Talk Ten Tuesdays

Latest Episodes:

EXCLUSIVE: Post-Pandemic Payer Contracting Jun 09, 2020

Show notes

When your team comes to the negotiating table with commercial payers this year, they’ll be doing so in the new normal: the coronavirus pandemic.

Whether contract negotiations come during or toward the end of this country’s most devasting healthcare crisis in a century, this will be a whole new ballgame. Having wreaked havoc on institutions, policies, and procedures, the lingering effect of the pandemic is expected to bring to the forefront unprecedented financial and public health challenges for both payers and providers, affecting the types of agreements both parties can strike.

Reporting our lead story is Terry Fletcher, nationally recognized professional physician coder and auditor. Fletcher will discuss points of negotiation and trends that could impact payor-provider negotiations.

The live broadcast will also feature these other segments:

Tuesday Focus: Susan Gatehouse reports on the need to focus on your compliance plan and isolate key areas related to COVID-19 to ensure fraud prevention and to help mitigate internal risks and external audit reporting.
Mental Health Report: H. Steven Moffic, MD reports on what he perceives as a “double whammy” on mental health: the confluence of the coronavirus pandemic and the impact of climate change on mental health.
The Coding Report: Laurie Johnson reports on the Inpatient Prospective Payment System (IPPS) final rule released last week by the Centers for Medicare & Medicaid Services (CMS).
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD reports on another thought-provoking topic that has captured her attention.

Physician Queries Pending COVID-19 Test Results Jun 02, 2020

Show notes

“In my opinion, as a physician and an ex-physician advisor, I can categorically assure you that it would irritate a provider to get queried to confirm a diagnosis they had already made clinically and documented in a codable format,” writes Erica Remer, MD, Talk Ten Tuesdays program host-turned-correspondent, who will be reporting our lead story during this edition of Talk Ten Tuesdays. “I agree with developing facility-specific coding guidelines, but they should be sensible and reasonable,” Remer added.
The podcast also feature these other segments:

Tuesday Focus: Holly Louie reports on how coders are encountering inadequate physician documentation, flawed facility policies, and misinterpretations of guidelines, all of which are creating barriers, errors, and problems for accurate diagnosis reporting.
RegWatch: Stanley Nachimson reports on the latest regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Missing in Action: Addendums to the Record May 19, 2020

Show notes

If physician documentation is missing or does not support the level or evaluation and management (E&M) service billed, surgery performed, or durable medical equipment (DME) issued, an addendum should be requested from the physician. A valid addendum must be received before the claim is submitted.
Reporting our lead story during this of Talk Ten Tuesdays will be Terry Fletcher, nationally recognized professional physician coder and auditor. Fletcher reports on the need to know how to correctly make these changes, but also, to know the difference between a "late entry" and an addendum to a medical record – and how Medicare's Program Integrity Manual relates it to reimbursement, compliance, and best practices.
The podcast also feature these other segments:

CDI Report: Robert Kopec, MD, reports on when physician queries are appropriate during the current coronavirus pandemic. Dr. Kopec is the medical director of infection prevention and control at Morton Plant Mease in Florida.
The Coding Report: Laurie Johnson has an update on major MS-DRG adjustments found in the proposed IPPS rule.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Safeguarding COVID-19 Reimbursement May 12, 2020

Show notes

Waivers, modifiers, lab tests, multiple diagnosis codes: they constitute layer upon layer of intricacies that could get in way of your reimbursement. That is why accurate COVID-19 coding cannot be overlooked when ensuring appropriate compensation and safeguarding claims against third-party payer audits.
Reporting our lead story during this edition of Talk Ten Tuesdays is Susan Gatehouse, founder and CEO of Axea Solutions.
The live broadcast will also feature these other segments:

COVID-19 Telehealth Update: CMS has issued two interim final rules, including expansion and relaxation of guidelines for telehealth services. The first was issued on March 30, the second on April 30. Kathy Pride, executive vice president of coding and documentation services for Panacea Health, will report on what has changed and where to look for guidance.
Mental Health Report: H. Steven Moffic, MD, returns to the broadcast to report on the impact of climate change on mental health – part of an exclusive series he is authoring for ICD10monitor.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
RegWatch: Stanley Nachimson joins the broadcast to give and update on the recently released IPPS proposed rule.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: COVID-19 Report: Post-Pandemic Fraud and Abuse Coming Soon May 05, 2020

Show notes

It’s coming. And it could soon be spreading, as is the coronavirus: healthcare fraud and abuse. After all, there’s lots of money involved, at a time when waivers have been issued and rules relaxed, as the nation’s healthcare system focuses on fending off COVID-19. These changes include FaceTime, Skype, and telephone calls being reimbursed as telehealth and telemedicine services: a factor that can lead to fraud and abuse on scale not likely to be seen ever before the deadly virus upended processes, practices, and lives.
The live broadcast will also feature these other segments:

RegWatch: Stanley Nachimson, reports on the latest regulatory news coming out of Washington, D.C.
Mental Health Report: H. Steven Moffic, MD, reports on the disparities in the delivery of mental healthcare, evoking the memory of late jazz legend Billie Holiday’s eerily prescient version of the song “Strange Fruit.”
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE BROADCAST: Under the COVID Spell: New Definition for PHI Apr 28, 2020

