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Sickness billing format for Administration

d [Music] [Music] n [Music] [Music] [Music] [Music] right [Music] [Music] d [Music] hello hey guys what's going on happy Thursday it is almost Thanksgiving Thursday we'll call it that um we've got like another week and change and then it's officially the holiday seasons if you don't count Halloween I kind of like to count Halloween I think that's the big kickoff because then time just flies by after Halloween so it's so great to see some of my ogs in the house craft decoder is here hello craft decoder BC Nelson AA hello thanks so much for being here we are so excited that you're here oh I see the little popup about um you Facebook name approval thing I don't know what exactly it looks like for y'all on the Facebook side but basically Facebook wants you to approve your name if you want to write a message so if you say anything from Facebook it might show Facebook user unless you mark that little approval that's what it's telling us here but okay so hello Karen great to see you is it Divine Missy I like it Divine Miss and maybe it's divine Missy Missy Missy blue butterflies back hello it's always great to see you friend thanks for being here o Karen coming in coming through with a new membership yeah I feel like we need like um a a sound or something like that we get a new membership so thanks for joining the community excited that you did that you made that choice so let's see oh I said it right oh okay I was right so Divine misses I like it I like it hi tan thanks for being here thanks for being here so um my friends we are in the holiday season um what do you look forward to when you're in the comments here let us know what you look forward to for the holiday season oh Nicole's putting a comment in here look forward to putting up oh excited put oh it's the very first time that's exciting that is exciting you just like piggyback got use your your parents before is that way you just visit the the parents and the in-laws I love that I love that so um I I'm excited about that too I feel like the decorating is probably my favorite part like getting the house like holiday ready um and so we're doing that this coming Tuesday with me and my kids so I'm excited about that random um day to be doing it but my daughter works a couple of jobs so like let's just do dinner on a Tuesday night and and put up decoration so so we're excited to do that um so what is y'all's favorite uh thing to do for the holidays or most exciting I don't know I don't remember how it was written and I'm waiting for it to scroll it's not scrolling fast enough what's your favorite holiday transition tradition what are you looking forward to this holiday season sorry you guys um y'all know me by now hopefully um if you're new here and you don't know who I am and you're like why is this random girl on my screen um I'm Jasmine welcome this is in Lara University in this space we work we focus to alleviate this alleviate alleviate the stress and confusion in the business of healthc care um I was told by um someone recently that I make healthc care which is like I'm good with that I think I think that should just be my tagline I feel like Ona lar University we make healthc care cool that's I'm good with that because you know what Healthcare Miss is missing out on like all of the really great on this on the on the business side especially all the really great innovative ideas and um and I don't know sometimes we're missing the kind people in certain practices and organizations um we're missing like people that maybe are kind of heart forward ironically on the business side of healthcare um and maybe sometimes even on the clinical side of healthcare um it's unfortunate truth but yeah so if we're if we could make healthc care attract the people who are doing all of the good and um out in the in the other Industries bringing bringing some um energy and love and compassion into those spaces um we'd like to make Healthcare look cool and um do that in the business of healthcare so I'm good with that so I am uh excited that you guys are hanging out so definitely decorating the house yeah exactly warm cozy and festive so today it feels like winter in Charlotte which we don't get usually this early but it is really cold it's also very rainy and very gray so we are officially in the holiday season in Charlotte I think it's our first what I would consider our first Like official holiday season day so um let's see I I missed a comment here oh so thankful for Nicole's assistance this week and was looking forward after session the after session today to assist with deciding our course today yay is that how did you say this okay Nast Nastasia n Nastasia I like your name it's very cool I hope I got that right I uh I'm brave with trying the names then I feel bad if I get if I butcher it so please know that you are welcome to correct me and send me like the pronunciation back so oh Nastasia I like it nastasha okay very cool thanks so much thanks so much for that all right the our pups birthday is Christmas Eve so our family stuff is done we have that is adorable that is adorable I've always wanted to be a a four-legged Mama that remembers the day to celebrate the animal I really I really have not W I've not done a great job of that though though to in my defense I haven't really owned my own dog like I dated someone who had a dog as an adult um I've had cats and cats I don't think they're as depends on the cat of course I have a friend who has a cat that they like photograph all the time and they put them in all these different costumes and things my cats have not been like that um I have cats that like to be independent and you know they want you around when they want you around kind of moments um but yeah like I have not had a dog that I could actually like remember their days their special days their birthdays so that's exciting and my C also doesn't really care didn't really care for treats um so like whatever I had a cat too who didn't like um what's it called hi de de's jour Deeds de's de I think I got that right hopefully de's Journey um I had a cat who didn't even like what is that called catnip like what why why not cat was like no for what so this is adorable Nicole will appreciate this Nico Nicole's a Big D and D fan so what year did this where we did dinosaurs and dragons dragons and dinosaur is that a backwards that's cute super cute I like it Nasha hello Anonymous growth hello hello I love it I want to rescue a be a dog mom oh you should you know they do during and I don't know if this is true in your city but you could check a lot of the shelters especially during this season um get full because people are busy doing what they do um with holiday seasons that they don't get a lot of folks who do like the weekend fostering um so there's a lot of um different types of foster communities or shelters and stuff that will'll do like weekend Foster so you can just schedule your weekend little kind of stay in babysitter you know you can be like the fun auntie and pick up the the pup from the uh from the um shelters and the um foster agencies love it I couldn't think of the name I can't think of the name while I was talking I was trying to think of the name of the organization here locally in Charlotte I feel like it's my bra is saying SPCA is their like acronyms is that right okay ni giving me thumbs up I don't remember what it stands for though but SPCA is the one that I know does a lot of um work here in Charlotte so um love that so oh hello Belinda so great to see Karen I'm a