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Indhold leveret af Sean McSweeney. Alt podcastindhold inklusive episoder, grafik og podcastbeskrivelser uploades og leveres direkte af Sean McSweeney eller deres podcastplatformspartner. Hvis du mener, at nogen bruger dit ophavsretligt beskyttede værk uden din tilladelse, kan du følge processen beskrevet her https://da.player.fm/legal.
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Jessica Shaw, Henry Goldblatt, and Tudum.co m editor Jean Bentley invite you to the wedding of the year in Virgin River ! Hear all about season six of the series and get a sneak peek of Mel and Jack’s long awaited wedding . Plus, get excited because the series has been renewed for another season ! Just in time for the holidays, you can buy Virgin River merch for your friends and family. Finally, Jessica and Henry preview Tyler Perry’s new film The Six Triple Eight which tells the story of the only US Women’s Army Corps unit of color stationed overseas during WWII who take on an impossible mission. This Christmas Day, Netflix will be streaming the NFL's two marquee games! The Super Bowl LVIII-winning Kansas City Chiefs will face the Pittsburgh Steelers and the Baltimore Ravens will take on the Houston Texans with Beyoncé performing during the latter’s halftime show. Follow Netflix Podcasts for more and read all about the titles featured on today’s episode exclusively on Tudum.com .…
Medical Billing Advertising
Manage episode 455191066 series 3382305
Indhold leveret af Sean McSweeney. Alt podcastindhold inklusive episoder, grafik og podcastbeskrivelser uploades og leveres direkte af Sean McSweeney eller deres podcastplatformspartner. Hvis du mener, at nogen bruger dit ophavsretligt beskyttede værk uden din tilladelse, kan du følge processen beskrevet her https://da.player.fm/legal.
What options are a good fit for medical billing advertising? We'll explore some of the most common options and whether they would benefit growing your medical billing company.
221 episoder
Manage episode 455191066 series 3382305
Indhold leveret af Sean McSweeney. Alt podcastindhold inklusive episoder, grafik og podcastbeskrivelser uploades og leveres direkte af Sean McSweeney eller deres podcastplatformspartner. Hvis du mener, at nogen bruger dit ophavsretligt beskyttede værk uden din tilladelse, kan du følge processen beskrevet her https://da.player.fm/legal.
What options are a good fit for medical billing advertising? We'll explore some of the most common options and whether they would benefit growing your medical billing company.
221 episoder
Alle episoder
×1 Can EHRs Stop Automated Scraping of Data? 9:14
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9:14A lot of organizations are scraping data (RPA automation) from their practice management PMS / EHR. This includes providers who want their own data and have issues with the system vendor, as well as RCM companies and software vendors like analytics platforms. But are they allowed to do this? Do EHR vendors have contracts that prevent this? Would that even be legal? Who owns the data legally and can an EHR company block access? We'll discuss these things and look at specific examples.…
1 Why is GenAI Taking Off Faster than Analytical AI? 9:35
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9:35What is GenAI (like ChatGPT) taking off faster than analytical AI (like machine learning ML) in medical billing? We'll discuss which has more value in RCM, the pluses and minuses of each, and some counterintuitive reasons why it is getting tested and adopted faster than ML AI.
What options are a good fit for medical billing advertising? We'll explore some of the most common options and whether they would benefit growing your medical billing company.
The murder of the CEO of United Healthcare has re-ignited a discussion about denials and bad payer / insurance company behavior, and AI is at the center of it. We'll discuss UHC's denials AI, the broader application of AI in denials, whether it is problematic, and why. And finally a little on what you can do about it.…
1 RCM Marketing Strategy - Effective Targeting 10:34
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10:34Many still seem to struggle with effective targeting in the medical billing arena. So what are the levers or variables involved? How can you find a good target market to carve out a successful positioning and differentiation? We'll give you some suggestions on how to do this effectively.
1 Medical Billing Advertising - Is TikTok Right for Your Business? 5:39
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5:39TikTok and other media platforms like Discord are really hot. Everyone is on them, right? Is advertising for medical billing on new media platforms a good call for your business? Listen to find out specifically about TikTok, but more broadly how we think about evaluating particular channels and media.…
1 Buying Medical Billing Leads - Numbers Deep Dive 9:36
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9:36Part 3 of 3 part series on buying medical billing leads. In prior episodes we discussed whether this is a good medical billing marketing strategy, then top tips for improving your results if you are going to do it, and this episode is a deep dive into the numbers. CAC, ROI, CLV, and more.
1 What Is The Best Channel for Medical Billing Marketing? 9:35
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9:35I frequently get this question. In this podcast we'll dive into what is the "best" channel and what criteria are involved in determining the "best".
1 Why Isn't Medical Billing Automation Taking Over? 8:23
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8:23Talk about technology, automation, and AI is everywhere in the medical billing industry, including around half the presentations at the HBMA this year. So why hasn't it taken over? Why are so few companies doing it and even then for such a small percent of the processes? Listen to find out, which should lead you to your solution.…
1 Buying Medical Billing Leads - 5 Tips to Succeed 8:42
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8:42In another podcast we have discussed why buying medical billing leads may not be the marketing strategy slam dunk people think it is. But if you are going to do it, we'll give you the top 5 tips to succeed doing it (or at least significantly improve your results).
