,

 

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talking to different

 

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colleagues I know in that specialty,

 

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we know that typically,

 

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at least right now,

 

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an unlisted code is what we

 

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have for this particular

 

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technique that was used.

 

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And so I explained that's

 

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what I currently am researching.

 

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This is what we are currently finding.

 

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and shot back with an email.

 

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And I could tell it was

 

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Google AI because I've used

 

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Google AI just to check.

 

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And I knew exactly what it

 

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looked like and that she

 

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was spitting out to me, Google.

 

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A lot of people don't

 

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realize that when you type in like,

 

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what is the CPT code for this in Google,

 

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that at the very top,

 

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it like starts spitting out

 

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stuff because it uses AI, right?

 

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So sometimes it's correct,

 

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or it will lead you to a certain,

 

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you know,

 

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route that you can further

 

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research just to verify.

 

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And, you know,

 

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remember your CPT code book

 

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published by the American

 

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Medical Association is your

 

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source of truth for

 

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matching a CPT code to documentation.

 

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Yeah.

 

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Now that may change based on, you know,

 

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the payer,

 

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but our source of truth for

 

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abstracting codes is

 

00:09:31.788 --> 00:09:33.830

is always our official code set,

 

00:09:34.250 --> 00:09:37.451

CPT or IC-Tensium, or HCPCS level two,

 

00:09:37.490 --> 00:09:38.672

if you're doing that.

 

00:09:39.292 --> 00:09:40.331

That's our source of truth.

 

00:09:40.952 --> 00:09:43.333

So what starts sprinkling

 

00:09:43.354 --> 00:09:44.214

down your screen at the

 

00:09:44.234 --> 00:09:46.174

very top when it starts to appear,

 

00:09:46.595 --> 00:09:47.955

that's artificial intelligence,

 

00:09:48.095 --> 00:09:51.797

or it's what we call generative AI,

 

00:09:51.817 --> 00:09:53.277

where it's kind of like chat GPT.

 

00:09:53.297 --> 00:09:54.097

It's pretty much their

 

00:09:54.138 --> 00:09:55.357

version of that within Google.

 

00:09:56.018 --> 00:09:57.259

And so that is happening.

 

00:09:58.239 --> 00:09:58.479

A lot.

 

00:09:58.499 --> 00:09:59.779

But it's not always accurate.

 

00:10:00.682 --> 00:10:02.342

I will say sometimes it's really great.

 

00:10:02.863 --> 00:10:03.643

It spits out stuff.

 

00:10:03.663 --> 00:10:04.043

I'm like, Ooh,

 

00:10:04.082 --> 00:10:05.283

I like the way they said that.

 

00:10:05.323 --> 00:10:06.283

Like, that's really good.

 

00:10:06.303 --> 00:10:06.384

Yeah.

 

00:10:07.283 --> 00:10:08.924

And then today I was looking

 

00:10:08.965 --> 00:10:10.065

up something for somebody

 

00:10:10.504 --> 00:10:11.745

just wanted to get some, you know,

 

00:10:11.806 --> 00:10:13.785

some ideas on where to, where to go.

 

00:10:13.905 --> 00:10:15.246

Cause sometimes as coders,

 

00:10:15.267 --> 00:10:16.986

we have to get a starting point.

 

00:10:17.006 --> 00:10:17.626

We just want to get some

 

00:10:17.667 --> 00:10:18.607

research out there.

 

00:10:19.408 --> 00:10:20.707

It was totally off.

 

00:10:20.788 --> 00:10:20.888

Yeah.

 

00:10:21.609 --> 00:10:23.408

Like I was trying to like

 

00:10:23.749 --> 00:10:25.029

show somebody how to use,

 

00:10:25.870 --> 00:10:28.091

use it for something with the hands.

 

00:10:28.390 --> 00:10:28.730

And I,

 

00:10:29.316 --> 00:10:31.817

It spit out something totally off the wall,

 

00:10:32.278 --> 00:10:33.879

like not even remotely

 

00:10:33.938 --> 00:10:35.801

related to what I was asking.

 

00:10:35.841 --> 00:10:37.522

It's just,

 

00:10:37.621 --> 00:10:39.163

I laughed because this is what

 

00:10:39.182 --> 00:10:39.884

we're dealing with.

 

00:10:39.903 --> 00:10:41.245

We're dealing with one day.

 

00:10:41.325 --> 00:10:42.304

It's super smart.

 

00:10:42.826 --> 00:10:44.767

The next day it's like, are you on crack?

 

00:10:44.787 --> 00:10:47.028

Like what in the world,

 

00:10:47.328 --> 00:10:48.470

where did you get this from?

 

00:10:49.049 --> 00:10:50.851

Like, that's how I feel some days.

 

00:10:50.892 --> 00:10:52.192

Like, I don't know.

 

00:10:52.212 --> 00:10:54.333

I mean, I guess sometimes we're like that,

 

00:10:54.374 --> 00:10:54.714

right?

 

00:10:55.294 --> 00:10:56.995

Some days we were like, why did I do that?

 

00:10:58.360 --> 00:10:59.200

she's laughing over here

 

00:10:59.240 --> 00:11:00.160

guys she's just having

 

00:11:00.181 --> 00:11:00.961

she's just trying to get

 

00:11:00.980 --> 00:11:04.782

through this I wasn't ready

 

00:11:04.822 --> 00:11:06.322

for the crack scenario girl

 

00:11:06.383 --> 00:11:07.363

out there I wasn't ready

 

00:11:07.403 --> 00:11:09.884

for that oh lord you got

 

00:11:10.004 --> 00:11:11.043

blunt jennifer today

 

00:11:11.104 --> 00:11:12.304

sometimes sometimes someday

 

00:11:12.325 --> 00:11:13.485

she comes out I'm telling

 

00:11:13.524 --> 00:11:16.025

you right right right but I

 

00:11:16.066 --> 00:11:16.905

think you know and it's

 

00:11:16.946 --> 00:11:18.187

really interesting how

 

00:11:18.366 --> 00:11:19.687

doctors don't know

 

00:11:19.826 --> 00:11:21.748

especially when you know

 

00:11:21.827 --> 00:11:23.168

it's a an emerging

 

00:11:23.208 --> 00:11:24.129

technology that they're

 

00:11:24.188 --> 00:11:27.070

unaware of but you got to think

 

00:11:27.671 --> 00:11:29.572

every quarter or twice a

 