dog mom I have two grand puppies that's adorable that's adorable yeah yeah they still do it actually um well it it depends on the area but like in Charlotte we're overcrowded and so what ends up happening is they um ask for people to take the the babies home you know because they don't have space so they just will you can like rent the weekend or whatever um You can reserve the weekend I should say rent the weekend sounds really funny so all right my friends okay so thanks continue to say hello and um answer the question of the day we are going Back to Basics I like to do that a lot during this time of year because we have a lot of new folks who are exploring new career paths and so I know there's some of you in hero OG's my my Reliance and and desire for y'all is to stick around and help our newbies out and weigh in on all the things um because you know this hopefully by now that this is a community effort we are trying to uh to get people excited about doing the good work in the business of healthcare that are really focused on supporting our patient Journeys right so folks that really care about what they're doing care enough to understand more deeply what they're doing in the um in the business of healthcare and so or health care administration I've been I should use the word healthcare administration more so I'm GNA use that that that phrase more um you know I have my own opinions of like the the term healthcare administration but I do believe that it is very relevant and important well I I was um it was a vot a vote was taken is that how do we call that is that yeah poll was taken Jasmine is wrong that healthcare administration is not an intimidating word for people so um but we are going to start using it more because I want you guys to get familiar with it especially my folks who are looking for positions you're not going to find a whole lot of positions that say um business of healthcare so there's that so that's that's the reason why we uh we spoke about um the whole topic of healthcare administration so oh okay I this question here I'm not sure I can answer it today um but do I do do I know how to use e-clinical Works um and can I teach you an interview with the client on November 23rd that's exciting what is that that's next next Saturday November 23rd okay that's exciting so here is the the truth is that um I can't teach you EC okay so most people call it ECW for short I can't teach you ECW because I do not have access to ECW right now plus it would be like a situation of like Phi violation if I like log you into someone else's so um I don't have a way to to show it to you um to teach you exactly kind of how to use it I'm going to be totally honest is in order for you to have a conversation with a client and support them in understanding I'm sorry to let them know that um that you can support them in I'm hoping their billing or or at least clean up or something like that you really need to have just good communication around what you will do when you get access to their software right you don't at this point you're you're meeting with a new client I imagine you're not going to hop skip and jump to providing solutions for them right away so at least that's what I hope um so you're if you do that sign a baa first and um get right into and hopefully you have enough experience to be a little dangerous meaning you might be able to navigate um around the system fairly easily uh if not they might be someone in the Facebook group that could help you that's probably um yeah oh that's good that's really good advice too there might be some people out there um there might be some YouTube tutorials ing to Wendy's that's a great some some great advice I would imagine ECW probably has some themselves that are public as well just so you know what the orientation is um the actual interface I don't love it I will say that you can find your way around if you've seen a software and you like to Tinker with things and hopefully you're in medical billing so hopefully you like to Tinker with things that's what we do a lot of um and so you get in there and you click around you kind of know what you're looking for um you're probably looking for denials you're um there they have like their denial work list type thing in there you're looking for the AR um you know any sort of backlogs making sure that like their their um Clearing House is set up correctly things like that so that is literally just me shooting from the hip trying to go off of like memory um which is not so good but um but yeah I do believe they have they function off of work lists including like a work list for claims rejections and things like that too but like I said you could totally post something in the Facebook group medical billers Network on Facebook the links should be somewhere down in the video this video or other videos um as well that can get you into the Facebook group if you're not in there and my friends we have so many people in the Facebook group who have not been accepted because they haven't answered all the questions or like approved the rules like you have to answer all those questions for us even if the question is I mean the answer is no um part of it is know it's kind of annoying but it's really us trying to um avoid Bots getting in and also um spammers people that just go in and just randomly spam Bots spam Bots too um can do the same thing so they get in there and they just like you know post a bunch of random stuff that none of us really care about so um so trying to preserve the community it's hard for us to tell um Unfortunately they get really really good so um let's see um uh I am trying to I was trying to remember the learn to set boundaries um trying to Oh Nicole is saying okay she she's going like this to me oh oh what advice did was you before you started out Nicole's going in the camera I'm like I don't know this word oh okay I love it okay okay I asked another question apparently thanks Nicole I missed that other question that my avatar asked I like this yes learn to set boundaries Todd is um yes boundaries boundaries are so and you know what setting boundaries can sometimes be easy but holding to those boundaries that you set sometimes is more difficult so I would add to that to say set and maintain the boundaries that you've chosen um that's probably the the the harder task especially when things kind of sound really tantalizing and exciting when dangling the carrots for us you know so um I hear that I hear that um let's see can you can medic can you Medicaid can Medicaid patients foree March Madness here I think you're going to need to reword that for me can you medicate am I unless I'm reading this I'm I understand NCD as Medicaid um is that correct and then Co I know what coob is but court can Medicaid patients coordinate benefit with commercials is that let me know if I'm interpreting that question right please um and we can come back to it so re rewrite it or expand on it a little bit for me and then we can um come back to it so let's see all right I I'm going to our little quick presentation uh in a second so yeah maintain the boundaries is the hard as uh love got love that um let's see I def recommend joining the Facebook group go a that is so amazing I love that that is so so great I feel like Nicole you need to save this you guys can always share amazing celebrations and feedback and testimonials we love hearing it it keeps us um what's the word fire in our belly that's how I will say it it keeps us excited and passionate and you know doing because you guys maybe don't know this but this world takes a lot of effort to