1 Improve Trade Show ROI - Top 10 Actionable Tips 13:41
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13:41In one of our other podcasts we suggested exhibiting at trade shows may not be the best medical billing marketing strategy. But if you're going to do it, here are the top 10 tips on how to dramatically improve your lead generation rate and ROI.
A message for those of you in the US...Today is election day.
1 Is AI Good at Medical Billing Marketing Strategy? 8:13
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8:13Gen AI and ChatGPT are getting tons of attention. How good is AI at doing medical billing marketing strategy? We test it and see how it performs and make suggestions.
1 Buying Medical Billing Leads - A Good Marketing Strategy? 6:32
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6:32Many companies buy medical billing leads, or at least have considered it. The question is whether this is a good marketing strategy. We'll explore the pluses and minues.
1 Medical Billing Companies are Rarely Good at Marketing or Sales 7:08
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7:08People think medical billing marketing and sales are difficult, but your competition is terrible at this. The reality is it isn't that tough and in this episode I share a story that illustrates why I think most medical billing marketing stinks.
1 Why Targeting Marketing is So Hard for Medical Billing Companies 7:21
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7:21We did a prior podcast on the benefits of targeted medical billing marketing. For most, this becomes a "duh!" moment after thinking about the pluses and minuses. Then why are so few billing companies doing it and why do some even after hearing the rationale continue to shotgun the market unsuccessfully?…
1 Don't Update Your Website - Sound Crazy? 4:33
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4:33When should you update your website or create a new website? If you're thinking about medical billing marketing strategies, will a better website increase your sales? Listen to find out.
1 Should Your Medical Billing Business Hire a Salesperson? 5:46
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5:46You want to grow your medical billing company. When people think grow they think sales, when they think sales they think salesperson. Is this the right approach for your business? Listen to find out our thoughts.
1 Billing Companies, Automation, and AI - Are They Overstating Their Capabilities? 7:02
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7:02I recently attended the HBMA (healthcare billing management association) national conference and heard a bunch of billing companies talk about automation and AI. But how many are really experts in this? How many are really even deploying these technologies in any reasonable scale? Listen to find out.…
1 Should Your Medical Billing Marketing Be Targeted? 4:11
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4:11Most medical billing companies take any and all comers, they are opportunistic and will do everything from family practice to pain management to ophthalmology. But is this a good idea from a marketing standpoint if you are trying to grow more quickly? Listen to find out our thoughts.
1 Medical Billing Company Branding - Good Idea? 4:43
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4:43Does your medical billing business need branding? Should you invest in this? I've heard many billing companies tell me they want to be seen by their clients and prospective clients and that this is really important. But is it? We'll dive into what this really means and the benefits and costs of branding.…
1 How Smart is Generative AI - an RCM Case Study 8:03
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8:03We decided to try and experiment and see how smart a generative AI (GAI) application is. In part because this is a hot topic and we get asked about it frequently, we thought it would be fun to test. We asked a LLM/GAI application whether you need generative AI at this point in RCM or even what would be good applications of it. The answer will astonish you.…
1 Should RCM Exhibit at Clinical Conferences? 3:50
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3:50Most medical billing marketing starts with exhibiting at trade shows. But is this a good investment for your medical billing business? We'll explore the pluses and minuses and give you the answer.
Is generative AI something you should jump into right now? Where is it applicable to RCM? Where could your technology focus be right now to get the most ROI?
There had been a lot of hype and some concern that automation will wipe out the medical billing / RCM industry. We'll explore is that real and what implications are for medical billing companies.
How does RCM move away from being an industry primarily of body shops? What does performance mean in revenue cycle and how do you get there?
What's a body shop in rcm? And why are so many cycle management companies and even departments set up as body shops? We'll discuss the implications and eventually get to an alternative.
If you have comments or suggestions please send them over to us we would love to hear from you.
Many are asking about AI in healthcare and about its application ave future or imminent dominance. Are the robots taking over?
What?!?! Voyant's core technology is based on automation, how can we dare to be saying this? Listen to find out what we counsel.
Is there something wonky happening with the data in Kareo? What does bad data mean? Listen to find out for a significant issue with this system.
AdvancedMD has an AI tool, but is it really AI i.e. artificial intelligence? We'll dive into this product and offer some thoughts on its capabilities and limitations.
What's better - more planning and detail or winging it... Err, I meant "agile". All jokes aside, which path is better - larger scope and more detailed specifications or the opposite?
What information would you want in order to run analytics? If you're like other practices or billing (RCM) companies, you want to answer a lot of questions and this means lots of information that isn't easy to get from your system or systems. Listen to the challenges of just one system we recently dealt with. And this doesn't even include everything you might want for analytics and using the data for workflow.…
Do we need data from clearinghouses and why? Can they provide this information accurately and export it in order to use it in analytics? We'll find out.