00:11:29.611 --> 00:11:31.251

year you have provider

 

00:11:31.292 --> 00:11:33.371

specialties that lobby for

 

00:11:33.412 --> 00:11:34.873

codes for emerging

 

00:11:34.932 --> 00:11:38.354

technology right so it's

 

00:11:38.474 --> 00:11:41.193

it's almost it's almost

 

00:11:41.234 --> 00:11:42.914

like okay so you know that

 

00:11:42.934 --> 00:11:44.335

your provider organization

 

00:11:44.875 --> 00:11:46.875

represents this every

 

00:11:48.181 --> 00:11:50.202

uh two uh twice a year they

 

00:11:50.222 --> 00:11:51.102

have the editorial

 

00:11:51.123 --> 00:11:53.565

committee where provider

 

00:11:53.625 --> 00:11:55.186

organizations lobby for

 

00:11:55.225 --> 00:11:56.386

having a specialty code

 

00:11:56.407 --> 00:11:58.427

created for them they test

 

00:11:58.467 --> 00:12:00.168

that technology and that's

 

00:12:00.188 --> 00:12:02.130

why there is a section

 

00:12:02.510 --> 00:12:04.971

three in your cpt book for

 

00:12:05.293 --> 00:12:06.232

new and emerging

 

00:12:06.273 --> 00:12:08.315

technologies and because of

 

00:12:08.355 --> 00:12:10.096

that we need to realize that

 

00:12:11.063 --> 00:12:12.065

your specialty,

 

00:12:12.184 --> 00:12:13.265

especially if you're really

 

00:12:13.326 --> 00:12:15.727

embedded with that specialty organization,

 

00:12:16.208 --> 00:12:17.990

has those types of

 

00:12:18.691 --> 00:12:20.251

inferences that say we're

 

00:12:20.292 --> 00:12:21.432

lobbying for this code,

 

00:12:21.472 --> 00:12:23.754

we're lobbying for this procedure.

 

00:12:23.815 --> 00:12:24.716

It definitely makes a

 

00:12:24.755 --> 00:12:25.636

difference in that

 

00:12:26.096 --> 00:12:27.558

providers may not be as in

 

00:12:27.599 --> 00:12:28.700

tune as they should be,

 

00:12:29.159 --> 00:12:30.922

but I promise you if they are,

 

00:12:31.241 --> 00:12:31.962

they would know that

 

00:12:31.982 --> 00:12:32.982

there's a Category Three

 

00:12:33.023 --> 00:12:33.744

code that should be

 

00:12:33.803 --> 00:12:35.586

submitted and whenever it's submitted,

 

00:12:35.645 --> 00:12:36.547

it should be accompanied

 

00:12:36.586 --> 00:12:37.908

with medical documentation.

 

00:12:38.347 --> 00:12:40.028

because it's new in emerging

 

00:12:40.048 --> 00:12:41.188

technologies and they have

 

00:12:41.229 --> 00:12:42.889

to prove that it works.

 

00:12:44.129 --> 00:12:45.249

Absolutely.

 

00:12:45.308 --> 00:12:46.950

And there's a whole separate

 

00:12:46.990 --> 00:12:47.750

process on that.

 

00:12:47.850 --> 00:12:49.409

I think that'd be a fun episode, right?

 

00:12:49.610 --> 00:12:51.250

Explain how you get a code approved.

 

00:12:51.650 --> 00:12:52.211

That'd be fun.

 

00:12:52.850 --> 00:12:53.431

Yeah.

 

00:12:54.671 --> 00:12:55.691

Should put that on the docket.

 

00:12:56.251 --> 00:12:56.711

All right.

 

00:12:56.951 --> 00:12:58.451

So I thought it'd be fun

 

00:12:58.471 --> 00:13:00.692

today just to go through

 

00:13:01.292 --> 00:13:03.773

like our brains and, you know, think of

 

00:13:04.383 --> 00:13:06.202

Just stories we've come across,

 

00:13:06.582 --> 00:13:07.344

things we've seen.

 

00:13:07.703 --> 00:13:09.943

I recently was working with

 

00:13:11.504 --> 00:13:13.144

a set of procedures that I do often.

 

00:13:13.764 --> 00:13:15.325

And you know how we love

 

00:13:15.365 --> 00:13:16.946

when surgeons put the

 

00:13:17.105 --> 00:13:19.365

actual CPT codes on their

 

00:13:19.426 --> 00:13:21.866

op notes because they're

 

00:13:21.986 --> 00:13:23.147

always right and we're

 

00:13:23.187 --> 00:13:24.167

never going to change them.

 

00:13:24.206 --> 00:13:25.567

So we might as well just

 

00:13:26.028 --> 00:13:27.648

keep them on there because

 

00:13:28.248 --> 00:13:29.128

I'm going to type in what

 

00:13:29.168 --> 00:13:30.489

my codes are and no one's

 

00:13:30.509 --> 00:13:31.509

going to change them ever.

 

00:13:33.214 --> 00:13:33.714

Right.

 

00:13:33.754 --> 00:13:36.615

So we had, I had one that I was doing,

 

00:13:36.654 --> 00:13:37.696

it's like ten coats on

 

00:13:37.716 --> 00:13:39.115

there all the time because it's a,

 

00:13:39.355 --> 00:13:40.355

it's a crazy surgery.

 

00:13:41.017 --> 00:13:42.356

And I was going through it

 

00:13:42.476 --> 00:13:43.677

and validating all of them.

 

00:13:43.736 --> 00:13:45.337

I get down to a couple of

 

00:13:45.378 --> 00:13:46.638

them and I'm like, wait a minute,

 

00:13:46.677 --> 00:13:47.619

what are these coats?

 

00:13:48.318 --> 00:13:48.798

I looked them up.

 

00:13:48.818 --> 00:13:50.200

They were like ten years old.

 

00:13:51.759 --> 00:13:53.341

Like they hadn't been active

 

00:13:53.360 --> 00:13:54.421

for a very long time.

 

00:13:54.461 --> 00:13:55.561

So my question is,

 

00:13:56.142 --> 00:13:58.422

how long have those been on

 

00:13:58.442 --> 00:14:00.322

there before we started coding for them?

 

00:14:01.639 --> 00:14:03.440

And the previous company or

 

00:14:03.980 --> 00:14:05.541

internal staff was coding for them.