consistently do things live and uh do content production in general um and it's not always there's not always like equal payoff for the effort so just gonna say that um just as like a some of the things we love to do and we do it because we love to do it um and yeah that's my that's my um soapbox so can you build Medicare patients can you build what can you build Medicare Medicaid patients for what can you Bild Medicaid patients for um I mean so you're not supposed to balance Bill Medicaid patients if that's the question um if they have certain types of policies but there are patients that have like Medicaid is such a it's a hard it's a hard topic to answer with like a straight answer because Medicaid is product based so Medicaid is contracted to a lot of different companies and each company has different plan allowances and things like that so I can't really say black and white I would say that if it is not something if the provider is Medicaid um eligible and the patient has um like no co-pay because of the um because of their level of Medicaid then you're not balance billing them but if that and it's it's like direct state plan so it's such a loaded question in my like to be able to answer black and white so I'm going to probably say and if anybody has a better answer um than what I'm giving that maybe we could give U March Madness that would help me I'm like while I'm speaking trying to wrap my head around how to the the types of plans that Medicaid offers and a black and white answer but it's not coming up for me at the very moment um I'm just checking to see if anybody else answer I see other comments okay hi Dana hello another member let's see even though I'm an extra season a I love that extra seasoned biller I would I would say you're in good company extra seasoned billers you love the group I we love you back thank you for um yeah billing is so not likeing yeah especially Med so Medicare I feel like truth if it's Medicare I could be like oh let's just look in the you know either the ncds or the LCDs and we can figure it out right because even though there's contractors like the they have those rules spelled out Medicaid isn't isn't exactly the same so yeah it's very very and yes billing overall is not black and white so um yay that's so awesome thank you for celebrating you divine misses thank you so much for uh for joining the community so um I'm going to get into thise presentation quickly okay so here's the deal is I'm going to disclaim my OG's most important thing is that y'all y'all I know y'all know this stuff okay my desire is for you guys to give lots of insight and input and even if it's just like yes that's right or no Jasmine that's not right or you know whatever just weighing in would be super helpful I've had a lot of comments come through for people that are brand new to billing and 've been looking at some of our older videos and some of them were like I'm just so confused can you please right so it's like go through this can you please give a a more visual support so I I know that most of us don't love when Jasmine pulls out the presentations I'm trying to move it differently but um what you guys don't love it when I get the presentations out but I do I do recognize that there are folks that need visual support and so um I have to do this and I only have a couple of slides um so it's not it's not going to um going to be the whole rest of the session together just put it out there because we stopped doing a lot of the presentations because as we looked at the analytics we realized you guys don't like it when we do presentations and so I'm just claiming that there's literally like three slides on this presentation I'm G to be talking more but there's um there's definitely um less time spent on the presentation so uh first thing to know is in healthcare we talk a lot about this idea my friends who are in the world of billing we sometimes fall into the the term medical billing as like a universal term and it's really really important to recognize that there's something broader than that right so we're not we are not just in the medical billing industry right we're in healthcare of course and we are the ones who are deep in the revenue cycle okay a lot of us and I say this us because for years in medical billing I never even heard the term revenue cycle or revenue cycle management really wasn't until I started to look at management and you know get really clear about my understanding of management because I was a manager before I really understood what a manager did it was just my boss was like we want you to be the office manager because you've got all the skills and and they kind of groomed me they taught me groomed me sounds so bad they they taught me how to be that word has forever changed for me um they taught me how to be a manager for their practice now I eventually went out to to get training and things like that but really wasn't until I went into the the um training for practice management that I understood this idea of revenue cycle um because it just wasn't really talked about when we're in the weeds of medical billing so why does it matter for you to know revenue cycle is if you're deciding to go any further than where you are in medical billing it's so important that you understand the full picture like if you don't understand where you fit in then there's no way for you to expand from there right what's happening is you are you're going to stay in in the weeds of what you're doing so there's possibility that let's say you're doing I don't know authorizations or you're doing payment posting or something right something very specific in the revenue cycle in medical billing right so when I say that it's basically like Health Care revenue cycle medical billing right it's like they're all a part of the same thing that is the business of healthcare healthcare administration healthcare administration and we're gonna get get more um specific right we're talking a little bit more specific but right now you might be working in one very very targeted area and if you only know what you're doing in that area then and you don't really understand what other folks are doing you you may not know how what you you do fits into the broader picture and how what you do can either make or break the rest of the revenue cycle if you understand what you do and how what you do well can impact the next um the next person's role or even you know start of the revenue cycle can change or how it can it how what happens before it comes to you if improved can actually make your job more more easily um flow more easily then there is a chance that you can be elevated to another role because people see that oh you understand what it takes to not just excel at your role but to hopefully save the company organization some resources so that we don't have to have people trying to screw this light bulb in right so we're not trying to have all these folks that are trying to uh fix constantly things and instead we're working to prevent things from happening all right so yeah yes my business are Reven ccle management yeah I love that and that's so it's interesting there's this argument billing World um we a lot of us as billing companies have they are stayed away from this term revenue cycle management as the marketing term because it doesn't SEO as well which means like you know you're look search engine optimization basically is like the way that people search for information online right um and medical billing companies and medical billing medical billing services all of that um SEO better so we stayed away from that phrase