Many systems have problems with their data. Listed to some issues we going with Clinix and why this makes reporting and even workflow difficult.
1 Time Travel is Possible...with Some Systems 5:31
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5:31Net you didn't know time travel was possible. With some healthcare (HCIT) systems it is. As fun as this sounds, this creates some real headaches.
We're back! New branding for the company.
What's a good way to evacuate the capabilities of a vendor offering RCM AI/ML? We'll tell you one expert's suggestion and explain whether it would be effective.
1 What is Data Science vs AI vs Analytics? 6:32
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6:32Machine learning, artificial intelligence, statistics, data science, analytics - what do all these mean? What do we need it use for financial data in healthcare (RCM)?
What limitations do you encounter when pulling data from billing systems? What works better as a data source for analysis? This is a detailed explanation of where to get data and where to analyze it to get the results you want.
What makes a good chart? How do you make sure that it isn't misinterpreted or misunderstood so that conclusions are correct and commonly understood across many people the same way? Listen to find out how we screwed one up, why, and what we should have done instead.
The MGMA had benchmarking data for a large number of practices. Listen to find out what they share in a webinar about benchmarks, as well as other esteemed presenters.
Robotic process automation is really hot right now. But do robots get tired? Listen to hear about the challenges of getting access to your data, the robot apocalypse (just kidding), and lazy robots. We all want answers to our questions using data, right?
Is there value in "knowing" things? Listen to my contrarian point of view. I think you'll agree after listening.
We'll tip you off on a webinar to avoid by a very well known and respected expert in the field. Why Is it so bad and a waste of your time? Listen to find out and what you should do instead.
Ever wondered if Oracle BI is better than SiSense or the other platforms out there? What is "the best"? What criteria would you use to evaluate? And what does a top rating organization have to say about it?
I don't want to give it away. You'll have to listen to the podcast to find out our impressions of the reporting and "analytics" for Kareo.
How much do you or your managers know about your healthcare business or revenue cycle management? If you're good, the answer is a lot. But no one knows everything. Listen to hear a discussion of knowing and finding out...and surprises.
Remittances often have errors or other issues that make doing analysis difficult. In particular practice name / entity name is a disaster. We'll explain this problem and tell you a very simple and effective solution so that your analysis is productive.
Most billing and practice management systems overwrite data when something changes, which means you lose your ability to analyse and solve problems. We offer a simple(ish) solution.
How are denials defined? Can we all standardize? Why isn't there already a standard from one of the financial or billing associations? We have an answer.
Why do so many supposed experts who talk about analytics not provide actual data? Are they making up numbers? What is going on?
Have you ever thought about when is the best time to work? To do analysis? Strategic thinking? Did you realize it depends on your genetics? Listen to find out how to be a better analyst and problem solver.
What's the worst, the bottom, the Nada land of analytics? And where is the top, what should everyone be striving towards? We'll talk about the hierarchy and what each level means so you can see where your organization resides.
What does healthcare in the United States have in common with the Catholic priesthood? Listen to find out.
We've discussed in RCM a definition of denials, discussed that there isn't a good definition, and why a definition is so important. Today we'll dive into some really specific examples of actual denial / remittance codes and whether they sounds be considered denials.
This is a follow up to the information and review we provided about OpenPM / Open Practice Solutions and their reporting capability with respect to denials. We dive in more deeply here to the problem they have and what you can do to solve it.
It never ceases to amaze us how many obstacles there are to successful analytics. We'll recount one of the problems you are likely to encounter. And a secret way to ensure you have success in getting all your data.
In a prior podcast we talked about why it is so important you define what is a denial and what problems you encounter if you do not have one. In this podcast we dive in more deeply to discuss what constitutes a denial.
We often do reviews of individual systems and their reporting capability. We'll discuss OpenPM (Open Practice Solutions), give you a bunch of positive things and discuss one really important flaw in their denials reporting.
Hard as it is to accomplish, we managed to link revenue cycle management, denials, the US Supreme Court, and pornography all in one podcast (don't worry, nothing distasteful). Sound ridiculous? Thus is the state of our industry, and listen to find out why these are all linked and actually quite important.…
1 Problem Solving Methodology Problem Gets Dwarfed 6:16
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6:16We recently reviewed a client billing analysis that concluded that alternate CPTs should be billed in order to reduce denials. This is NOT about compliance. Listen to hear about what to watch out for when doing your analysis.
Are you looking at a flat file report when working on your medical billing? How does this relate to the relational database and its structure? Is anything being lost? Are we somehow being misled because the output doesn't make sense or is designed poorly and we may not even know? Listen to find out.
1 Shark Attacks, Spider Bites, and RCM Analytics 6:51
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6:51What do these seemingly unrelated things have in common? Have you ever heard of Freakonomics? Listen to hear discussing human behavior, data, and how it drives our decisions and business in revenue cycle management.