 

00:14:06.000 --> 00:14:07.542

Were they just not putting

 

00:14:07.562 --> 00:14:08.582

them on there or were they

 

00:14:08.702 --> 00:14:10.443

entering those codes and

 

00:14:10.504 --> 00:14:11.664

not telling the provider

 

00:14:11.684 --> 00:14:12.644

they were outdated?

 

00:14:13.385 --> 00:14:14.926

Like, is that what was happening?

 

00:14:15.166 --> 00:14:15.767

I don't know.

 

00:14:16.287 --> 00:14:18.368

But let's just say, for instance,

 

00:14:18.607 --> 00:14:21.129

they billed them on a claim.

 

00:14:22.370 --> 00:14:23.510

They weren't getting paid.

 

00:14:23.691 --> 00:14:24.371

But guess what?

 

00:14:24.392 --> 00:14:25.412

They were still done.

 

00:14:25.572 --> 00:14:26.812

They were just the wrong codes.

 

00:14:27.892 --> 00:14:29.552

So, I mean, like, think about that.

 

00:14:29.592 --> 00:14:30.094

They were not,

 

00:14:30.114 --> 00:14:31.054

they were just not getting

 

00:14:31.095 --> 00:14:32.436

paid for that all this time.

 

00:14:32.475 --> 00:14:33.756

Let's just say for two years,

 

00:14:33.876 --> 00:14:34.597

this was happening.

 

00:14:35.298 --> 00:14:37.500

And then if you calculate

 

00:14:37.539 --> 00:14:38.821

the cost of those codes,

 

00:14:38.841 --> 00:14:40.261

it's like a couple thousand bucks,

 

00:14:41.003 --> 00:14:41.243

you know,

 

00:14:41.283 --> 00:14:43.365

especially when you have several

 

00:14:43.424 --> 00:14:46.488

levels of the spine being done.

 

00:14:47.368 --> 00:14:49.029

And it's like, really?

 

00:14:49.049 --> 00:14:49.370

I was like,

 

00:14:49.389 --> 00:14:50.831

how much money did they lose

 

00:14:50.951 --> 00:14:52.371

over that two-year period

 

00:14:52.412 --> 00:14:53.493

where now we're catching it?

 

00:14:53.933 --> 00:14:55.355

We're like, that's not the right code.

 

00:14:55.854 --> 00:14:57.514

let me flip it to the new codes,

 

00:14:57.894 --> 00:15:00.716

you're still getting paid for it.

 

00:15:00.735 --> 00:15:01.557

But we're now we're giving

 

00:15:01.576 --> 00:15:02.537

you the right codes that

 

00:15:02.557 --> 00:15:03.697

are actually payable in

 

00:15:03.738 --> 00:15:05.618

twenty twenty five.

 

00:15:05.859 --> 00:15:06.558

Wow.

 

00:15:07.339 --> 00:15:08.580

You know, that's that's that's.

 

00:15:10.640 --> 00:15:11.301

Unfortunately,

 

00:15:11.341 --> 00:15:12.501

it's not surprising because

 

00:15:12.542 --> 00:15:13.601

it goes on all the time.

 

00:15:13.642 --> 00:15:13.902

Right.

 

00:15:14.501 --> 00:15:16.763

And when you have people who

 

00:15:16.802 --> 00:15:18.504

bill and don't know codes

 

00:15:18.583 --> 00:15:19.924

and doing it robotically,

 

00:15:20.605 --> 00:15:21.947

where they're not reading

 

00:15:21.966 --> 00:15:23.846

the cmn or the the latest

 

00:15:23.947 --> 00:15:26.648

lcd or this this uh the

 

00:15:26.727 --> 00:15:27.928

element that comes out from

 

00:15:27.989 --> 00:15:29.990

cms right that talks about

 

00:15:30.029 --> 00:15:31.610

the new technology you know

 

00:15:32.110 --> 00:15:32.910

it's going to be something

 

00:15:32.931 --> 00:15:34.230

that happens all the time

 

00:15:34.691 --> 00:15:37.793

right I mean I I can't tell

 

00:15:37.832 --> 00:15:39.373

you how many times where

 

00:15:39.413 --> 00:15:41.274

there was a delay fourteen

 

00:15:41.313 --> 00:15:43.095

days in a delay that was

 

00:15:43.154 --> 00:15:45.595

related to how the last

 

00:15:45.654 --> 00:15:46.855

biller did it did it

 

00:15:47.874 --> 00:15:49.315

um you're supposed to send

 

00:15:49.335 --> 00:15:50.674

claims out every day and

 

00:15:50.695 --> 00:15:51.556

you're supposed to check

 

00:15:51.576 --> 00:15:53.135

the claim status every day

 

00:15:53.416 --> 00:15:54.356

to make sure that it was

 

00:15:54.417 --> 00:15:56.037

accepted and make sure you

 

00:15:56.057 --> 00:15:57.557

can follow up on that claim

 

00:15:57.758 --> 00:15:58.958

once it's accepted to make

 

00:15:58.979 --> 00:16:00.438

sure that from fourteen

 

00:16:00.479 --> 00:16:02.100

days after it was submitted

 

00:16:02.360 --> 00:16:03.860

there was a payment right

 

00:16:04.181 --> 00:16:05.301

but again if you're just

 

00:16:05.321 --> 00:16:06.522

doing things robotically

 

00:16:06.621 --> 00:16:09.043

and not checking why you

 

00:16:09.062 --> 00:16:10.202

should be getting paid or

 

00:16:10.403 --> 00:16:12.504

if you got underpaid or if

 

00:16:12.543 --> 00:16:14.404

the code is even valid then

 

00:16:15.153 --> 00:16:15.673

you're going to have a

 

00:16:15.714 --> 00:16:17.414

bigger problem and you're

 

00:16:17.434 --> 00:16:19.416

going to be struggling to

 

00:16:19.436 --> 00:16:20.397

keep your business open.

 

00:16:21.677 --> 00:16:22.217

Absolutely.

 

00:16:22.778 --> 00:16:23.158

You know,

 

00:16:24.119 --> 00:16:25.558

there are a lot of things that

 

00:16:25.639 --> 00:16:26.799

aren't just coding related

 

00:16:26.840 --> 00:16:28.221

that happen in the practice.

 

00:16:29.500 --> 00:16:30.201

So, I mean,

 

00:16:30.282 --> 00:16:31.682

and people do things different ways.

