Auditing Antics: Navigating Medical Coding and Auditing
Stephanie Allard, CPC, CEMA, RHIT has 20 years of experience in the medical industry and knows the complexities that the professional world is facing on a daily basis. She also knows the lack of public education about our healthcare industry in the United States which contributes to the inability for patients to advocate for themselves. Her Auditing Antics Podcast will explore the healthcare industry from the viewpoint of a medical coder, medical auditor and the patient perspective as a consumer. This series will provide insight to various services in the medical/dental industry and help you n
Episodes
Join us for the first episode in a series related to medical documentation and coding policies and the role they play within a compliance program as a whole and to offer structure for consistency and adherence to guidelines. Creating policies is not just about checking a box to say it is present and complete. Instead, it is about building a strong foundation for compliance and organizational integrity.
Coding for critical care services is not dictated based on diagnosis, practitioner specialty and/or the setting/unit where the patient is seen. So what supports compliant documentation for billing of critical care services? Join us during this episode as we dive into the coding guidelines and discuss common struggles we face when coding, auditing and educating in this specialty. Sign up for our updates and the latest compliance new...
With the Recent Extension What Does Telehealth Look Like Through September of 2025? While 5 months seems like a long time, developing a contingency plan now will allow your practice to quickly pivot if the regulatory environment should change after the extension period expires. Stay informed!
Download the FREE telehealth guide on our homepage at https://www.stephanieallardconsulting.com/Sign up for our updates and the latest c...
During this episode we will discuss why the routine waiver of co-pays and out-of-pocket costs is problematic when not handled correctly internally. Depending on the actions taken by the organization this can even be considered illegal violating the False Claims Act. Join us to learn more about running this side of an organization and the policies you need to have in place to ensure compliance.Sign up for our newsletter here!
So many organizations are focusing on the financial side of incident-to and not investing enough time and attention to fully understand and ensure compliance. During this episode we will look beyond the 100% reimbursement of the physician fee schedule and uncover the complexities that practices are facing through the typical workflow that does not coincide with incident-to.
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Join us for Episode 7 where we will tackle some of the common E/M questions in the office setting and the thought process behind the answers.
The coding and billing workflow is not only about getting claims out the door. Too many organizations do not have a strong focus on the "backend" and denial management. This can cripple the revenue of a practice. During this episode, we will discuss the various types of structures for a medical organization's billing team internally and/or externally. We will review steps and tips to stay on top of the volume and work...
There is a lot of confusion in the coding and billing side of the industry related to preventative services. During this episode we will discuss the differences between a full physical examination that would be relevant to the non-Medicare population and how a wellness visit is different from a workflow and documentation perspective. We will also address "split billing" and how to address, code and bill for active problem...
Many practices and hospital systems currently have providers prescribing medications and/or are wanting to practice "life style" medicine related to weight loss. These types of services are not always reimbursable by the payers, but in the "pay and chase" environment organizations are getting paid and not aware of the future compliance risks associated. During this episode we will review the medical weight loss ...
During this episode we will discuss the scenario when a provider is planning to perform a service that they expect the insurance to not cover. Is the practice required to notify the patient of this tricky situation? Is the patient responsible to pay out of pocket every single time in every situation? We will review what the medical staff and a patient need to be aware of to prevent reimbursement issues with services that may not be...
During this episode we will break down the documentation requirements for medical necessity that are often missing or not detailed in the encounter progress note. We will also review the coding requirements, common payer coverage and how the documentation and billing can impact patient out-of-pocket costs.
Welcome to the Auditing Antics Podcast! During this episode Stephanie will explain the motivation of the podcast and its relevance to not just those of us in the medical industry, but also to help the everyday consumer advocate for their healthcare.
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