NSCHBC Edge Podcast

More than 100,000 doctors have left private practice and become employees of hospitals and other corporate entities since 2019. Today, nearly 3 in 4 physicians are employees of larger health care entities or other corporations — a record high. The cost of managing a medical practice — whether in primary care or a specialty practice — has surged. Not to mention, reimbursement rates from Medicare have not kept pace with higher operational costs. So how does a physician make sure they are collecting all that is due to them, not just from insurance payers, but where it begins: At the front desk? In today’s NSCHBC Edge Podcast, Healthcare Business Consultant David Zetter and Terry Fletcher, discuss front desk collections, making sure you have the right staff at the front desk and billing office to collect those out of pockets and share of costs. How to manage workflows, and how to insure you are getting every penny you are entitled to.

Terry welcomes fellow NSCHBC Member and Healthcare Consultant Anthony (Tony) Werner to discuss reducing administrative burden and costs incurred by meeting payer requirements. Most likely there will be resistance from most payers to incorporate intraoperability terms in contracts, including those required by legal or governmental directives. Terry and Tony discuss the complexities of these discussions and how to be successful in the process of contract negotiations.

There is always competition for patients and location in healthcare, but how do “non-compete” contracts affect patient care? Or a physician’s ability for career advancement? How do different states handle this hot topic? Healthcare Attorney Amanda Waesch and Edge host Terry Fletcher tackle this discussion today looking at the legal and business angles and relationships that will factor into these agreements. Also, are non-compete clauses always valid and enforceable? Listen to find out.

Christine Hall and Terry Fletcher, both SMEs in the Telehealth space, discuss the new rules for 2024, what the flexibility extensions “really” mean to physicians, and what traps of FWA not to fall into. For anyone currently participating in the Telehealth delivery of medicine, this is an important podcast to listen to.

In this month’s episode of the NSCHBC Edge podcast, Terry talks to life NSCHBC member, Kathy Moghadas, RN, CLHRM, CHBC, CHCC with Associated Healthcare Advisors, to discuss where the healthcare industry started back in the 80’s and where we are headed with all of the digital advancements, including AI. Is it all good? Not even close. Listen and find out why!

As you know BH and MH services are now being covered by Medicare and many commercial payers. Also, coverage has expanded like nothing we’ve ever seen. Even Telehealth has made some permanent changes to coverage that is only for Behavioral Health and Mental Health Services. To discuss this topic and to look at the proposed Medicare Final Rule and Fee Schedule for 2024, Terry invites fellow NSCHBC member Sonda Kunzi to the podcast. There are some services that we are concerned about and we are wondering where the specific guardrails and payment policies are.

Cyber Security in Healthcare, focuses on preventing attacks by defending systems from unauthorized access, use, and disclosure of patient data. The primary aim is to ensure the availability, confidentiality, and integrity of critical patient data. If compromised, this could put patient lives at risk. The more we add digital access the more interconnectedness between different healthcare systems comes with increasing healthcare cybersecurity threats. Edge podcast host Terry Fletcher discusses this threat to physician and dental practices with Debi Carr of DK Carr and Associates. Debi brings light to the importance of risk analysis, security compliance plans, and knowing the limitations of your IT department when it comes to this risk. You don’t want to miss out on this important podcast discussion.

In Healthcare, is credentialing the same thing as contracting? No, credentialing is the process of reviewing the doctor's qualifications while contracting. Payer enrollment is the process of applying for and obtaining participation contracts with insurance plans for your provider or entity. Award-winning podcast host Terry Fletcher and Healthcare Consultant Scott Graham navigate through these differences while giving tips on how to be successful in payer contract negotiations and provider credentialing. Join us for these important business of medicine tips.

An MSO is a company that provides non-clinical services to medical practices, ambulatory care facilities, or other healthcare providers. Services provided by an MSO may include some or all of the following: Billing and Collection. Accounts Payable. RCY, Contracting and Credentialing, and Staffing. What can an MSO do for your practice? Can you create your own? In this episode, Terry discusses all options with Healthcare CPA and Financial Consultant Jacki Jacox. Don’t miss this important topic that could provide many practices with administrative relief.

Is your practice considering a merger? Is the phrase “bigger is better” a true statement when it comes to private medical practices? Join us on this episode of the NSCHBC Edge podcast as SME Reed Tinsley CPA discusses the complexities of practice mergers. It’s not an overnight process to be successful in a merger. Reed offers tips to work your way through the myriad of issues and processes.