What makes a good dashboard? We'll discuss a key element for making a great dashboard and how it relates to eCW (eClinicalWorks) dashboard.
Are you capturing all your denial information in order to do analysis and solve problems? If you're like the overwhelming majority of providers and billing companies the answer is no and one thing makes it really hard, which we'll discuss.
What is Destructive Transformation such a big issue? We'll explain how this creates huge problems even while it solves a pressing problem with Excel analysis.
What should you do in AR Recovery, or what should you expect if you are a provider? We'll dive into some details and talk about how to make this work and have that cash register ring.
Does your billing department or billing company have regular problem solving meetings designed to tackle problems in medical billing? We'll discuss how one of these went recently and what you can do to ensure success in your billing. Spoiler alert: it includes analysis and problem solving.
Are you a destructive analyst? We've all been there. We'll discuss what is destructive transformation and why it occurs so frequently in data science and analysis.
How good is the reporting for eCW? We'll review some of their reports and discuss what is broken, what works, and what could be improved.
1 Kitchen Toasters and RCM Reporting Systems 8:18
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8:18What do toasters and medical billing reporting have to do with each other? Listen to find out. I think this highlights a huge problem we have in the revenue cycle management industry.
In a prior podcast we outlined why not to do a data warehouse. In this one we'll expand on that a little and provide a very specific and detailed solution on what you should do instead. And it will save you money, not cost more.
What do Zillow and billing analytics have in common? We'll talk about why Zillow, who is famous for their algorithm, data, and analytics, and others have a problem in real estate and how to avoid that in medical billing.
1 Successful RCM Analytics Implementations 7:42
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7:42What challenges come up on implementations of medical billing analytics? Not just overcoming resistance, we'll discuss a key challenge and give you the solution that works every time.
OK...Start Trek references aside...how do we overcome resistance to using analytics in billing departments in order to improve profitability and customer satisfaction? We discuss some problems we've seen and potential solutions.
We will review eCW eClinicalWorks "Analytics" module in their cloud based application. We'll tell you exactly what it does and does not do. I thin you'll be surprised. We certainly were.
What's happening with data science and specifically in healthcare? Where are the data scientists most in demand? We'll give you a little update on this and talk about an opportunity. I'll also share something very personal about a healthcare experience with my daughter in the process.
What are medical billing KPIs? I think this is often confusing and misunderstood. We'll explore what constitutes medical billing KPIs, and what does not.
1 Knuckle-draggers, Sports Fans, and "Analytics" 5:23
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5:23I'm going to on a rant, so watch out. I feel strongly about this. It's all editorial BTW with a little "analysis" thrown in for good measure. (Tongue firmly in cheek)
Why do so many projects never get started? Or completed? Or are never used? Or fail? Is it the technology? Is it the specification, scoping, or implementation? Or is it something else entirely? Listen to a recent experience and my thoughts on what's really going on. If you want success...
We'll give you an update on how it is going with getting data from a big clearinghouse. Also explain what FTP is and how it can be critical to your analytics program.
More suggestions and some real specifics on dashboard design that will make them more utilized and more effective.
1 Smooth Operator - Clearinghouses Update 5:04
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5:04This is a follow on podcast about the challenges of getting access to your data, just do you can actually do analytics. I'm update you on the journey to go through the clearinghouse to get 835s/ERAs.
A frequent member of Top 10 KPI lists for medical billing is "cash receipts". But what does this mean? How do you calculate it? How often should you monitor it - daily? We'll cut through the BS, tell you what matters and what to do.
Do you ever have people talk to you in a way that seems really profound but actually has absolutely no value? This is the art of consultant speak. Billing managers do it too. Listen to hear an example from am MGMA Benchmarking webinar that is really painful and why it stinks to high...
We seem to find ourselves simplifying things and implementing less complex solutions. Why? Shouldn't the world be progressing towards more sophisticated and larger implementations?
If you haven't heard of Simpson's Paradox you're probably getting hurt by it. Not knowing makes you look bad. We'll explain what it is, how it impacts on you, and what to do to make sure people see you for how well you are really doing in medical billing.
Don't you want benchmarking around RCM performance? Where can you get it? Where should or be available? What should it accomplish? And do any of these match up to the expectations?
The follow-up podcast to the last one about accessing data in order to do data warehousing and analytics in healthcare revenue cycle management. Think clearinghouses are your salvation? Guess again.
Where do you go when you can't get the data you want to do revenue cycle analytics? To the source, of course! But where is that? And can you get it?
Why talk about a Caribbean island and data? Listen to find out.
What does a dystopian sci-fi political satire have to do with statistics, intelligence, and revenue cycle management?
1 Baseball, Game Theory, And Surprise Billing 7:45
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7:45What do baseball and surprise biking laws have in common. It isn't "Moneyball". Listen to learn a little about game theory, surprise billing, and arbitration in out of network medical billing.
What do coin flips and gambling have to do with checking in patients? We'll explain expected value and discuss why it is important in healthcare revenue cycle management.
