Healthcare Crossroads

A podcast showcasing the connections in Healthcare Data, Compliance and Patient Care

Are you a Healthcare Advocate?

In this episode we highlight why we are all here in the Business of Healthcare. To provide access to care for the patient population. It doesn’t matter what our role is, we have an obligation to fight for the patient so they can get what they need to improve their quality of life and in many cases save their life.

I had the privilege of speaking with two Healthcare Advocates and I am sharing that conversation with you all. Elizabeth Johnson and Melissa Paige join me today to talk about how they became Patient and Healthcare Advocates and how Healthcare Advocate Summit came about.

Learn more about our guests:

Elizabeth Johnson is the Chief Executive Officer for MedicoCX, a group of independent specialists unified by patient centric access to biologics in a timely and cost effective manner, as well as a co-founder and the President of NAMAPA, National Association of Medication Access & Patient Advocacy, Inc. Their goal is to empower healthcare advocates by providing a collaborative community focused on resources to navigate medication access and support.

Melissa Paige is the Co-Founder of HealthCare Advocate Summit, and the Co-Founder of NAMAPA. She is Recognized as an expert in patient access programs and navigation. She is a Prolific public speaker and educator. She uses her Leadership skills to oversee and coordinate process improvement projects that enhance business models and redesign workflows for improved efficiencies. Her passion for the patient and this drives her to break down access barriers and seek avenues for the highest quality care.

The Healthcare Advocate Summit is LIVE in person September 7-9 in New Orleans.

Grab your Tickets Today and support this very important event.

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Is your staff up to the Challenge?

In this week’s episode I dig into the heart of getting your providers paid. Many of the breakdown starts with the data collected at the time of the appointment. In my career I started at the front desk. The most important role beside the Physician! I will walk you through my career from Receptionist to Consultant

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What’s the Law got to do with it?

In this Bonus episode I am joined by Kimberly Clayson of Jaffe Raitt Heuer & Weiss as we give you a preview of the legal issues facing the industry and some insight into No surprise billing that she we give us at the Orthopedic Conference.

  • What is No Surprise Billing?
  • What it means for Orthopedics?
  • Upcoming topics for the OrthoCare Summit

Join us and get your Tickets

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What Triggers a Behavioral Health Audit?

Welcome to Episode 1 of Season 6!

We are happy to invite our first guest of the Season Laurie Bouzarelos MHA,CPC on the show today to talk about Behavioral Health audits.

Laurie Bouzarelos, MHA, CPC is a health care consultant with a special interest in supporting the unique business needs of behavioral health practices. Laurie works with psychiatrists and behavioral health providers to improve practice revenue and address compliance shortfalls. Laurie helps providers understand their revenue and facilitates operational changes to meet managed care and government payer requirements and state and federal laws. Areas of focus include managed care contracting, documentation improvement, EHR templates, coding accuracy and medical billing.

We will discuss the recent OIG audit that was done in NY and what we can learn from it.

Read more

Our focus will be on the areas of:

  • Treatment Plans
  • Frequency
  • Documentation
  • Incident to requirements
  • Time documentation
  • Telehealth
  • Know the OIG Workplan

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The Who, What, Where, When, Why and How of LCD Policies 1 CEU

In todays episode we dive into LCD policies, Coverage and Evaluation and Management tips for Diagnosis Documentation. It is so important to understand the impact that Medical Necessity and Coverage guidelines play in reimbursement. Outside of direct care providers many patients rely on their insurance coverage to get the services they need. By accepting assignment on their behalf and submitting their claim we can aid them as professionals to continue getting these service and to be reimbursed the highest amount available. We can do this by understanding:

  • Current Active LCD Policies
  • Prior Authorization Criteria vs Coverage Guidelines
  • Documenting Risk and conditions that effect the risk
  • Timely Submission of accurate claims with supporting Documentation

Medicare Coverage Process

Patient LCD Disputes

LCD What’s New Report

LCD Q/A

Diagnostic Colonoscopy LCD

Do not keep writing off claims for preventable Prior Authorization Denials. Get started with Authparency

Watch it in Action!

Earn a CEU for this Episode by becoming a Patreon Member

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