unless you were looking to attract Hospital size um practices and small Hospital groups and Hospital siiz practices right um or flip that whole thing around basically larger groups people that specifically use that terminology internally um a lot of practices are so accustomed to using medical billing and medical billing services and medical biller and things like that and so there isn't always um a a clear benefit to us so uh I love that you're using it I think that it is important that we continue to expand what we do beyond the medical billing especially if you're someone who is wanting to have a more integral part in your client's um practices an organization right that whatever is happening for their practices you want to actually help improve the overall function of their business revenue cycle management is a great way to position yourself right because you that means you understand and the bigger picture just like I was just painting right so like it yeah exactly yep yep it say she apart from just villing company yeah exactly yep so you get the full the full scope and it helps people see clearly right that you understand so much so much more um I see some other comments here but let's see yeah I like that not just Miller hash just so so real yeah some coders don't know the revenue cycle either I know no it's real this whole the we grew care especially the business side of Healthcare in silos and which means for my folks who are new here this basically means that we're kind of like narrow focused right we're like these these groups these folks do this and they don't know what these people do they but they're over here and they only do this right and so there's this um very disjointed way that Healthcare had has operated for a long time that doesn't always connect and I'm not saying that it's healed we are far from that being like a thing of the past um it's certainly something that has the potential and maybe that's what you guys are here for is to continue um allowing that um that healing to take place I got to take my bracelets off I swing my hands around a lot and then it dingles dangles and makes a lot of noise in my in my own ear um so so yeah so I feel like um you guys have the potential to make it to improve it right to make it better so Gabriel hello um okay I don't know what that means but cool hospice department for a year and a half thank you for sharing that all right um let's see Anonymous growth please tell me what I should choose for a long-term career credentialing Reven cycle management work big question um all right I'll give you my quick um answer and then I'm going to jump back into the revenue cycle conversation more specifically credentialing is a very narrow Niche revenue cycle management is more broad there's a lot more going on um credentialing has the potential for you to work both with practices serving the medical providers helping them get their credentials and also get contracts with insurances and you also can work with Hospital systems that have credentialing departments I don't know where you're located but a lot of the credentialing departments for the hospital systems are internal or state side they have contractors that are here in the states um if you want to look at all into more details about Contracting there is an organization called nams um I think just looking real quick because I forget the yeah n a m as in Mary and SS as in sam.org Nicole can put the the link in for us nams is an organization that that focuses on credentialing and they focus on credentialing for both Healthcare organizations meaning the hospital systems themselves um and I'm sorry educating people who do credentialing um and they're like an association for folks who do credentialing for organizations and for medical providers um for Contracting and things like that so if you're interested in looking in a credential link again it's a very narrow Niche revenue cycle manager is more broad there's more opportunities in revenue cycle management though if you're someone who um wants to get a contract um or work for a hospital system with great benefits and all the things credentialing might be where you want to go and it and there's there's a long a long just like medical billing World um there is a a long way we are a long way from it being um heavily consumed or supported by technology there's just so many nuances with when we're talking about credentialing that that um take place both in the healthcare organization side and on the insurance side that are very manual so um you also have to like paperwork I should mention that very very paperwork heavy so um uh and a hold on I forget um yes uhuh yeah that's right Nicole sorry nams if you type nams and then credentialing into the browser that's what I typed it it came up nms.org I think was the website all right um sorry is asking me an internal question to make sure that she that she sends the right link to y'all okay so healthc care revenue cycle what is it it is the way that money is generated and moves through Healthcare organization or practice with the starting with the creation of a patient's appointment through to payment and I've changed this a little bit from some of our old presentations because I think it said creation of a patient's account that isn't as specific as it could be because a patient doesn't have to have an account to have an appointment um and be scheduled and technically revenue cycle it starts when the patient is scheduled actually starts when the patient um gets referred though the new practice may not know that they got referred until um if they don't have an electronic refr system until the appointment actually excuse me actually shows up on the practices schedule itself so um my thr is telling me I need water so give me a second okay all right my friends so here is a diagram that I share quite often when it comes to revenue cycle various different iterations of this that I've done this one is different in the sense that it has um areas highlighted that kind of illustrate more medical billing versus the revenue cycle because the whole thing is the revenue cycle so starting at the top here the patients drop in from the referral and then it rotates clockwise right now we are referral patient scheduling and then sometimes even the patient visit encoding is not touched by the medical biller all right so if we find that a patient has um sorry that a practice has a medical coder that also does the bill and things like that um or medical biller coder that's involved in all things that takes the claim the rest of the revenue cycle then we might see someone um that kind of starts the medical billing at this stage but the rest of this and I'll go through them is our medical billing responsibilities so it's really helpful to to pull up this diagram when we talk about medical billing versus revenue cycle because um again I really want you guys to understand that it is the whole picture Health Care revenue cycle being kind of that business side the backbone of the Health Care System the part where the money is generated and moves through the system without the money generated unless it is a get federally funded program meaning like the government funds it in some way um the money generating is the backbone it's the thing that keeps the medical practice organization open right so that's why I call it the backbone so we talk about Healthcare we are then moving into revenue cycle that the the business of healthcare the the backbone of the practice and then we go a little bit deeper into medical billing and so when medical billing um started a