I think about things differently than the average person. I'm a quant. In economics we used to think everyone behaved rationally, but with the advent of behavioral economics we know that's not true. So how can we change our thinking in healthcare that helps us? We offer a really important suggestion.…
What's the solution to the reporting lag time issue? For denials it's easier than you think. I'm share my incredibly valuable Secret on what you do to avoid having to wait 6 to 9 months to know what is going on.
Everyone suddenly wants data warehousing. We'll discuss whether this is a good idea (wait...what? Sean you love data warehousing) and for who and when.
The new federal surprise billing law is complicated and has some interesting aspects to it. Data had always been a key part of determining reimbursement and we explore how this new law changes things with respect to medical billing for emergent and inadvertent out of network claims.
What is the average rate of denials on a percentage basis? What is the top quartile? How good can you actually get? What are the key things to implement a successful denials management program?
A few more best practices about healthcare financial dashboards...including when you should just scrap it.
Follow up to HBMA podcast about lack of data and analytics at the conference. I discuss why it isn't there with recent revelations about the revenue cycle management industry.
How can providers benchmark financial performance without exposing sensitive competitive information? We tackle this problem and offer a solution.
1 Interoperability and 21st Century Cures Act 4:36
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4:36The solution is nigh...or is it?
What kind of target is achievable or even realistic in avoiding medical billing denials? What is "normal" and what is exceptional? And can it be replicated? Listen to find out what we just ran into.
Denials reporting is among many in healthcare finance and revenue cycle management where we are forced to look at really old data instead of current. Why? Does it really have to be this way? We have a different view than most and offer a potential solution to help. Listen to find out.
1 No Data and Analytics at HBMA Conference? 3:40
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3:40Looking at the agenda for the upcoming HBMA Conference I was floored to see there is nothing about analytics or data going on there. What is happening?
How long do you need to wait in order to get financial results? Should you have to wait a day? A week? A month? A year? What about other information? What about RCM performance results? Listen to hear our take on reporting.
What is denial recovery rate, how do you calculate it, and what is it good for? We'll discuss whether this is a good RCM KPI (spoiler: it isn't) and why.
What is a healthcare provider or a medical billing company to do when you're short staffed and are having a hard time hiring enough employees? The consequences can be dire. Listen to hear what this means for your organization, what your options are, and what you might consider doing.
What is AR recovery and why should everyone be doing it? We'll explain what it is and why it's the best thing since sliced bread.
What are the Do's and Don't's for creating a healthcare financial dashboard? Best practices and common mistakes are discussed in this podcast.
If you are interested in our denials management application for beta testing, it comes with the ETL module that extracts, cleans up, and joins data from your system(s). Please contact us if you are interested.
What's MECE and how can it help your organization when it comes to RCM Analytics?
Money I save I often put into real estate to diversify and this is the second part of the story about how I used data and analytics to make money in my personal life.
What's the difference between a dashboard and a set of reports? Most people find them indistinguishable, and yet that destroys the value of dashboards. Listen to our take on this.
1 Denials Management Software - Seeking Beta Testers 3:36
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3:36We are offering a limited number of organizations free usage of our new denials management software. Listen to find out some of the features of what it does, as well as benefits, and how to apply and see if you qualify.
1 Data is Everywhere, Use It And Make Money 7:04
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7:04This isn't even about healthcare. It's about a personal story of looking at how I approach things analytically and modifying and improving that approach. And then making a bunch of money.
What does HIMSS have in store for us analytics nuts?
What comes before denials management 101...denials management 100. In order to do basic denials management in any way, whether it is analytics or basic medical billing denials workflow, you need data and we'll discuss some ways to get that if you're having trouble.
What is the first thing to do in implementing a denials management process? What gives the greatest bang for the buck in time to implement and cost? Listen to find out what should be step 1.
Who has good practice management KPI's? While we usually slam organizations for poor, non-existent, or fictitious metrics, we'll share with you an organization that has come up with a good list...and their list.
Is everything bad in RCM metrics? Are we just hypercritical? There have to be good medical billing KPI's right? Listen to find out.
How many hours of a high level analytical resource does it take to do charge reconciliation every month? We've gotten a quantification from a client where we deployed our Charge Recon application. Listed to find out.
How much time is saved by automating charge reconciliation? Not doing it or doing it on excel? Charge recon is finding encounters clinical missing from billing.
Why can't it be that we just do a quick analysis and we're done? We explore the operational challenges that make this a pipe dream or dare I say fantasy in RCM analytics.
What constitutes a denial? Does everyone agree on this definition? Why does it matter what we include? Check in to hear our thoughts on medical billing denial definition.
What can we learn from venture backed startups (like Slack) that applies to healthcare providers? Are there any frameworks that could make them more successful and how do these relate to analytics?
What issues can you run into doing charge reconciliation? Errors can undermine your ability to find missing charges. Listen in to find a key tip for success.
Wyatt do idiosyncrasies of cultures have to do with medical billing and performance? Listen to find out and hear some tips to improve RCM ave your analytics.