On this episode of the Edge Podcast, Terry welcomes fellow NSCHBC member Sandy Shecter. Sandy is a CPA and the Director of Solutions for Rehmann, a fully integrated, professional advisory and asset management firm working to empower success for businesses of all sizes and industries. Our topic today is physicians and medical practices who manage their finances in-house. Should they outsource to a CPA who knows the healthcare environment?

In today’s world of marketing, the healthcare provider is sometimes overlooked. Have you asked these questions? In this month’s NSCHBC Edge podcast, Marketing Consultant and SME Expert Carl White joins Terry Fletcher to discuss the best strategy for marketing your practice and where to start.

Is your staff suffering from spring fever? And how can you motivate the “keepers” with the nationwide landscape of staffing shortages? In this episode, Terry Fletcher is joined by healthcare consultant and fellow NSCHBC member Merikay Hunt to discuss the employer-employee relationship, and how to keep the staff you not only want, but also need.

On this episode of the NSCHBC Edge Podcast, Terry welcomes NSCHBC member and Certified Healthcare Business Consultant, Jackie Coult, who doubles as an SME in practice and revenue cycle transparency and negotiations. Physicians: we have your back! Jackie shares her expertise on how to set gross charges, and what the best practice methods are for setting rates so revenue isn’t lost. The hosts also discuss how practices and providers should monitor the payor reimbursement annually so that changes don’t harm your bottom line.

This month on the NSCHBC Edge Podcast, Terry welcomes a new member, Healthcare Consultant Christine Hall, to discuss the importance of Compliance Programs, Policies, and Accountability for actions in a physician’s practice. They discuss how to start the process of implementing a Compliance Program, and what departments need to have clear rules and best practice policies to be successful. Don’t forget the ACA and OIG state clearly that to collect government funds (Medicare payments, PRF, etc.), as it is “required” to have a compliance program in place. Also, commercial insurance contracts now require some kind of compliance program as part of a your contract participation. Are you prepared?

Terry welcomes back, our own “compliance guy” and NSCHBC member, Sean Weiss, to discuss the last-ditch regulatory add of CFR 42, on self-reporting, and the proposed changes to the 60-day rule for Medicare. This means that if you find an overpayment from a federal payer, what is your responsibility to identify it, return it, and what is the timeline? Terry and Sean discuss the ins and outs of this process and the importance of being proactive in your compliance and self-auditing policies.

In this episode of the NSCHBC Edge podcast, Terry welcomes back Healthcare attorney and NSHCBC member Amanda Waesch Esq, to discuss the Single Audit Requirements, for providers and recipients that spent $750,000 or more in federal funds, including Provider Relief Fund (PRF) payments. There is some confusion on who has to report, when and why. Amanda and Terry try and clear up this confusion, and give you the tools and cited references for compliance.

What is PE? At its core, PE is an alternative investment class consisting of capital that is not listed on a public exchange. PE is comprised of funds and investors that directly invest in private companies. Most PE firms invest in companies and then look to sell their stake in 3 to 5 years for a substantial profit. So how does this translate to the Healthcare field with Medical and Dental practices being courted daily by PE investors? Listen to the NSCHBC Edge Podcast this month to get insights from healthcare attorney Bill Kalogredis and podcast host Terry Fletcher to consider your pros and cons options.

How much does the average physician retire with? When is too soon to start planning? What age does a physician usually retire? Did the pandemic change the retirement mindset? Are physicians retiring early due to financial readiness or burnout? Traditional 401(K)s? Pensions? IRA's? What is the right fit for a physician and/or dentist? Listen to this edition of the NSCHBC Edge podcast for all of the answers to these important questions, as Terry talks with fellow NSCHBC member and Healthcare CPA Marc Lion.

Many practices will hire coders for coding jobs or billers for the billing department, relatives or newbies for the front desk, or hire from within to fill RCM positions in Medical and Dental Practices. But when mistakes are made, or updates are not realized, the RCM suffers. Host, and Healthcare Coding and Reimbursement Consultant, Terry Fletcher, joins fellow NSCHBC Member and industry expert, David Zetter of Zetter Healthcare, to discuss staffing issues and problems that can arise when the wrong people are in the wrong job: and the positives and expectations when the right fit happens. Listen to this episode of the NSCHBC Edge Podcast for answers to the right questions.