lot of the the language really wasn't like wasn't clear um as far as like separating the two and I'll explain this as like we started out with medical billing and coding as one thing coding was not as complex as it is today all right we have gone from ICD9 to ICD 10 some years ago now it's been a minute it's been a minute now um we've gone from having practices that did a lot of stuff on paper and the coding would go out in variety different ways or the claims would go out in a variety of different ways um to us now having everything go electronically and our practi is mostly having electronic uh medical records and health records all right I'm not going to talk about the difference the two right now there is a difference between the health record and the medical record but um EMR and EHR were not not as heavily in existence about 10 years ago now um there was a there was Big Money pushed into the industry through an incentive that came out asking our providers to invest oh I'm getting a popup asking our prior to invest in um does it sound okay canical yeah kind of weird all right I'm getting like a a connection error randomly it just started out of nowhere hopefully it's okay all right looks like it's growing hopefully it's getting better um but basically that when that pushed money into the industry it started moving or migrating our doctors to having um a lot more EHR but before that there wasn't as much there were not as much um there was not as much technology that drove Healthcare forward and when the healthcare started um wanting to standardize the birth of ansy a lot of other there's a lot of other history back here I'm not going to go too far down that um basically the health healthc care as a part of hipa as a matter of fact it's been a long time that was 1996 um but Hippa basically was the the launching point for all of the standardization and simplification that started in healthcare and that's what brought about like the need for procedures like when I started in healthcare you can believe this is hilarious when I say this um there were times that we didn't actually have to send CPT codes in like you could actually write in a procedure without having a pro a CPT code that was like a miscellaneous procedure and give them like a explanation of what it of what it was um very different time very different time that's not really possible in exact terms now um because at that time we actually even could send in um invoices like kind of what if you guys do billing to like uh medical expense carriers and auto carriers back then you could actually send in an invoice instead of a claim instead of something that was standardized right so things have changed and as they've changed the the the along with those changes to be able to push us to use more technology which is wonderful because we needed it and when the technology became available we we needed to use it as that has started it also required us to have our own language so coding is our own language right and coding they realize like we started out our language with ICD we're gonna talk about ICD9 not gonna go before that but ICD9 had a lot think about like language without um was gonna I'm gonna try to like refer to grammar and talk like I know what I'm talking about with grammar and I don't know enough about grammar and sentence structure but imagine I spoke to you guys right now and I just every two words I just they the words didn't exist the and I just strung together we call billing I just randomly like instead of saying we call that medical billing like I just randomly St missing most key words to help you understand what I'm talking about that's how it was when we first started doing like the the coding for both the both both the procedure codes and the diagnosis codes there's like all of this really specific information that helped tell the story that was missing and so what happened a lot is we would get record requests um we'd have to give narratives right the medical notes or the operative reports to fill in the details so now with icd10 it gets more detailed but those details went to thousands upon tens of thousands of of procedure I mean of um yeah of codes and so now of diagnosis codes and now we go into this vast world of coding that requires a medical coder specialize in medical coding and so when I explain that medical billing and medical coding in this day and age is separate some people go H it shouldn't be whatever if you are working in a specialty that you are required to code and you are coding to the specificity from documentation I guarantee you do not have time to do medical billing if you are doing something that is very standard lots and lots of other um I'm saying lots of time because you have this maybe limited to two or three procedure codes and all of your patients are coming in for one or two diagnosis codes right that is very possible in some Specialties so in some Specialties it's easy to be still be a medical biller encoder and be dangerous meaning like you still can do some some some stuff and get some things done but most of us that are doing medical coding as a main career and you're in a specialty that's more broad where you have a variety of procedures you have a variety of diagnosis codes and your practice needs you to actually code meaning they are generating documentation and you are selecting codes and the volume is normal meaning you know fairly mid-range volume there is a chance that you will not have time or bandwidth to actually do the medical billing and be dangerous about it so I want to make sure that everybody understands why I speak what as if they are different um I believe that I want you to be in your area of strength they are take two different sides of the brain they take lots now they're both creative thinking but medical coding heavily research based I have a video that I'm going to be posting here soon that answers this question from someone that was about um they were saying that they have dyslexia ADHD and um there one other condition that was I think it was anxiety yeah um yeah something like that there's one other condition and it was like you know do you think you recommend medical billing versus medical coding well if you have dyslexia medical coding will drive you crazy because it is all it is all heavy heavy research you're you're in guidelines constantly you're also needing to flip back and forth between books it can it can really depending on how well-managed and the kind of you know dyslexia that you have or the the level it certainly can feel like challenge the whole time all right medical billing is it is it is um problem solving oriented there is research absolutely research but it's like I'm researching this to up to to now figure out a way to solve a problem coding is yes there is still Pro some uh some light problem solving but we are I would say kind of opposite 7030 when it comes to research as a medical biller it is more trying out things looking at previous things that we've done and and really trying to piece together the best path forward it also is constantly variable so we're constantly shifting and switching between claims and verifications and looking back at at um at AR if you're doing end to end you're there shifting and variability all day long medical coding not the same not the same so anyway I hope that it might have it's hilarious this so it might have also been your specialty I worked at a Cardiology um group and then a Pediatric Group and they did a lot of um studies so it and it was like there were Co they didn't exist the codes for what they were doing did not