You won't believe the dumb things on this massive RCM company's website. It kind of makes you cringe. They should either fire their entire marketing department or operations team...it's not clear which.
What do you need to be doing now in order to ensure regulatory compliance? We'll talk about data, analytics, penalties, and audits.
1 What Does Basketball and RCM Have to Do With Each Other? 6:38
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6:38We'll take you through some fun examples of what to consider in making a good basketball team and what this has to do with medical billing.
Is there an easy way to collect more money from patients? Here is one SECRET we have implemented for clients that significantly improves patient collections.
If this is such a quantifiably large problem, why are so few organizations doing charge reconciliation to find all the missing encounters? Let's walk through the issues so we can set them up to be solved. Then an those claims can be billed.
What is scope creep? Why does it occur? What can you do to mitigate it? These are difficult questions when it comes to analysis and software development. We'll talk through some of these issues.
1 Seems Like Charges Are Missing? It's a Safe Bet They Are. 7:44
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7:44Ever feel like not everything is getting billed but just can't put your finger on the problem? This can be complex, especially because no one may know how to quantify the problem. Listen to hear about charge reconciliation.
1 Multiple Systems for Medical Billing Companies 7:02
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7:02Billing companies are often forced to use many practice management or EMR systems in order to do billing, but this poses some huge challenges in data, reporting, and analytics.
Why are custom reports needed so often and yet few get them? Big systems are notorious for not charging a ton of money for every module, feature, and report. Listen to hear our thoughts on this.
1 AR Aging Buckets is Antiquated - Possible Solution 9:00
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9:00If AR aging buckets isn't the best way, what should medical billing teams do to prioritize and work claims most efficiently? Listen to find out.
This is one of the most common tools used in medical billing and yet it has limited use and lots of issues. We'll examining some factors involved and discuss what is better.
Sometimes we have problems with our data and it's because we made good data into bad data. Listen to find out about what we found in the operational workflow when we were automating charge reconciliation for a medical billing company.
How is it possible that you can have more than a 100% patient net collection rate in medical billing? Listen to find out how this sometimes happens, what it means, and what you need to do to address the problem.
1 Calculating Patient Net Collection Rate 5:41
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5:41What is patient net collection rate in medical billing? How do you calculate it? What is a good performance level to achieve? What are some tips and nuances in this arena?
Sick of promises that aren't kept? Vague statements that seem to answer the question but don't really commit to anything in medical billing, software, or RCM vendors? Here are some detailed methods to make sure you end up with the result you want.
1 Promises and Vague Answers? - Here Are Solutions 8:46
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8:46In a prior podcast we talked about healthcare vendors, employees, and software companies that make vague promises or try to make things look great without much substance. Here is the meat on how to dig in and get the answers you want to evaluate how real it is.
Vendor promising something that you want? Trying to figure out if you will get results or just a headache and a hole in your wallet? How can you distinguish fact from fantasy or deception? Software, billing, reporting...this happens everywhere. Listen to hear what to do.
Why are there so many fields you can't report from healthcare revenue cycle management systems (practice management systems, medical billing systems, HIS, RIS, LIS, etc.)? Don't you want this information?
1 Denials, Hard to Collect Claims, and Economies of Scale 8:08
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8:08Why do economies of scale matter so much in medical billing when it comes to hard to collect claims? Shouldn't it just be that it is a question of hard work, being detailed and thorough, and having good billers?
There are not a lot of free lunches out there, but saved reports are one of the most important in healthcare revenue cycle management and medical practice management.
Looking at the spreadsheet calculating net collection, medical billing performance, and accounts receivable balance, we found massive problems. Don't make these mistakes like they did.
1 Bank Reconciliation Part 2 - Action Plan 7:12
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7:12Missing money? What specifically needs to be done in order to reconcile medical billing collections to deposits in the bank account? Here is the detail.
What's the #1 fake metric or KPI in revenue cycle management / medical billing? Listen in to find out.
If someone in your organization is billing something incorrectly, whether accidentally or intentionally, you may face huge legal and financial consequences. In this podcast were show one simple way to check compliance using data.
1 Missing Deposits - Not Matching Collections? 7:02
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7:02Have you ever tried matching bank deposits to a collections report? Bet it didn't line up. Now what? What are the problems that can lead to significant mismatches? We'll talk about why bank reconciliation is so important to stem losses.
Certain issues like understanding how your system stores data is critical. Especially whether data is overwritten or stored as a separate record. There is often a problem that prevents a lot of analysis, i.e. you can't get the answer to your question. What is a "state change" in your medical billing software, what does it mean for you, and how can you deal with it to get your questions answered with data?…
1 Medical Billing Charge Reports - More Than Meets The Eye 6:20
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6:20Isn't it simple - just run a "charge report"? But what if the question you are trying to answer is not the same as your colleague? How many different types of medical billing charge reports are there and what are their purpose? What should be in them and how should you quality control them? This is way more complex than most people realize if you want to do it well.…
Once again Medicare For All has resurfaced since Democrats have taken control of the White House. In this non-partisan discussion we look at whether this is a sound financial policy.
