Healthcare Inspired

In this episode, we will explore the challenges that the healthcare industry faces in today's rapidly evolving landscape. Join us as we uncover the intricacies of these challenges and discuss potential solutions to improve the overall state of healthcare.🔹 Understanding the Complexity: Gain insights into the intricate nature of the modern healthcare landscape and how it impacts patients, providers, and the industry as a whole.🔹 Bridging the Gap in Patient Care: Explore the barriers and gaps that hinder seamless and effective patient care delivery. Discover innovative solutions and strategies to overcome these challenges.🔹 Financial Strains on Healthcare Providers: Delve into the financial pressures faced by healthcare providers and the impact it has on the delivery of quality care. Uncover potential approaches to alleviate these strains while maintaining sustainable healthcare systems.🔹 Innovative Solutions and Strategies: Learn about cutting-edge technologies, transformative models, and best practices that are revolutionizing healthcare delivery. Discover how these innovations are addressing the challenges and transforming the industry.Join us on this captivating journey as we uncover the challenges, explore opportunities, and inspire positive change in the healthcare industry. Tune in to the Healthcare Inspired podcast and be part of the conversation!Learn more at www.healthcareinspiredllc.comOur Services: Gain insights into the range of services provided by Healthcare Inspired LLC. From consulting to technology solutions, we offer comprehensive support to healthcare organizations striving for excellence. Learn how our services can help you overcome challenges, improve patient care, and optimize operations.Hiring our Data Team: Find out how you can leverage the expertise of our skilled data team. We discuss the importance of data analytics in healthcare and how our team can help you unlock valuable insights from your data. Whether it's optimizing workflows, identifying trends, or improving decision-making, our data team is ready to assist you.Upcoming Events: Stay informed about the exciting events on the horizon. We highlight our upcoming conferences, webinars, and workshops where healthcare professionals, thought leaders, and industry experts come together to share knowledge, exchange ideas, and drive innovation. Be sure to mark your calendars and join us for these enlightening events.

In today's episode, we discuss the Impact of Front-End Denials to explore the significant repercussions of front-end denials in the revenue cycle. Join us as we delve into the causes, consequences, and potential solutions for reducing front-end denials. Experts and industry leader Maya Turner shares her insights and experiences, providing valuable knowledge to help organizations overcome this critical challenge. More about Maya With over 27 years of comprehensive experience in healthcare coding and reimbursement, Maya Turner is a highly skilled professional known for her exceptional analytical abilities and extensive knowledge of AR management. Maya's expertise spans various domains, including inpatient and outpatient billing, E/M coding and compliance, SNF/LTC billing, DME, high-end collections, HCC coding (Medicare risk adjustment), commercial third-party payers, and Medicare Parts A and B, along with Medicaid. Maya's superior proficiency extends to outpatient medical records abstraction, encompassing multi-specialty and sub-specialty coding and compliance. She possesses a deep understanding of payer mix reimbursement, HEDIS, ICD-9, CPT, HCPCS, and (MDS 2.0) RUGS-III. Furthermore, Maya has a proven track record in designing coding and compliance curriculum, as well as delivering training tailored to address denial trends and analysis. Recently, she also obtained certification in ICD-10 training, further enhancing her already vast skill set. Maya Turner brings a wealth of knowledge and practical experience to the table, making her an invaluable asset in the ever-evolving landscape of healthcare coding and reimbursement. Her dedication to excellence and commitment to staying up-to-date with industry standards make her a trusted expert in optimizing revenue cycles and ensuring compliance in healthcare organizations. Episode Highlights: Understanding Front-End Denials Definition of front-end denials and their key characteristics. Discussion on why front-end denials occur and their impact on organizations. Causes of Front-End Denials Examination of the root causes behind front-end denials. Discussion on issues related to eligibility verification, prior authorization, and patient information accuracy. Strategies to Reduce Front-End Denials Identification of best practices and strategies to mitigate front-end denials. Implementing effective patient eligibility verification processes and tools. Learn more from our host and guest at the upcoming Practice Management Symposium on October 5th! Get Tickets Now! --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcare-inspired/message

In this podcast episode, we explore the concept of patient-centered healthcare and delve into the topic of in and out of network benefits. Join Jennifer McNamara and Maya Turner as they discuss the importance of putting patients at the forefront of healthcare decisions and understanding how in-network and out-of-network benefits can impact healthcare coverage and costs. Our experts will share insights and tips to help you navigate the complexities of health insurance and make informed choices for your medical needs. Tune in for a comprehensive and informative discussion on this crucial aspect of healthcare. Need CEU's and additional opportunities for growth in Healthcare? Join us for the upcoming Virtual CDI Awareness Conference on September 14th and 15th. That's right, this conference is fully online, so you can attend from anywhere in the world. This two-day event is packed with valuable insights and expertise from leading experts in Clinical Documentation Improvement. We'll be covering a wide range of topics related to CDI, ensuring you stay up-to-date with the latest trends and best practices in the field. And here's the best part – you can earn 15+ CEUs (Continuing Education Units) just by participating in this conference! Stay ahead of the curve and fulfill your educational requirements all at once. Whether you're a seasoned CDI specialist or new to the field, this conference is designed to cater to all levels of expertise. Learn from the best and connect with like-minded professionals to broaden your network and exchange ideas. Registration is now open, so secure your spot before it's too late. Head over to our website and sign up today to join the CDI community at this exclusive virtual event. Mark your calendars for September 14th and 15th, and get ready for a knowledge-packed experience that will elevate your CDI skills and career to new heights. Don't miss out on this fantastic opportunity! --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcare-inspired/message