exist basically so I love that yes I am I I look deceivingly young that so where are V scottt Scott I just called you Scott that's my best friend's name Todd so there you go um Todd um Todd is a member and he's also in our Inner Circle so um he knows that he he knows his family um so the BS just so everyone knows verification of benefits is um Todd's asking about where does that fall here um so verification of benefits I don't put on here because it can potentially fall somewhere between here or here um because basically you know it depends on the practice and their structure but there are some practices that before they even let a person get on the calendar they want to do some benefit verification and I believe your specialty might be like that too right you got to get some details before you actually put them on um for for scheduling and like make sure their referrals are intact and all of that so it kind of compare here but then there's others that wait until the patient actually is either in office or about to come into the office we might run an eligibility check or um verify to get financial um confirmation of the of the patient's financial responsibility after the visit has taken place and they've gotten treatment plan from the doctor so it it is one of those things that could literally fall into any one of these three so verification of benefits for everybody who doesn't know is US reaching out to Insurance to try to confirm what the patients coverage is for specific services so we talk about eligibility a lot eligibility checking is just that it's seeing that the patient is eligible for treatment verification benefits goes a layer deeper is very separate from um eligibility checking because eligibility checking is just saying it's like a thumbs up good job you've got coverage right it's like I sound like you've got mail you've got coverage um does anybody know that reference um again aging myself um the the um verification of benefits it's it's going to tell you whether or not the patient actually is going to receive the coverage for services that we are um wanting to Prov provide or perform on a particular day so um I love question what was the biggest challenges that you had when you became a medical biller oh what point did you become so passionate about it a that's so kind you love the way I explain it a thank you thank you that is so sweet butterfly and blushing um okay this is a really good question let me think okay when what was the biggest challenge the biggest challenge for me becoming a medical biller was that I became a medical biller while also doing the practice management stuff so it was definitely time right like always feeling like I was behind the eightball and back in the day oh my gosh you guys this again I'm aging myself oh no my connection's going bad again does it sound okay yeah I'm good okay um back back in the day claim submission days they were project days like y'all to send claims out it would take hours because they were all paper so what would happen was claims would generate and I get a big old W and stack let me make my camera bigger a big old W and stack and I'm saying this like so this is like almost stack of a Rema paper which is 500 pages right so like I was in a um therapy oriented practice we had physical therapist and some um orthopedist on on staff and chiropractor um but the medical practice had a lot of providers and so like you know we're literally every week sending claims but there's hundreds of visits because most of these types of practitioners see somewhere between 30 and 50 patients a day right so you've got hundreds of claims and I would like have a party with me on a table and so would be me sorting out like okay you know Blue Cross claims Sigma claims Etna claims and then what claims needed attachments for procedures okay let me print out the operative reports or the you know documentation which ones needed referrals y'all back in the day the claims that needed referrals actually needed referrals attached so that I have to go to the patients files print out the referrals grab the referrals or copy because some of them actually had they were physical referrals that were in their files copy the referral staple the referral like literally was projects um so that coupled with you know me trying to figure out how to help the at the time office manager who was trying to exit she was I was there helping her at first and then you know she ended up wanting to kind of exit the practice but basically um that was the hardest part for me is I learned medical billing as a um as a person doing a lot of things um and I I guess I should back up like the work I did when I first got into Healthcare was um marketing based and front desk support so my folks who like are going in like completely from ground level like I started like that like I I did marketing so my old as you guys know this I talk about I cold called like I was would cold call people we I don't I don't I love selling the story because people don't even understand what I'm talking about back in the day there was these like sweep Stakes boxes that and I say sweep stakes and air quotes that used to exist and people like win a free trip to whatever and um yeah I I don't even remember why these made sense like I'm just like thinking about it it sounds crazy but literally you would fill out this form and you put your thing in the box and I would be the one to call you and be like hey my name's jasine would you be open to um a verbal screening of what for your health or whatever I don't even remember the the script of course that's been a lot of years 27 years or something but um basic basically it was the way that we initiated the conversations with people who were not familiar with the kind of um practice that we were and the potential of you know being their new practice so that was what I started doing um and I started from that area and basically being interacting with the patients you're in the revenue cycle right again that's back to that front part of the revenue cycle that we're talking about here um but I really wasn't doing anything in medical billing until I um had been there for a couple of years and I say medical billing meaning like when she started having me do things like basically the claim submission project we started doing would help her with claims and I would you know she started teaching me a lot of different things with billing I did some training my doc my doc sent me out for um for training and then I came back in and then I tried to to implement what I learned and all the things so it was it was it's a time thing and I'm going to tell you guys this real talk is most of y'all who are in Billing right now know what I'm talking about because it doesn't really hasn't really gotten better it feels like there's not enough time to get the things done that you need to get done which is why conversations like this are really important because we talk about optimization like the optimization or like Improvement of what we do in this world is always possible and more you know the more that you can do right you have to actually be willing to gain more knowledge to be able to learn even if it's just 1% of what you could do a little better a little faster a little cleaner that saves you a little little bit of time right a lot of effort hopefully down the road um and so that is the purpose of this type of community um that's the purpose of you guys still growing and learning like my my biggest pet peeve is meeting people who are like but I've been doing it for so long so I don't really need any more training