1 Do Insurance Companies Tell the Truth? Part 2 - Some Results 9:03
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9:03Medical claim denials contain information from insurance companies. Are they telling the truth? Listen in to find out as we analyze the data to find the truth.
1 Reviews of Reporting Capabilities in Billing Systems 6:44
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6:44Do medical billing systems have good reporting? What do user reviews indicate? We look at the average rating (positive or negative) of reviews that comment specifically about the capability of reports and analytics.
1 Can You Trust Insurance Companies To Tell the Truth? 5:23
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5:23Can you rely on the information in a medical billing remittance (EOB / ERA) from health insurers that tell you what to do to modify, resubmit, or appeal claims in order to get paid?
1 Average Reimbursement Analysis - Part 2 9:07
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9:07We dive in more deeply here to look at how this is calculated and what went wrong. Is the medical billing company trying to pull a fast one on its client? Listen in to find out.
1 Average Reimbursement Analysis from Billing Company 7:07
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7:07Caveat emptor when it comes to getting analysis done for you. Listen here to find out all the problems we see in what should be a simple analysis of average reimbursement from a medical billing company. And we'll tell you what to do.
Office Ally is free medical billing software (clearinghouse, practice management system PMS / EMR). We briefly review be reporting capability.
We put some real effort into finding resources for teaching conditional logic. Listen to find out why this is so important in medical billing and where to get some FREE courses.
What does the great Raymond Smullyan have to do with revenue cycle management analytics? Listen to find out (and learn about my goofy childhood).
What the heck is this thing? Why does it matter in medical billing? Is it only for analysis or does it impact anything else?
Why are there so many problems and so much resistance to codifying rules in medical billing so they can be analyzed and measured? Let's look at why and what to do about it.
Bouldering
1 Medical Billing Rules in Heads - part 2 5:21
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5:21What happens to those medical billing rules that are in everyone's heads? Your company needs those and there are competing reasons fighting to get those out or keep them secret.
There are a ton of little nuances to billing that everyone in the industry know exist. What does this do to your analysis?
Which claim remittances and correspondence go to which departments in the medical billing company or division? It depends. Listen to find out about a huge productivity boosting analytics setup for your department.
1 Analysis or Quality Control - Which is More Important? 5:12
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5:12Ever find a mistake or a problem in an analysis? Who hasn't. The question is not how to prevent it, but how much time and effort needs to be devoted to finding mistakes in RCM analytics compared to the actual analysis itself. Listen to find out the ratio we suggest.
1 Contact Compliance - Part 2 - Finding Problems 8:21
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8:21Are you ready to do the quality control to figure out if all those incorrect payment flags are actually incorrect payments or just an error in the system? We'll dive in so you can know what you'll need to do and how to plan for it. In the end you can catch insurance companies underpaying you.
How can you tell if you're getting taken advantage of by insurance companies? Are they underpaying you according to your contract? What are your options for catching this?
Running into problems where you have lots of different payer names fire the exact same insurance company? Why does this happen? What kind of problems does it create? And how can you fix it?
What do different people in the organization need for data and reporting? What kind of analysis is appropriate for a biller compared to a CFO of a system? And how can that be obtained for all those levels?
If you want a medical billing company to bill for you, how do you ensure that you keep your data or control the data so that you are safe in the event something happens? We walk you through the typical decision process and what your options are.
Trying to define exactly what software you need built or what you need analyzed can be extraordinarily difficult. Here are some of the issues typically encountered and a suggestion on how to improve outcomes.
Not going to give this one away in the description. You'll have to listen to find out this tip on how to improve your medical billing denials management process using an analytical trick.
A fun little episode about the difference between correlation and causation and some spurious correlations for entertainment.
There are other metrics on which you can evaluate whether a payor is bad, other than just denials. We'll take you through a couple and suggest what to do.
Who are the worst payers? How do you identify your "worst" list? And what do you do about it once you have this naughty list?
What is gross collections in medical billing, how do you calculate it, is it valuable, and what are the pros and cons of this metric? We'll break it down for you.
1 How to Know if Your Billing (Company) Is Good 4:27
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4:27How do you know if your billing or billing company is performing well? Do you just ask them?
I'll going to go off again on one of my favorite targets Kareo. They have a metric that is called Payment Velocity and it is complete and utter garbage. Listen to find out why.
1 Data in Eligibility Verification Problems 10:14
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10:14Eligibility verification problems in medical billing can really destroy the financial success of a provider. This is the story of a catastrophe because of eligibility problems, finger pointing, confusing data, very complex problem solving, and ultimate success.
What counts as a denial? How can you actually calculate, what fields are you going to use, what unique key will allow you to figure out what counts and what doesn't and are your denials getting better or worse? This is much more complicated than you might think. And it's necessary to improve your medical billing.…
1 Billing Company Pricing and Perverse Incentives 6:41
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6:41What's wrong with flat rate pricing from a medical billing company? Everything. Incentives drive behavior and we'll discuss how this undermines performance.