 

00:16:31.863 --> 00:16:33.023

And so when you come into a

 

00:16:33.062 --> 00:16:34.464

new organization, for instance,

 

00:16:34.984 --> 00:16:37.725

you might say, okay,

 

00:16:39.225 --> 00:16:40.106

I do things a certain way.

 

00:16:40.918 --> 00:16:42.059

in my last practice,

 

00:16:42.320 --> 00:16:43.139

but you come into a new one

 

00:16:43.159 --> 00:16:44.061

and they do things differently.

 

00:16:44.120 --> 00:16:44.961

So there's just like a weird

 

00:16:45.001 --> 00:16:46.342

example of like just on the

 

00:16:46.383 --> 00:16:47.722

copay collection side, right?

 

00:16:48.244 --> 00:16:49.924

Some organizations I've worked with,

 

00:16:50.024 --> 00:16:51.966

they will go ahead and they will just,

 

00:16:52.046 --> 00:16:52.706

if that patient has

 

00:16:52.746 --> 00:16:54.207

deductible and coinsurance,

 

00:16:54.748 --> 00:16:55.668

they will go ahead and they

 

00:16:55.708 --> 00:16:57.970

will just wait till the

 

00:16:58.009 --> 00:16:59.410

claim comes back and then

 

00:16:59.431 --> 00:17:00.392

they'll bill the patient, right?

 

00:17:01.072 --> 00:17:02.192

Others will keep a card on

 

00:17:02.232 --> 00:17:04.394

file so they can charge the

 

00:17:04.433 --> 00:17:06.556

patient when it comes through, right?

 

00:17:07.435 --> 00:17:09.738

Or they'll collect like half of it, right?

 

00:17:10.321 --> 00:17:11.823

And then they'll bill them for the rest.

 

00:17:12.103 --> 00:17:12.343

I mean,

 

00:17:12.542 --> 00:17:13.784

I wouldn't say there's nothing

 

00:17:13.844 --> 00:17:15.223

wrong necessarily with any

 

00:17:15.285 --> 00:17:16.484

of that unless your state

 

00:17:16.505 --> 00:17:18.645

has a specific rule on how you collect.

 

00:17:19.247 --> 00:17:21.248

But every practice does

 

00:17:21.288 --> 00:17:22.028

things differently.

 

00:17:23.028 --> 00:17:25.750

Some people will wait to bill, I've heard,

 

00:17:26.589 --> 00:17:27.891

because they want to wait

 

00:17:27.931 --> 00:17:28.730

to see if it hits the

 

00:17:28.750 --> 00:17:29.912

deductible from somebody else.

 

00:17:31.252 --> 00:17:32.353

Like if another practice

 

00:17:32.692 --> 00:17:33.634

hits the deductible.

 

00:17:33.913 --> 00:17:35.394

So how does that make any sense?

 

00:17:35.694 --> 00:17:36.134

I don't know.

 

00:17:36.555 --> 00:17:37.756

You're delaying payment by

 

00:17:37.816 --> 00:17:39.777

waiting to see what happens.

 

00:17:41.714 --> 00:17:43.536

Have you ever heard that?

 

00:17:43.655 --> 00:17:45.057

Yeah, actually I have,

 

00:17:45.196 --> 00:17:45.957

especially when you're

 

00:17:45.977 --> 00:17:48.998

dealing with procedures, right?

 

00:17:49.358 --> 00:17:50.479

The first three months of the year,

 

00:17:50.499 --> 00:17:50.959

you're going to have

 

00:17:50.999 --> 00:17:52.799

deductibles or you're

 

00:17:52.839 --> 00:17:54.540

waiting until they've met

 

00:17:54.580 --> 00:17:57.321

their out-of-pocket max

 

00:17:57.402 --> 00:17:58.583

when you have a PPO.

 

00:17:58.722 --> 00:17:59.522

And for those of you who are

 

00:17:59.583 --> 00:18:01.163

not familiar with the out-of-pocket max,

 

00:18:02.085 --> 00:18:03.164

when you have a PPO,

 

00:18:03.204 --> 00:18:04.025

there's a certain amount

 

00:18:04.065 --> 00:18:05.586

that the PPO will allow to

 

00:18:05.625 --> 00:18:07.267

be out-of-pocket before

 

00:18:07.307 --> 00:18:08.307

they start paying a hundred

 

00:18:08.346 --> 00:18:09.127

percent of the claim.

 

00:18:09.728 --> 00:18:10.929

And typically the number is

 

00:18:10.969 --> 00:18:12.871

like maybe fifteen, twenty five hundred,

 

00:18:12.911 --> 00:18:14.132

sometimes a little bit higher.

 

00:18:14.531 --> 00:18:16.534

But once you've met that out of pocket max,

 

00:18:16.574 --> 00:18:17.934

that's due coinsurance.

 

00:18:18.335 --> 00:18:19.796

Any procedure that goes out

 

00:18:20.016 --> 00:18:22.878

after that is an out of pocket max.

 

00:18:23.038 --> 00:18:24.900

And that PPO plan will pay

 

00:18:24.920 --> 00:18:27.021

one hundred percent of the claim.

 

00:18:27.541 --> 00:18:29.123

But again, it has to meet it.

 

00:18:29.163 --> 00:18:30.765

But some providers, what they do,

 

00:18:30.825 --> 00:18:31.766

especially if they're close

 

00:18:31.786 --> 00:18:33.146

to the end of the year.

 

00:18:33.567 --> 00:18:33.846

Right.

 

00:18:34.086 --> 00:18:35.228

They want to make sure that

 

00:18:35.248 --> 00:18:36.009

they could get.

 

00:18:36.675 --> 00:18:38.037

a hundred percent rather

 

00:18:38.076 --> 00:18:39.676

than the ninety percent but

 

00:18:39.696 --> 00:18:45.799

again on appropriate

 

00:18:45.819 --> 00:18:47.520

billing and one is also

 

00:18:47.580 --> 00:18:49.942

contingent upon um if it's

 

00:18:49.981 --> 00:18:51.162

built appropriately right

 

00:18:51.221 --> 00:18:52.262

and the medical necessity

 

00:18:52.282 --> 00:18:52.883

because you could have

 

00:18:52.923 --> 00:18:53.863

something pre-authorized

 

00:18:53.903 --> 00:18:54.804

all day long but if it's

 

00:18:54.844 --> 00:18:55.584

not meeting medical

 

00:18:55.624 --> 00:18:56.263

necessity in the

 

00:18:56.304 --> 00:18:57.444

documentation it can't be

 

00:18:57.484 --> 00:18:59.125

built so there's a whole

 

00:18:59.144 --> 00:19:00.385

lot of caveats to that but

 

00:19:00.405 --> 00:19:02.767

for the most part that's what happens

 

00:19:03.672 --> 00:19:05.232

Yeah, I understand it.