like okay I'm gonna go I'm gonna go over here you're not my people like I you know just because I I'm always believer that there's an opportunity because there's someone else who's doing it differently they're they could be doing exactly what you're doing and they're doing it differently and you could maybe learn something from their techniques so I'm getting another popup again so hopefully it's not messed up but I love when did I get passionate about it I don't know if I know the answer to that question I feel like I've just got a lot of fire in me probably passionate all the way through I I can tell you guys this story you know what we should put this on our list I could tell you when I fell out of love with it there was a long there was a big window of time that I really hated what I was doing and most of it was because I did not um what was the T to Todd's comment I didn't say it goes back to that I did not um say no to the things that did not align with me right I just said yes to all the things and I hated every second of it um and it has to do with the biggest opportunity I went from um from like you know I had a number of clients it was going well but then I had this massive opportunity to serve a much bigger client and I thought oh my gosh this is the dream client I've always wanted you know it's like yeah I mean literally it was it was it was a big account I'll just say that um for today I'll I'll share more later but um but yeah I thought I thought this was going to be it I was going to um to be doing um this and it's going to be amazing and I'm gonna be rolling in cash and sitting on a beach somewhere if that did not happen I'll um I'll share the full story at another later date I feel like y'all need to know this story um now that you brought this up so thank you so much for that question blue butterfly I hope that you guys um found that helpful so yeah exactly oh the sweet Clank of the dot matrix yeah if you guys don't know what we're talking about there then Google it and you will giggle but basically Matrix is what we used to print on and they were literal especially claims Healthcare we were like the last to get like just separated claims but yeah we literally had to peel apart our pages and take these little dots off the sides sounds really crazy so I like it yeah without pronouns yeah without pronouns that was from earlier comment so yeah um okay here we go I totally supported V okay totally support V before seeing the patient yes check patient El ability at the beginning of the week it's important yeah you know what it's so real software that exists that does not have things like basic things like um RTE which stands for real-time eligibility that is um a mindboggling thing to me at this point like why can we not have a tool that's set up that tells you whether or not the patient does not have insurance or it's not covered anymore because you guys such a basic need such a basic need um hey I have a big request scheduling issue on my calendar is a link there's a session happening at 3: and I think there's people signed up for it can you log in there and check on them they're like question session okay sorry guys I realize we have a scheduling conflict we have we do have an info session that's scheduled at 3M that Nicole will be on if you need support if you need support um all right so I just want to make sure we answer this like a lot of great questions coming in here so it's a patient closture as well yeah yeah um oh I love this I love this I love this so much more efficient okay I didn't mention the word PMS earlier so practice management software PMS or PMS PMS PMS were were were separate from ehrs for a long time which means like or emrs which basically is like all of the things that we do for billing didn't exist in the same software as what we do for the um for the EMR um sorry yeah for the patients's documentation for the clinical side right so the billing side and the clinical side totally separate for a very very long time and there are still a lot of systems right to this day and age that don't have them together don't have them integrated but because of that it makes it does make it a lot more um challenging because it means redundancy is what it means right it's like if a patient has do be entered into two systems there's already a potential for human error um especially if it's happening manually and it's not being like imported in there's that's one thing and then we have the the possibility of things getting lost patient's just not making it where it's supposed to go right so you have all of these potential gaps in the process um so there's a ton of um benefit to having an all-in-one system even though some of them they all have their issues right some of them are not as great it's still it does still save a lot of time and and money potentially because like I said there's a tremendous amount of losses we talk about the number one still is data capture and some of it's data capture right this reason why claims don't get paid I didn't finish my thought the number one reason why claims don't get paid is data capture right always has been probably will be forever unless somebody discovers a way to eliminate that um is B basically because there is either a redundancy happening meaning patients having to go in multiple times to multiple systems um or the software isn't doing things like we just talked about verifying the patient's identity like such a silly thing but like we ask for information from our patients and sometimes manually put the information into a system but don't the systems don't often have a way of even just checking that the person is actually a person and also did we even put the information in correctly and I know that sounds kind of weird and maybe people don't feel comfortable around the idea of like any sort of like verification system being legit but here's the deal is like most of us have the problem with patients giving information over the phone and we don't have a way for us to just verify that we got the information done correctly Ed in correctly and then patient comes in you get their their insurance information maybe you get their driver's license or verify it or not and you maybe you're busy and you skip over a step and you didn't realize that last name was given either incorrectly or you put it in the wrong space or you missed some letters in it right so if you could have like these systems that trip me out like when I go trying to think of um in Charlotte I can't think of the name of this rule but up until very recently there in order for places to be open in Charlotte without um food meaning like basically they're like a bar they would have to have what are called membership they're like membership clubs and the all these people these places had systems that were connected to the DMV and they would have to scan our driver's licenses and it would load all of our information so I'm like we have to do this in random public restaurants and or bars or whatever right like there here we have a lot of like hangout spots that alcohol like we've got like arcade like adult arcades and like um yeah all kinds of places breweries out the wazo Charlotte is big on beer if you've never been to Charlotte North Carolina um I don't drink beer but Charlotte is big on beer um if you like beer you should come to Charlotte um but there's a lot of other cool things about Charlotte but we have a lot of um hangout places for people including like places we were talking about dogs earlier we have a ton of like dog bars where there's like no food but there are people hanging out