1 Why Are Hard to Collect Claims Not Worked? 8:52
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8:52Notice we didn't say collected. Why are they not even worked frequently or at the level they should be to maximize revenue for a provider? We show you the answers and you may be surprised.
1 Happy New Year, making data-driven decisions, and a mea culpa 6:36
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6:36Where can we be more data driven? How can we make decisions that are better informed? This year we should be making a commitment to improving our business and profitability through data. And that includes Apache.
We'll be off for a week for the holidays.
1 Measuring RCM Productivity Part 2 - Solutions 11:01
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11:01We provide you some simple solutions on how to measure the productivity of medical billing team members for various different parts of the revenue cycle including patient registration, charge entry, accounts receivable, collectors, etc. We even offer a few higher level answers to more nuanced and complex issues you encounter.…
Congress looks set to pass a bill that will eliminate surprise medical bills for patients.
What should you measure to figure out productivity in medical billing? What do you do to make sure the people don't be in the system or do you want to create incentives that actually result in good outcomes?
1 Medical billing service and medical billing software - one-stop-shop good? 5:29
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5:29Is the trend towards practice management / medical billing software companies offering outsourced medical billing service a good one? And for who exactly?
1 Are health insurance companies screwing doctors with underpayments? 6:01
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6:01How do you know if you're getting underpaid and are insurance companies doing it intentionally? Is there a way to know conclusively? (We use "doctors" as a symbol of all providers, whether it is hospitals, laboratories, physicians, ASC's, imaging centers, or other providers.)
When finger pointing happens in medical billing, whether it is with an external billing company or in-house department, what do you do? How do you know who is responsible for claims not getting paid? We have a suggestion.
What do you do with the inherent problems of the blame game? Who is responsible when claims don't get paid or there is a problem? Billing blames insurance, insurance blames billing. Now what?
Why AR days should NOT be the gold standard in measuring accounts receivable and medical billing performance.
How do you evaluate and select a medical billing company to perform you billing? Reference are the number one method and we'll discuss whether that is a good criterion.
1 Defining Metrics, KPIs, Data, Analytics 9:35
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9:35Defining and getting through the marketing BS on RCM and medical billing terms and acronyms.
1 RCM visualization tools, "analytics", and...dynamite 10:03
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10:03What do medical billing, financial data, analytics, and visualization tools have to do with dynamite? Listen in to hear about Xifin Revenue Cycle Management "business intelligence" solution.
Why do so many ambulatory surgery centers not have EMR? Will it change? We look at a hypothesis on why, what the impact is, as what you can do with data mining until it is implemented.
How do you figure out what payers are unwilling to pay? What CPTs are going to get denied in medical billing? What's the right question and what's the right way to analyze to identify and prevent problems with insurance companies?
1 What's a Good Use of Time in the Pandemic? 1:58
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1:58What can you do when you're alone in your home office?
1 Bridging the Medical Billing and Technical Teams 8:28
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8:28How can people who don't understand each other communicate? Billers don't know software, database structures, etc. and IT people / analysts don't know billing. What's an organization to do when you need answers?
Does athenahealth have a good medical billing system or is it just an EMR/EHR and is their reporting good? What are the major pros and cons?
Is Epic Software really epic when it comes to reporting? Find out in this podcast discussing the reporting capabilities of one of the largest hospital and EMR software companies on the planet.
1 Revenue Cycle Management is the wrong name 8:01
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8:01What are we focused on in our industry? Seems like our target is off the mark in medical billing and we're looking at metrics and KPIs that are not in alignment with our financial goals.
I'm giving you one of our most secret Secrets for RCM Denials Metrics. The most important KPI there is for your medical billing appeals process.
What does Guy Kawasaki have to do with revenue cycle management? Listen to find out.
Often when you do revenue cycle management (RCM) analysis, you and up not getting the answer you were going for. And suddenly you need to look at why, are there different questions, and how does this impact on my data?
Let's be honest...Data prep sucks. Wouldn't you rather just do denials analysis? Hear what happens when analysts focus on analysis instead of what is even more important...
1 Top 10 Medical Billing KPI's...That Aren't Actually KPI's At All 8:38
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8:38Why is it that so many consultants, billing companies, and software platforms in RCM / revenue cycle management / medical billing give you such garbage advice? They after even actual performance metrics, just best practices at best.
How many times have you heard the buzzword analytics in healthcare and revenue cycle management? Seems like at what conference and in tons of articles we're being bombarded. But is it really analytics being offered?
Now that we extracted reason codes from the text field Notes in the medical billing system (aka EMR), can we figure out the top problems to solve?
When it's ugly just trying to get the information you want. How do you solve medical billing problems when you can't get good data on what is being rejected ir denied and why?
Diving into denials reporting for medical billing for one of our clients takes me to a clearinghouse rejection report and the result is surprising.
What's the best way to tackle the entire healthcare reimbursement system problems? I'm going to find out.
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