 

00:19:05.333 --> 00:19:06.334

But at the end of the day, I mean,

 

00:19:06.394 --> 00:19:06.815

it's just,

 

00:19:06.934 --> 00:19:09.096

it's a lot better to submit

 

00:19:09.116 --> 00:19:11.618

your churches once they're ready.

 

00:19:11.739 --> 00:19:14.381

I mean, if everyone does that,

 

00:19:14.401 --> 00:19:16.182

then nobody is getting their claim in.

 

00:19:16.201 --> 00:19:17.523

So it's like, what if everybody does that?

 

00:19:18.203 --> 00:19:19.045

Like, I don't know.

 

00:19:19.365 --> 00:19:20.746

That mentality is just different to me.

 

00:19:20.806 --> 00:19:22.126

But yeah, you're going to find that.

 

00:19:22.528 --> 00:19:23.429

You're going to find where

 

00:19:23.509 --> 00:19:24.269

we've always done it that

 

00:19:24.288 --> 00:19:25.109

way and it's worked fine.

 

00:19:25.854 --> 00:19:27.075

But what if there's a better way?

 

00:19:27.255 --> 00:19:28.194

What if there is a better

 

00:19:28.234 --> 00:19:30.536

way to find out that information?

 

00:19:30.556 --> 00:19:32.156

There's a lot of artificial

 

00:19:32.196 --> 00:19:33.617

intelligence or automation

 

00:19:33.657 --> 00:19:35.378

tools that can pull that

 

00:19:35.419 --> 00:19:37.140

stuff for you and let you

 

00:19:37.180 --> 00:19:39.000

know where the patient is sitting.

 

00:19:39.760 --> 00:19:40.601

And so there's a lot of

 

00:19:40.621 --> 00:19:41.961

things now you can do that

 

00:19:42.001 --> 00:19:43.262

are more efficient than

 

00:19:43.843 --> 00:19:45.104

we've always done it that way, right?

 

00:19:46.523 --> 00:19:47.585

Let's talk about contracts.

 

00:19:47.644 --> 00:19:49.026

I mean, we love talking about contracts,

 

00:19:49.066 --> 00:19:49.365

right?

 

00:19:49.905 --> 00:19:51.987

So practices that haven't

 

00:19:52.067 --> 00:19:54.188

reviewed their contracts in eight years,

 

00:19:54.608 --> 00:19:55.348

I've seen longer.

 

00:19:56.624 --> 00:19:56.963

Now,

 

00:19:57.644 --> 00:19:59.565

I understand rates are horrible right

 

00:19:59.625 --> 00:19:59.945

now.

 

00:20:00.306 --> 00:20:02.426

So maybe you have an awesome

 

00:20:02.507 --> 00:20:03.307

rate right now,

 

00:20:03.906 --> 00:20:05.067

but what else is in your

 

00:20:05.087 --> 00:20:06.008

contract that might be

 

00:20:06.048 --> 00:20:07.509

hurting you besides the rate?

 

00:20:07.528 --> 00:20:08.910

You know,

 

00:20:08.970 --> 00:20:10.130

and it's ironic that you're

 

00:20:10.150 --> 00:20:10.971

talking about that because

 

00:20:11.010 --> 00:20:12.432

I'm speaking on that at the

 

00:20:13.531 --> 00:20:14.772

medical cost containment

 

00:20:15.133 --> 00:20:17.733

summit that's coming up in September.

 

00:20:18.513 --> 00:20:19.575

And again,

 

00:20:20.515 --> 00:20:22.215

one of the things that is really

 

00:20:23.057 --> 00:20:25.718

key about your contracts is

 

00:20:26.978 --> 00:20:29.759

one, that they're paying you, two,

 

00:20:29.980 --> 00:20:31.520

that they're paying you on time,

 

00:20:32.101 --> 00:20:32.922

and three,

 

00:20:32.961 --> 00:20:34.021

that they're paying you at the

 

00:20:34.082 --> 00:20:35.583

rate that they're supposed to pay you.

 

00:20:35.982 --> 00:20:37.384

Now, again,

 

00:20:37.523 --> 00:20:39.164

if your contract is more than

 

00:20:39.204 --> 00:20:40.165

five years old,

 

00:20:40.846 --> 00:20:42.326

that means you're probably

 

00:20:42.987 --> 00:20:44.147

under the market rate.

 

00:20:45.709 --> 00:20:45.929

And

 

00:20:46.637 --> 00:20:49.419

Based upon the Medicare

 

00:20:49.439 --> 00:20:50.519

physician final rule,

 

00:20:50.900 --> 00:20:53.500

and this is mind blowing, Jen,

 

00:20:54.040 --> 00:20:55.221

and we're going to be talking about this,

 

00:20:55.261 --> 00:20:55.501

right?

 

00:20:56.142 --> 00:20:57.363

It's mind blowing that

 

00:20:57.482 --> 00:20:59.064

Medicare has not changed

 

00:20:59.223 --> 00:21:01.724

their rates for certain

 

00:21:01.785 --> 00:21:06.346

services since twenty oh five.

 

00:21:07.013 --> 00:21:09.795

They're using the same rates.

 

00:21:10.194 --> 00:21:10.595

Why?

 

00:21:10.654 --> 00:21:13.336

Because they're sending out respondents.

 

00:21:13.355 --> 00:21:14.757

They're sending out surveys

 

00:21:15.156 --> 00:21:16.798

and nobody's filling them out.

 

00:21:16.897 --> 00:21:17.518

Of course.

 

00:21:18.738 --> 00:21:19.578

Why would I do that?

 

00:21:19.598 --> 00:21:21.398

I don't want to help Medicare.

 

00:21:21.519 --> 00:21:23.160

Twenty oh five.

 

00:21:23.400 --> 00:21:24.940

Two thousand and five.