with their dogs but those places used to all have memberships like up until recently they did away with it but those I say all of this to say that they used to have to scan the driver's license and it would automatically load things from our driver's license systems and you know if you go to the grocery store right now and you buy alcohol in Charlotte at least they scan your driver's license and it loads the information of the system so it's like why systems don't do that with Healthcare if you just get it and it scans it and it loads the information and yes you might have to update the address because it might be outdated that happens all the time but something as basic as making sure that our patient's date of birth is in and that they are a person it sounds weird but people oftentimes commit fraud going into medical practices and not under their own identity and some of it is for reasons right we we that we respect but we definitely we want to make it possible for us not to have a lot of claims that we then have to go back and clean up so if you have something like that and then you have your RTE system for insurance cards doing the same thing you know can we scan the card and the card populates the information right um and have the the insurance information automatically pull from from the RT at that same moment right all these little things that would be amazing um so I'm dreaming with you guys right now so if anybody's out there that is a software developer listening to this I do expect that you'll reach out to me because I'm giving you all these great ideas so all right um big clients can be big nightmares you guys I really really want to share this story we're going to add it to our list so um what is the biggest medical billing software that is such a big question um yeah I would say that there's probably a resource out there that's published this as far as market share goes I do believe that epic might be because they work in Hospital systems work contract with Hospital Systems so I'd say from the volume of patient accounts epic probably wins that if that's what you're looking for from the number of providers I don't know Athena maybe the second because that's a lot of medical practices um Athena Health might be that's my second guess so yes and get a physical copy of the card yes crafty coder that's yes great tip there so some of the biggest things that we do here in healthcare is um we just don't follow procedure we don't establish a procedure so um oh change um so Wendy's answering this question and she's on Facebook so I'm going to share it on here just in case you don't see it um this is for hack Hilton um Hinton sorry um epic and now change healthc care is the biggest um change healthare big and clearing house air yeah yeah um change I have my my feelings about change um they bought a lot of people they bought a lot of systems um after they did their name change from indon so that's kind of why they own more what they own but um yeah that's Clearing House so little little different but yeah epics got the most patient Ser I say patient served because they do hospitals um but again there's probably a resource out there um but Athena I believe they have one of the large practice based softwares that exist if you're looking for medical practice systems um ECW does they're big Contender as well we s mentioned them earlier um e-clinical works that one's um a big Contender um feel like I'm missing another one it's not coming to mind right now maybe someone else can chime in on the chat all right um here we go so um give me a second I want to go back to my notes because I'm I'm way off track here we go okay all right so I'm not going to spend time talking about each one of the areas specifically I want to do that on the coming um lives again we're just trying to support some of our um our newbies to healthcare but what I do want to go through is like a couple of different kind of high level things so um is it important to understand revenue cycle it's super important to understand revenue cycle and medical billing and billing functions really in any role in healthcare so if you are if you're building a software I really hope you understand it enough to build a software that helps us um but if you are a um an administrator like you're you know someone that runs the practice or the practice manager um that is is um or kind of the one who is um I was going to say organ organizing the team who is hiring the team and putting folks in place it's really important that you understand what they are responsible for and what it means to have a really well-oiled machine like what what is best practice what is a strong revenue cycle right and I yes I believe you can rely on a team member to bring a lot of that expertise but how do you know you've hired the right person if you don't really have an understanding of what you're asking them to do so it is important for practice administrators practice managers um even our provider owners that are doing the hiring like the medical practices that hire medical billers this hope and prey it's concerns me because it is literally the financial arm of your business right it's basically like you're like hey here's the keys to my home and my car and all my things and use what you do and make sure it all properly like make sure I can pay for all of it and make sure that like my lights stay on and food keeps coming in and all the like you're basically giving someone the keys to the kingdom and if you don't understand whether they're qualified enough to do it or what it means to even uh what's the word to to quantify whether they're doing a decent enough job or certify in any way like by looking at their uh performance metrics like if you're not even asking for that kind of criteria from them because you don't understand it or they're get you're getting it from them and you don't understand it um it's concerning because it's an easy path to things falling to pieces for your practice because you're entrusting too much too fast and really are not Discerning right whether or not you've made the right higher you've not decided whether or not you've gotten the right um the right person over this function and unless you really have a clear sense of what this function is right so I do recommend that practice owners and medical providers that are owners um get at least Baseline understanding you need to at least take like medical billing 101 or something so you understand fully what the what we're talking about here like we're going over some things today but we've talked about it kind of high level and we've I've interrupted a bunch of times as I do um to talk about specific things that are very high level and so you you may um need it broken down in a course way like the like our medical billing 101 course is a great example of that because it walks you through each of the areas and kind of just talks what exactly goes on in these places there someone in these stages because if someone comes into your practice and um has been doing something hyperfocused like I mentioned earlier where they've only worked in payment posting they might be Masters you know going out or maybe your system does it automatically they're getting posted posting payments they're getting that done but they didn't really have experience in anything else and so you've hired them into a role that is end to-end billing yet they do not have the skills to support the other areas now it doesn't mean that they can't develop those skills but what how would you know unless you know the language and can ask these questions so it is im