Accurate physician documentation is essential to reimbursement and compliance. Poor documentation can be a cause of inaccurate code selection, denied claims, and payor take backs. To help you understand these risks and how to avoid them, we talked with nationally recognized consultant, coding educator, and author of Greenbranch Publishing’s Field Guide to Physician Coding, 4th Edition, Betsy Nicoletti. In this episode, Betsy shares her “dos and don’ts” for ensuring proper documentation and accurate payment.
Betsy Nicoletti's blog and subscription product: Coding Intel
The Field Guide to Physician Coding, 4th Edition

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Dos and Don’ts of Physician Documentation

Betsy Nicoletti, MS, CPC

Quality and Risk

Risk Management

Team Building and Teamwork

Working with and Through Others

In this expanded episode of SoundPractice, host Mike Sacopulos sits down with Jerome Adams, MD, MPH, the 20th Surgeon General of the United States, to discuss his remarkable journey from a rural community in Maryland to becoming the nation's top doctor. Adams shares personal anecdotes, professional insights, and the challenges he faced while serving as Surgeon General. This episode covers the nuances of the role of the Surgeon General and is a must-listen for anyone interested in public health, physician leadership, and the evolving role of physicians in society. Tune in to this insightful conversation that sheds light on the critical issues facing our healthcare system today.

Episode Highlights

- Path to Leadership: Explore Adams’ unexpected journey into medicine, including parental influence, personal health challenges, role models, and the impact of professional organizations.

- Role and Responsibilities of the Surgeon General: Understand the historical and modern roles of the Surgeon General and key initiatives during Adams’ tenure, such as promoting Naloxone to combat the opioid crisis.

- Trust in Physicians and Institutions: Learn strategies to rebuild trust in healthcare through personalized care and patient concern.

- Balancing Individual Freedom and Public Health: Examine the balance between individual freedom and public health, emphasizing empathy and communication in addressing issues like vaccine hesitancy and chronic diseases.

- The Importance of Public Service: Recognize the value of public service in enhancing the skills and character of physicians.

Resource:
Book by Jerome Adams, MD, MPH: Crisis and Chaos

Learn more about the American Association for Physician Leadership at www.physicianleaders.org


From Small Town to Surgeon General: Dr. Jerome Adams on Leadership, Public Health, and Trust

Jerome Adams, MD, MPH, FASA

Professional Capabilities

Influence

Motivations and Thinking Style

Trust and Respect

Comfort with Visibility

Host Mike Sacopulos interviews Jennifer O’Brien, a healthcare expert and author, to discuss her book, Care Boss: Leadership Strategies and Resources for Family Caregivers. They delve into the growing demographic of family caregivers, address the challenges they face, and the perspective of caregiving as a leadership role. Don’t miss this insightful discussion where Jennifer shares actionable advice, strategies, and resources to help caregivers manage their responsibilities effectively.

Episode Highlights

- Growing Demographics: Discover the rise in family caregivers in the United States, with 53 million Americans currently serving in this role and the expectation of continued growth because of an aging population.

- Caregiving as Leadership: Recognize caregiving as a leadership role that can provide clarity and direction in managing care responsibilities and apply leadership strategies to effectively handle the emotional and logistical challenges associated with caregiving.

- Early Preparation: Learn the importance of planning and preparing for caregiving duties before illness strikes, and explore the benefits of early considerations, such as home modifications and end-of-life conversations.

- Support Systems: Identify and use available support systems, including professional caregivers, to enhance caregiving effectiveness, engage family and friends in specific caregiving tasks to distribute responsibilities and lighten the caregiver's load, and understand the role of healthcare professionals in involving and supporting family caregivers as vital members of the care team.

- Emotional Resilience: Acknowledge the isolation and emotional strain that caregivers often experience and use leadership tools to manage stress and maintain perspective.

Resource

- Book by Jennifer O’Brien: Care Boss: Leadership Strategies & Resources for Family Caregivers  offers practical tools, from creating a go-bag to comprehensive medical records and is an essential resource for caregivers, providing both strategic guidance and heartfelt support.