In the final part of our denials series we dive deep into the world of coding and backend denials. If you're a medical coder, biller, healthcare provider, or just someone interested in the healthcare revenue cycle, this episode is for you. Join us as we explore the challenges and nuances of coding denials – those frustrating moments when insurance claims are rejected or disputed. Our experts Maya Turner and Jennifer McNamara will unravel the complexities of coding guidelines, documentation requirements, and compliance issues that often lead to claim denials. We'll also shed light on the critical role of accurate coding in ensuring that healthcare providers are fairly reimbursed for their services. In each episode, we'll cover: Understanding Denials: We'll dissect common denial scenarios, exploring the reasons behind them and providing insights into how accurate coding and documentation could have prevented these issues. Coding Guidelines: Dive into the world of coding guidelines for various medical specialties, discussing best practices, updates, and potential pitfalls. Documentation Excellence: Learn how proper medical documentation not only supports accurate coding but also strengthens your organization's defense against denials. Appeals and Resolutions: Explore effective strategies for appealing denials, interacting with payers, and navigating the appeals process successfully. Preventive Measures: Discover proactive measures to minimize denials, streamline the billing process, and optimize revenue cycle management Tune in and empower yourself with the knowledge and skills to conquer coding denials and contribute to a smoother, more efficient healthcare revenue cycle. --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcare-inspired/message

In this episode, we delve into an insightful discussion. From specialized skills to leadership development, we cover the spectrum of growth opportunities within healthcare. Today, we have a special guest joining us - the incredible Dr. Lisa Campbellhttps://www.linkedin.com/in/drlisalcampbel. With a wealth of experience in the healthcare field, Dr. Campbell will share her insights on leadership, its challenges, and the remarkable impact it can have on patient care and organizational success. She brings a wealth of wisdom, empathy, and practical insights that will resonate with listeners at every stage of their journey. Episode Highlights: Discovering Your Passion: Uncover the key to a fulfilling healthcare career by aligning your passion with your profession. Navigating Career Transitions: Learn how to successfully transition between healthcare specialties or move from a different industry into healthcare. The Heart of Healthcare: Sr. Lisa shares heartwarming stories that remind us of the true essence of patient care and the impact healthcare professionals can make. Leadership and Mentorship: Understand the pivotal role of leadership and mentorship in shaping your healthcare career trajectory. Balancing Compassion and Self-Care: Explore strategies for maintaining your own well-being while providing exceptional care to others. Excellence in Action: Dr. Lisa's personal journey to excellence and the invaluable lessons she's learned along the way.

In this compelling episode, we go on a transformative journey of a healthcare manager who becomes a patient. Our guest, Kelly Luby shares her personal story of transitioning from a role of authority within the healthcare system to a position that demands vulnerability, empathy, and a deep understanding of patient advocacy. Join us as we explore the challenges, insights, and profound impact this experience had on reshaping perspectives on healthcare. Episode Highlights: A Shift in Perspective: Explore the pivotal moment when Kelly Luby, a seasoned healthcare manager, found herself on the other side of the healthcare system as a patient. We will explore the initial challenges and emotions faced during this unexpected transition. Empathy in Action: Learn the ways in which Kelly navigated her healthcare journey with newfound empathy, understanding the patient experience from the inside. We will share anecdotes and insights that highlight the significance of empathy in healthcare management and advocacy. Challenges and Lessons Learned: Uncover the unique challenges Kelly encountered in advocating for her own healthcare needs. Hear the lessons learned and how these experiences have influenced her approach to healthcare management and patient advocacy. Impact on Professional Practices: Find out how this personal experience has shaped her professional practices as a healthcare manager. Learn the broader implications for improving patient care and the importance of bridging the gap between healthcare providers and those they serve. Speak with Kelly Luby and Others at the upcoming Practice Management Symposium on Feb 16th, 2024. Tickets On Sale Now! --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcare-inspired/message

In this episode of Healthcare Inspired, I am joined by Barbara Shaw a leading CDI and Risk Adjustment expert and we will discuss the role that documentation plays in the AI within the business side of healthcare. As technology advances, we need to explore the impact of documentation and discuss how coders can elevate their approach by adopting an auditor's mindset. Show Highlights: The Impact of Documentation in AI-driven Healthcare How AI is reshaping roles and responsibilities across healthcare Spotlight on coders and the importance of adopting an auditor's mindset Real-world significance of clear and effective documentation. We encourage listeners to embrace the future of technology and documentation. Tune in as we navigate the intersections of technology, healthcare, and the transformative power of documentation. Let's embark on the journey together and make documentation great again! Learn more from industry leaders at the upcoming Business of Healthcare Colloquium November 11-12 --- Send in a voice message: https://podcasters.spotify.com/pod/show/healthcare-inspired/message