 

00:21:25.260 --> 00:21:26.921

They haven't changed the

 

00:21:27.000 --> 00:21:29.041

rates because physicians

 

00:21:29.342 --> 00:21:30.803

are not responding.

 

00:21:31.643 --> 00:21:34.523

So that's twenty years old.

 

00:21:36.146 --> 00:21:37.188

Think about what you paid

 

00:21:37.228 --> 00:21:38.888

for gas twenty years ago

 

00:21:38.949 --> 00:21:43.993

versus what you're paying now.

 

00:21:44.054 --> 00:21:46.255

Crazy, crazy, crazy.

 

00:21:46.736 --> 00:21:46.875

Well,

 

00:21:46.955 --> 00:21:48.156

I know you and I are helping a

 

00:21:48.217 --> 00:21:50.219

practice on the West Coast right now,

 

00:21:50.419 --> 00:21:52.099

you know, who is part of an ACO.

 

00:21:52.721 --> 00:21:54.102

And over there, you know,

 

00:21:54.122 --> 00:21:56.064

it's very heavy with different, you know,

 

00:21:56.304 --> 00:21:57.444

organizations that are

 

00:21:57.464 --> 00:21:59.425

managed service organizations or they're,

 

00:21:59.886 --> 00:22:01.268

you know, physician organizations.

 

00:22:01.710 --> 00:22:02.890

And so these organizations,

 

00:22:02.930 --> 00:22:04.290

you go into a contract with

 

00:22:04.310 --> 00:22:05.451

them because they can

 

00:22:05.490 --> 00:22:06.730

supposedly get you better rates,

 

00:22:06.770 --> 00:22:08.951

which is why most people go in there.

 

00:22:09.511 --> 00:22:11.531

But then you find out after

 

00:22:11.571 --> 00:22:14.053

so long that all your nine, nine, two,

 

00:22:14.153 --> 00:22:15.634

one threes are getting paid

 

00:22:15.673 --> 00:22:18.473

at sixty dollars.

 

00:22:18.653 --> 00:22:19.634

And, you know,

 

00:22:19.694 --> 00:22:21.414

and I have the contract in front of me.

 

00:22:21.555 --> 00:22:23.214

I have the rates that that

 

00:22:23.255 --> 00:22:26.056

that they secured for the practice,

 

00:22:26.756 --> 00:22:27.896

according to the contract,

 

00:22:28.257 --> 00:22:29.317

are supposed to be getting them.

 

00:22:30.446 --> 00:22:30.886

Actually,

 

00:22:31.007 --> 00:22:32.127

I think their rate was a hundred

 

00:22:32.147 --> 00:22:33.167

and ten percent of Medicare,

 

00:22:33.188 --> 00:22:34.429

which is unheard of right now.

 

00:22:34.648 --> 00:22:35.490

It's a great rate,

 

00:22:35.509 --> 00:22:37.009

but they're not getting it.

 

00:22:37.971 --> 00:22:39.152

So my question is,

 

00:22:39.612 --> 00:22:42.093

whose job is it to make

 

00:22:42.133 --> 00:22:43.834

sure that that money gets captured?

 

00:22:43.933 --> 00:22:46.535

Is it the ACO or the person doing that?

 

00:22:46.555 --> 00:22:46.895

Actually,

 

00:22:46.935 --> 00:22:48.636

the MSO actually doing the

 

00:22:48.676 --> 00:22:49.737

billing for them and then

 

00:22:49.757 --> 00:22:51.357

paying them from that.

 

00:22:51.498 --> 00:22:52.578

They're almost like, you know,

 

00:22:52.598 --> 00:22:55.640

like an employee right to this MSO.

 

00:22:55.680 --> 00:22:57.080

So they're responsible.

 

00:22:58.257 --> 00:22:59.837

for making sure it happens.

 

00:23:00.117 --> 00:23:01.078

The practice is just now

 

00:23:01.118 --> 00:23:01.839

finding out about it,

 

00:23:01.859 --> 00:23:03.000

just thinking everything is

 

00:23:03.040 --> 00:23:06.803

going along just fine until it's not.

 

00:23:07.983 --> 00:23:09.045

And now we have to have a

 

00:23:09.085 --> 00:23:10.625

conversation about why

 

00:23:10.665 --> 00:23:11.807

they're not holding up

 

00:23:11.846 --> 00:23:12.788

their end of the deal,

 

00:23:13.268 --> 00:23:13.949

or at least not

 

00:23:13.989 --> 00:23:14.909

communicating to the

 

00:23:14.949 --> 00:23:17.530

practice with reports and

 

00:23:17.971 --> 00:23:19.992

updates on why their

 

00:23:20.012 --> 00:23:21.134

revenue isn't where it should be.

 

00:23:22.587 --> 00:23:23.808

there's a whole lot of ways

 

00:23:23.848 --> 00:23:24.789

that I could answer that,

 

00:23:24.990 --> 00:23:26.851

but I'm not going to say everything.

 

00:23:26.971 --> 00:23:28.011

I'll just say this.

 

00:23:29.153 --> 00:23:31.494

When you sign up for an MSO,

 

00:23:31.535 --> 00:23:34.416

which is a managing services organization,

 

00:23:34.457 --> 00:23:35.218

that's what that is.

 

00:23:35.858 --> 00:23:38.461

They serve as a mediator

 

00:23:38.500 --> 00:23:40.622

between the provider and the payment.

 

00:23:40.942 --> 00:23:42.503

That's what an MSO does, right?

 

00:23:43.064 --> 00:23:43.365

But

 

00:23:44.464 --> 00:23:46.425

If you're in charge of managing it,

 

00:23:46.885 --> 00:23:47.567

then you should be in

 

00:23:47.606 --> 00:23:48.886

charge of getting that money.

 

00:23:49.347 --> 00:23:52.489

Think of an MSO as it

 

00:23:52.528 --> 00:23:54.670

relates to where you pay rent.

 

00:23:55.770 --> 00:23:57.371

A managing company who

 

00:23:57.431 --> 00:24:00.313

manages who gets the rent.

 

00:24:00.472 --> 00:24:02.374

If they aren't collecting the rent,

 

00:24:02.933 --> 00:24:04.954

Whose job is it to collect the rent?

 

00:24:05.394 --> 00:24:07.695

The MSO works the same way.

 

00:24:08.135 --> 00:24:09.836

So if they're not getting the money,

 

00:24:09.856 --> 00:24:11.156

there's some liability that

 

00:24:11.196 --> 00:24:12.758

should be addressed that's

 

00:24:12.798 --> 00:24:15.459

associated with that payment.

