MGMA Week in Review: Valentines Day, Reimbursement Audits, and Heart Health

In this episode of the MGMA Week in Review podcast, host Daniel Williams discusses the importance of financial accuracy in healthcare organizations through regular audits of payer payments. He also addresses the challenges faced by women physicians and highlights the role of the MGMA Women's Forum in advancing gender equity in medicine. In recognition of Valentine’s Day, Daniel shares key insights on heart health and practical steps for cardiovascular well-being.

Key Topics Covered:

The Importance of Regular Audits for Accurate Reimbursement

• 47 percent of medical group practice leaders conduct monthly or quarterly audits of payer payments.
• Auditing helps detect underpayments, claim denials, and inconsistencies in reimbursements.
• Suggested actions for healthcare organizations:
  • Implement structured audit processes to compare payer remittances with contracted fee schedules.
  • Use automated auditing tools in revenue cycle management.
  • Conduct retrospective audits of claims to identify patterns of underpayment.
• Read More Here

Advancing Women Physicians in Healthcare

• Women physicians face higher rates of burnout, depression, and suicide compared to their male counterparts.
• Sponsorship and allyship are essential for increasing leadership opportunities and professional recognition.
• The MGMA Women’s Forum provides networking, resources, and support for women in healthcare leadership.
• Join the MGMA Women’s Forum

Heart Health Awareness for Valentine’s Day

• Cardiovascular disease remains the leading cause of death in the United States.
• Simple heart-healthy choices for Valentine’s Day:
  • Choose nutritious meal options over heavy, processed foods.
  • Opt for dark chocolate, which offers cardiovascular benefits.
  • Engage in physical activity such as walking or exercise.
  • Learn CPR, a life-saving skill that can make a difference in emergencies.
• Heart Health Tips

Stay Connected

• Subscribe to the MGMA Week in Review podcast for future episodes.
• Join the Conversation: Sign up for MGMA Stat to participate in weekly polls.
• Follow MGMA for the latest insights in medical practice management.

For more information or to suggest a topic, visit MGMA.com.

Host: Daniel Williams
Podcast Website: MGMA Podcasts

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capt

Episode Transcript

Daniel Williams (00:54):
Well, hi, everyone, and welcome to the
MGMA Week in Review podcast. I'mDaniel Williams, and I'm flying
solo today as my cohost, ColleenLuckett, had a scheduling
conflict, but we wanna wish hera good weekend. Before we dive
into this week's stories, I dowanna wish you all a very, very

(01:15):
happy Valentine's Day. This isour Valentine's Day weekend
edition, and I have someexciting personal news. I'm
gonna be heading out later thisafternoon for my very, very
first weekend yoga retreat inthe beautiful Colorado
Mountains, and I am ecstaticabout this.
I am so excited to, just spend alot of time relaxing, being

(01:43):
mindful, and doing some yoga aswell. And I'm looking forward to
some very much needed r and r,and I'm excited to unplug,
unwind, and just immerse myselfin the experience. So I'm gonna
be sure to share somereflections on that in a future
episode. So with that said,let's jump into our first story.

(02:06):
So our first story is thisweek's MGMA stat poll.
Regular auditing of payerpayments is crucial to ensure
accurate reimbursement. Now ifyour practice isn't regularly
auditing payer payments, youcould be leaving money on the
table. A recent MGMA stat pollfound that 47% of medical group

(02:30):
practice leaders conduct monthlyor quarterly audits to ensure
that they are being paidaccurately according to their
contracts. These audits areessential for identifying
underpayments, claim denials,and inconsistencies in payer
reimbursements. Now with thecomplexity of insurance

(02:53):
contracts and the constantchanges in reimbursement
policies, it's easy for paymenterrors to slip through
unnoticed.
Many medical practices assumethat payers are always paying
them correctly, but let's facethe facts here. The reality is
the discrepancies are morecommon than you might think.