Show notes

Most of us are working from home now. That’s quite amazing. During the month of July 2019, an estimated total of 4.7 million folks telecommuted, either full or part-time.
Fast forward to the national stay-at-home edict, and now, according to Global Workplace Analytics, those working at home could possibly number 75 million.
So, what new privacy concerns are emerging, with healthcare professionals now working remotely as a result of the lockdown? How is it possible to stay alert, fit, and nimble, while at the same time, being conscious of your work product?
Reporting our lead story during this edition of Talk Ten Tuesdays, while remaining in self-isolation, is Rose Dunn, past president of the American Health Information Management Association (AHIMA) and the chief operating officer for First Class Solutions.
The live broadcast will also feature these other segments:

Healthcare Data Report: Amid the coronavirus pandemic, the need for reliable health information has never been more immediate. Reporting the fourth iteration in his exclusive five-part series will by Joseph C. Nichols, MD, president of Health Care Data, who focuses on data analysis.
Tuesday Focus: How will you and your team manage the after-effects of coding and billing, as COVID-19 cases start to move through an organization’s billing cycle, while maintaining up-to-date information? Susan Gatehouse, founder and CEO of Axea Solutions, reports on this latest development brought about by the coronavirus.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, returns to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE BROADCAST: CDI Increasing in Importance During the COVID-19 Pandemic Apr 21, 2020

Show notes

The costs of managing prolonged ICU stays for COVID-19 patients, combined with lost revenue from decreased ambulatory visits and the cancellation of elective procedures, will have health systems and provider groups emerging from the ongoing pandemic with significant financial challenges.
It will be more important than ever to ensure that clinical documentation reflects the true complexity of care being delivered. Reporting our lead story during this edition of Talk Ten Tuesdays will be Matt Lambert, MD, an emergency medicine physician and the chief medical officer for Curation Health.
The live broadcast will also feature these other segments:

Mental Health Report: H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on the impact of climate change on mental health – part of an exclusive series he is authoring for ICD10monitor.
Tuesday Focus: The Centers for Medicare & Medicaid Services (CMS) recently announced expanded coverage for essential diagnostic services amid the COVID-19 pandemic. Susan Gatehouse, founder and CEO of Axea Solutions, reports on this latest development.
Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will return to the broadcast to report on another thought-provoking topic that has captured her attention.

Medical Necessity versus Medical Decision-Making Apr 14, 2020

Show notes

Medical decision-making (MDM) and medical necessity are not the same thing. MDM specifically refers to the complexity of establishing a diagnosis and/or selecting a management option. Medical necessity refers to the appropriateness of the service provided for a certain condition. But which determines how you get reimbursed, when many healthcare professionals use these terms interchangeably?
The live broadcast will also feature these other segments:

Mental Health Report: H. Steven Moffic, MD, one of America’s foremost psychiatrists, returns to the broadcast to report on how best to test your survival skills during this challenging time in our daily lives.
Tuesday Focus: Susan Gatehouse, founder and CEO of Axea Solutions, reports on the Families First Coronavirus Response Act enacted on March 18, the Act was passed in response to the COVID-19 pandemic.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, returns to the broadcast to answer many of the COVID-19 coding questions that came in from previous broadcasts.

EXCLUSIVE: World Health Day in the Midst of COVID-19 Apr 07, 2020

Show notes

The confluence of the global COVID-19 pandemic and the World Health Organization (WHO) designation of April 7 as World Health Day is fast approaching.
Nonetheless, the organization is asking its global partners to take the time to recognize the work of nurses and midwives, acknowledging the “critical role they play in keeping the world healthy,” marking the raison d'être for the International Year of the Nurse and Midwife.
Reporting our lead story during this edition of Talk Ten Tuesdays Lorraine Fernandes, president of the International Federation of Health Information Management Association (IFHIMA), who says that “World Health Day gives us a unique opportunity to explore the ways IFHIMA supports their 23 member nations and other members, including individuals, corporate and educational institutions.” Fernandes will also report on initiatives to advance the IFHIMA mission: “a healthy world enabled by quality health information.”
The live broadcast will also feature these other segments:

RegWatch: Stanley Nachimson, former Centers for Medicare & Medicaid Services (CMS) career professional turned well-known healthcare IT authority, reports on the latest regulatory news coming out of Washington, D.C.
The Coding Report: Laurie Johnson has an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will return to the broadcast to report on another thought-provoking topic that has captured her attention.

EXCLUSIVE: Social Determinants of Health and 2021 E&M Codes Mar 31, 2020

Show notes

Eighty percent of what influences a person’s health is related to non-medical issues such as food, housing, upbringing, social support, and income. These socioeconomic and psychosocial circumstances are known as the social determinants of health (SdoH). With the goal of allowing physicians more time with their patients, the American Medical Association (AMA) has made significant revisions to the Office and Other Outpatient Services New and Established Evaluation & Management (E&M) categories for 2021.
During the next live edition of Talk Ten Tuesdays, Collen Deighan will report on what you need to know about this unique coding topic, and how the SDoH are addressed in the medical decision-making component of these revisions to drive proper payment and impact all patients’ health and well-being.
The live broadcast will also feature these other segments:

The Coding Report: Laurie Johnson will have an update on the deadly coronavirus that continues to dominate international as well as domestic news headlines.
News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.
Tuesday Focus: Data Deep Dive: Dr. Joseph Nichols returns to the broadcast to report his third installment in his exclusive five-part series for ICD10monitor on healthcare data.
Special Report: COVID-19 has impacted the lives of people around the world. Over the past few weeks, many healthcare professionals and colleagues have had to switch to working remotely, from home on the fly. Working remotely has clarified what successful and sustainable remote work requires. Terry Fletcher will provide tips for those who are now working from home.
TalkBack: Erica Remer, MD, returns to the broadcast to discuss how to stay sane and well during quarantine.

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