 

00:24:16.038 --> 00:24:17.019

Think of it this way.

 

00:24:17.400 --> 00:24:19.080

Think of the MSO as like the

 

00:24:19.260 --> 00:24:20.941

union for the services that

 

00:24:20.961 --> 00:24:21.682

you're providing.

 

00:24:21.902 --> 00:24:23.342

That union should be able to

 

00:24:23.382 --> 00:24:24.423

stand up for your rights.

 

00:24:24.823 --> 00:24:26.022

It should be able to stand

 

00:24:26.063 --> 00:24:27.324

up for when something is wrong.

 

00:24:27.683 --> 00:24:28.584

And they should be able to

 

00:24:28.624 --> 00:24:30.984

keep you in the loop by newsletters,

 

00:24:31.025 --> 00:24:32.105

contacts, whatever.

 

00:24:32.790 --> 00:24:34.271

But if it's not happening,

 

00:24:34.811 --> 00:24:36.353

somebody should be held liable.

 

00:24:36.853 --> 00:24:37.133

Right.

 

00:24:37.252 --> 00:24:37.772

My husband,

 

00:24:37.833 --> 00:24:40.513

he has a union and they contact

 

00:24:40.534 --> 00:24:41.315

him all the time.

 

00:24:41.755 --> 00:24:42.515

They send letters.

 

00:24:42.535 --> 00:24:43.355

There's a website.

 

00:24:43.855 --> 00:24:45.036

But if nobody's checking to

 

00:24:45.076 --> 00:24:46.037

see if they're up to date,

 

00:24:46.997 --> 00:24:47.998

then whose fault is it that

 

00:24:48.018 --> 00:24:49.137

you don't know that they're not?

 

00:24:49.157 --> 00:24:49.198

Oh.

 

00:24:49.919 --> 00:24:53.920

Yeah, it's true.

 

00:24:53.980 --> 00:24:54.160

I mean,

 

00:24:54.180 --> 00:24:55.661

I don't know how else how much

 

00:24:55.740 --> 00:24:57.741

plainer to say it.

 

00:24:58.021 --> 00:24:59.042

And there's also other

 

00:24:59.083 --> 00:25:02.084

things in your contracts.

 

00:25:02.765 --> 00:25:06.126

that affect you.

 

00:25:06.387 --> 00:25:08.028

What is their rules on prior

 

00:25:08.048 --> 00:25:08.969

authorizations?

 

00:25:09.450 --> 00:25:09.829

What are your

 

00:25:09.869 --> 00:25:11.631

responsibilities to collect co-pays?

 

00:25:12.031 --> 00:25:13.071

There's things that are your

 

00:25:13.112 --> 00:25:14.472

responsibility as an organization.

 

00:25:14.492 --> 00:25:15.814

They can come back and tell

 

00:25:15.834 --> 00:25:17.355

you that you're not holding

 

00:25:17.414 --> 00:25:18.516

up your end of the bargain

 

00:25:18.997 --> 00:25:20.458

on this and vice versa.

 

00:25:21.376 --> 00:25:22.917

Really dig into those contracts.

 

00:25:23.057 --> 00:25:25.137

Know what those fine prints are.

 

00:25:25.298 --> 00:25:27.999

I recently put an article out on Substack.

 

00:25:28.538 --> 00:25:29.839

I'm doing a lot of Substack

 

00:25:29.900 --> 00:25:30.740

writing these days.

 

00:25:30.779 --> 00:25:31.339

So check it out.

 

00:25:31.400 --> 00:25:32.520

I love writing on Substack.

 

00:25:32.580 --> 00:25:33.980

It's just like my outlet for

 

00:25:34.000 --> 00:25:34.961

just talking about stuff.

 

00:25:35.461 --> 00:25:36.642

So jump over to Substack if

 

00:25:36.662 --> 00:25:37.541

you haven't ever heard of it.

 

00:25:37.582 --> 00:25:38.843

It's a great place to find

 

00:25:38.903 --> 00:25:41.483

good content from e-revenue experts.

 

00:25:42.344 --> 00:25:43.644

Really great data people in

 

00:25:43.684 --> 00:25:44.865

healthcare are on there too.

 

00:25:44.904 --> 00:25:46.464

So it's really great stuff.

 

00:25:46.505 --> 00:25:47.766

But just think about that, you know,

 

00:25:48.367 --> 00:25:49.709

Look at your processes.

 

00:25:49.828 --> 00:25:51.128

Are there any outdated

 

00:25:51.189 --> 00:25:53.390

practices that you want to look at?

 

00:25:54.530 --> 00:25:56.071

Nothing wrong with some of

 

00:25:56.112 --> 00:25:57.451

your processes that might,

 

00:25:57.571 --> 00:25:58.333

if it's not broke,

 

00:25:58.373 --> 00:25:59.472

don't fix it kind of thing.

 

00:25:59.492 --> 00:26:01.173

If it's not harming your practice,

 

00:26:01.894 --> 00:26:02.775

maybe it's fine.

 

00:26:03.154 --> 00:26:05.576

But what if it could be improved?

 

00:26:05.756 --> 00:26:08.317

What if it could help you

 

00:26:09.417 --> 00:26:10.417

have money in your budget

 

00:26:10.438 --> 00:26:12.038

for a new fancy machine

 

00:26:12.078 --> 00:26:13.759

that could actually improve

 

00:26:13.819 --> 00:26:15.820

patients' lives?

 

00:26:16.922 --> 00:26:17.863

their quality of life?

 

00:26:18.002 --> 00:26:19.063

What if all that money could

 

00:26:19.083 --> 00:26:20.144

be used elsewhere?

 

00:26:20.943 --> 00:26:22.644

You know, are you still using paper?

 

00:26:22.984 --> 00:26:26.086

Oh, don't get me started on that.

 

00:26:26.106 --> 00:26:26.866

I know there's lots of

 

00:26:26.906 --> 00:26:28.008

practices who like to print

 

00:26:28.107 --> 00:26:29.087

everything out.

 

00:26:29.969 --> 00:26:31.849

And I try to get with,

 

00:26:31.930 --> 00:26:33.089

I try to train coders and

 

00:26:33.109 --> 00:26:34.851

billers to code without printing.