(03:15):
Even small payment variances canadd up over time, significantly
impacting revenue. One of themost effective strategies for
catching these discrepancies isimplementing a structured
auditing process. This meansregularly comparing payer
remittances to contracted feeschedules and flagging any

(03:39):
mismatches.
Technology can also help. Manyrevenue cycle management systems
offer automated auditing toolsthat make it easier to track
payment accuracy. If you're notsure where to start, a good
first step is to conduct aretrospective audit of recent
claims to identify any patternsof underpayment. From there,

(04:02):
practices can develop aproactive auditing strategy to
ensure they're receiving therevenue they rightfully earned.
Accurate reimbursement is thebackbone of financial
sustainability, and auditingpayer payments should be a
priority for every health careorganization.
This is a section that Colleenusually handles, the MGMA stat,

(04:27):
but I will add here yourcontributions are vital to
MGMA's ongoing work to providegreat resources, education, and
advocacy for medical groupleaders. So please sign up for
MGMA stat to make your voiceheard in our weekly polls.
Simply text stat, s t a t, to33550 or visit

(04:52):
mgma.com/mgma-stat, and thenpolls will be sent to your phone
via text message. I received my,MGMA text yesterday and got my
this actually got this statpoll, and that's why I included

(05:13):
it here. So let's go to our nextstory, building support and
allyship for women physicians.
We need your help. Now this nextstory, I really do wish that
Colleen were here for it. She'sbeen actively involved with the
MGMA women's forum, and I knowshe'd have some great insights

(05:35):
on this topic. So let's getright to it. Women physicians
face unique challenges in theworkplace, and a recent piece
from Medical Economicshighlights the importance of
sponsorship and allyship inadvancing gender equity in
healthcare.
Women physicians experiencehigher rates of burnout,

(05:56):
depression, and even suicidecompared to their male
counterparts. This isn't justdue to workload. It's also about
bias, workplace culture, and alack of leadership
opportunities. Despite making upnearly 40% of the physician
workforce, women are stillunderrepresented in executive

(06:18):
roles and decision makingpositions. One way to address
this disparity is throughsponsorship, not just
mentorship.
While mentorship is valuable,sponsorship goes a step further.
It means actively advocating forwomen physicians by recommending
them for leadership roles,speaking opportunities, and

(06:41):
professional recognition.Research shows that when men use
their influence to support womenin medicine, it helps break down
structural barriers in ways thatmentorship alone cannot. If
you're wondering how to getinvolved, the MGMA Women's Forum
is a great place to start. Itprovides networking

(07:01):
opportunities, resources, andsupport for women leaders in
healthcare.
Whether you're a physician,administrator, or an ally
looking to make a difference,supporting initiatives like
these is essential. Let'scontinue the conversation and
ensure that women in medicineget the recognition, leadership
opportunities, and support theydeserve. What I'm gonna do is

(07:25):
I'm gonna drop a direct link tothat, women's forum in our
episode show notes, so look forthat there. And then finally,
this is Valentine's Day, andit's Valentine's Day weekend. So
I'm just gonna say, pleasecelebrate Valentine's Day with
actual hearts in mind.

(07:45):
It is Valentine's Day, and wecould not end this show without
talking about heart health.While today is about chocolates,
flowers, and romantic dinners,it's also a great time to think
about your physical heart andhow to keep it healthy.
According to the American HeartAssociation, cardiovascular
disease remains the leadingcause of death in The US, and

(08:09):
small lifestyle changes can makea big impact in reducing risk.
We all love indulgentValentine's treats, but there
are plenty of ways to celebratewhile keeping heart health in
mind. Consider swapping outheavy processed meals for a
heart healthy dinner.
Think grilled salmon, roastedvegetables, or a fresh salad

(08:32):
with avocado and nuts. Insteadof a box of chocolates, try dark
chocolates with high cocoacontent, which has antioxidants
that support heart health.Physical activity is another
great way to celebrate lovewhile taking care of your heart.
Dancing, a long walk, or even acouple's yoga session can boost

(08:55):
endorphins, strengthen yourcardiovascular system, and bring
you closer to your loved ones.And if you really wanna make an
impact this Valentine's Day,learning CPR could be the best
gift you ever give.
Every year, thousands of peopleexperience sudden cardiac
arrest, and a bystander CPR candouble or even triple survival

(09:19):
rates. The bottom line, loveyour heart as much as you love
your loved ones. ThisValentine's Day, consider making
small, intentional choices thatsupport heart health because the
best way to show love is toensure you're around for many
more Valentine's Days to come.This wraps up our show for

(09:41):
today. As always, you can findlinks to all the articles we
discuss here in the episode shownotes.
If you enjoyed today's episode,be sure to subscribe to the MGMA
Week in Review podcast so younever miss an update. As I
mentioned at the beginning, I'mgonna be off at a yoga retreat
this weekend, but I hope you allhave a wonderful Valentine's Day

(10:04):
filled with love, health, andmaybe a little heart healthy
movement. Take care, and we'llsee you next time.