 

00:26:35.892 --> 00:26:36.112

I mean,

 

00:26:36.132 --> 00:26:37.291

sometimes it's necessary to get a

 

00:26:37.311 --> 00:26:38.252

piece of scrap paper out.

 

00:26:38.272 --> 00:26:38.853

That's great.

 

00:26:39.313 --> 00:26:41.473

But you don't want to be

 

00:26:41.554 --> 00:26:42.795

printing constantly.

 

00:26:42.815 --> 00:26:44.415

And there's a lot of these just, you know,

 

00:26:44.861 --> 00:26:45.621

we've always done it that

 

00:26:45.661 --> 00:26:46.602

way kind of attitudes.

 

00:26:46.662 --> 00:26:49.061

And I'm like, but is it efficient?

 

00:26:49.342 --> 00:26:52.603

No, not, but that's just me.

 

00:26:52.722 --> 00:26:53.983

I mean, I just,

 

00:26:54.104 --> 00:26:55.523

I can't understand the

 

00:26:55.644 --> 00:26:56.765

people that don't want to

 

00:26:57.924 --> 00:26:59.285

move forward and save their

 

00:26:59.305 --> 00:27:01.766

practice money, whatever it happens to be,

 

00:27:02.586 --> 00:27:04.086

but that's just me.

 

00:27:05.007 --> 00:27:07.907

And so if the only answer is

 

00:27:07.968 --> 00:27:10.909

you're getting, because we always have,

 

00:27:11.490 --> 00:27:12.471

If that's the answer you're

 

00:27:12.491 --> 00:27:13.451

getting from somebody,

 

00:27:13.491 --> 00:27:14.932

then you need to make a change.

 

00:27:15.513 --> 00:27:16.974

Because an organization that

 

00:27:17.295 --> 00:27:19.135

that's their response is

 

00:27:19.256 --> 00:27:22.218

not interested in moving

 

00:27:22.278 --> 00:27:23.940

along with where healthcare is going,

 

00:27:24.319 --> 00:27:25.019

and they're not going to

 

00:27:25.039 --> 00:27:26.300

survive potentially.

 

00:27:26.740 --> 00:27:28.001

Or they're going to get audited,

 

00:27:28.061 --> 00:27:29.202

and then they're going to have a problem.

 

00:27:29.462 --> 00:27:30.503

Because I guarantee you the

 

00:27:30.523 --> 00:27:32.105

practices that are still

 

00:27:32.144 --> 00:27:34.446

saying that have huge red

 

00:27:34.467 --> 00:27:36.387

flags buried in their documentations.

 

00:27:37.199 --> 00:27:38.440

Or their revenue is two

 

00:27:38.460 --> 00:27:39.381

million dollars and

 

00:27:39.441 --> 00:27:40.721

nobody's checking to see

 

00:27:40.801 --> 00:27:42.442

how much of that money is

 

00:27:42.583 --> 00:27:44.845

actually due or a credit

 

00:27:45.224 --> 00:27:46.125

for an overpayment.

 

00:27:46.586 --> 00:27:48.247

Oh, the overpayments.

 

00:27:48.607 --> 00:27:49.888

We got to have an episode on that.

 

00:27:50.068 --> 00:27:50.808

Oh, my goodness.

 

00:27:50.848 --> 00:27:51.750

We dig apart that.

 

00:27:51.829 --> 00:27:52.530

That's insane.

 

00:27:52.590 --> 00:27:53.892

I have lots of stories on that one,

 

00:27:53.912 --> 00:27:54.311

by the way.

 

00:27:54.652 --> 00:27:56.433

Oh, hello.

 

00:27:57.433 --> 00:28:00.016

So we've had some great fun

 

00:28:00.135 --> 00:28:01.698

dissecting this topic here today.

 

00:28:01.798 --> 00:28:02.597

And I want to let everybody

 

00:28:02.637 --> 00:28:05.140

know we're so excited on Monday.

 

00:28:05.200 --> 00:28:05.780

That is the.

 

00:28:06.505 --> 00:28:09.067

Monday coming up, guys, on the eighteenth,

 

00:28:09.528 --> 00:28:10.669

we're going to have a

 

00:28:10.709 --> 00:28:12.351

special episode to dissect

 

00:28:12.391 --> 00:28:13.672

the proposed rule for the

 

00:28:13.711 --> 00:28:14.593

Medicare Physician Fee

 

00:28:14.633 --> 00:28:16.154

Schedule twenty twenty six

 

00:28:16.714 --> 00:28:18.596

with Maya Turner and myself.

 

00:28:19.201 --> 00:28:20.121

And we're very excited to

 

00:28:20.141 --> 00:28:21.902

dig apart and really just

 

00:28:21.942 --> 00:28:22.682

talk about this.

 

00:28:22.701 --> 00:28:23.801

We've been itching to talk

 

00:28:23.842 --> 00:28:24.923

about this proposed rule,

 

00:28:24.982 --> 00:28:26.363

all the little nuggets and

 

00:28:26.923 --> 00:28:28.483

the not so fun things that are in it,

 

00:28:28.584 --> 00:28:29.723

but things we have to know.

 

00:28:30.203 --> 00:28:31.064

So stay tuned for that.

 

00:28:31.443 --> 00:28:32.484

We will not have a regular

 

00:28:32.525 --> 00:28:33.865

episode next week because

 

00:28:33.904 --> 00:28:35.885

we are going to be out of town next week,

 

00:28:35.965 --> 00:28:37.445

but we'll be returning for

 

00:28:37.465 --> 00:28:39.047

a regular scheduled episode

 

00:28:39.106 --> 00:28:40.186

on the following Wednesday.

 

00:28:40.816 --> 00:28:41.696

So stay tuned for that.

 

00:28:41.757 --> 00:28:43.077

We will see you guys Monday.

 

00:28:43.538 --> 00:28:44.740

We're going to dig apart this final,

 

00:28:44.880 --> 00:28:45.701

this proposed rule,

 

00:28:45.760 --> 00:28:47.122

and we're really looking forward to it.

 

00:28:47.142 --> 00:28:48.042

So thank you for supporting

 

00:28:48.063 --> 00:28:48.763

the Practice Perfect

 

00:28:48.804 --> 00:28:50.565

podcast and always

 

00:28:50.605 --> 00:28:52.126

supporting Healthcare Inspired.

 

00:28:52.186 --> 00:28:53.087

Have a good week, you guys.