Learn more about the American Association for Physician Leadership at www.physicianleaders.org


Care Boss: Leadership Strategies and Resources for Family Caregivers with Jennifer O’Brien

Jennifer A. O’Brien, MSOD

Problem Solving

Strategic Perspective

Self-Management

Resilience

Action Orientation

In this episode of SoundPractice, Ron Howrigon, president and CEO of Fulcrum Strategies, brings his extensive experience in the healthcare industry to the forefront. Having worked as a senior executive with major managed care companies like Cigna, Kaiser Permanente, and Blue Cross Blue Shield, Howrigon shares his journey. From negotiating contracts to founding Fulcrum Strategies, his consulting firm helps doctors and hospitals navigate the complex world of managed care agreements so they can focus more on patient care.

With a keen eye on the flaws of a profit-driven healthcare system, join us as we delve into the complexities of the healthcare system and discuss innovative solutions for a better future.

Key Takeaways:

- Navigating Capitalistic Healthcare: Uncover the inherent problems of a for-profit healthcare system where insurers often prioritize shareholder profits over patient care. Howrigon also discusses Medicare reimbursement cuts and provides a balanced view on private equity in healthcare, highlighting both potential benefits and risks.

- Changing Patient Experience: Over the last 30-40 years, increasing bureaucracy and challenges in accessing necessary care have dramatically altered the patient experience, leading to poor health outcomes and a more critical patient perspective on the industry.

- Solutions and Reforms: Howrigon suggests vital reforms to ensure medical directors for third-party payers adhere to medical practice standards when approving or denying claims, aiming to enhance patient care.

- Impact of Physician Employment: Explore how the shift from self-employed physicians to those employed by non-physician-controlled organizations affects relationships at every level of healthcare. Howrigon predicts significant access issues and reimbursement changes because of the worsening physician shortage.

- Learn more and Connect:

   -- Gain more insights in Howrigon’s books, CLEAR! Reforming Healthcare to Save the U.S. Economy and FLATLINING: How Healthcare Could Kill the U.S. Economy.

   -- Visit fsdoc.com to connect with Ron Howrigon.

Learn more about the American Association for Physician Leadership at https://www.physicianleaders.org/.


Physician Contract Negotiations: The Landscape and Predictions with Ron Howrigon

Ron Howrigon

Finance

Economics

Operations and Policy

Governance

Payment Models

In this episode of SoundPractice, we dive into an engaging and informative discussion on the future of AI in healthcare and its implications for both doctors and patients. Host Mike Sacopulos is joined by Laura Landro to explore the emerging world of ambient listening technology.

Laura Landro, an award-winning writer and journalist, former Wall Street Journal “Informed Patient” columnist, and author of Survivor: Taking Control of Your Fight Against Cancer, brings an innovative perspective on medical technology advancements.

This technology captures clinician-patient conversations, aiming to alleviate documentation burdens, enhance patient care, and reduce clinician burnout. However, it also raises important concerns about privacy and data security. Tune in to learn how leading institutions are pioneering research while ethical considerations continue to shape its future, especially in sensitive areas of healthcare.

Episode Highlights:

• Research Insights: Discover the benefits that institutions like Mass General Brigham are experiencing in terms of cost and time savings, and improved quality of care.

• Regulatory and Liability Concerns: Explore the potential need for FDA oversight if the technology influences clinical decisions, and the implications of errors in AI-generated documentation.

• Initial Patient Reactions: Gain first-hand insights from patients, including those who find the technology beneficial and others who have privacy concerns.

• Future Outlook: Project how ongoing development and ethical considerations will shape the integration of AI in healthcare.

Resources

• Laura Landro’s WSJ Article: Why AI May Be Listening In On Your Next Doctor's Appointment - https://www.wsj.com/health/healthcare/ai-ambient-listening-doctor-appointment-e7afd587

• Book by Laura Landro: Survivor: Taking Control of Your Fight Against Cancer - https://www.amazon.com/Survivor-Taking-Control-against-Cancer/dp/0684856786

Learn more about the American Association for Physician Leadership at https://www.physicianleaders.org/


Hospital Walls May Have Ears? Ambient Listening Tech with Laura Landro and the WSJ

Laura Landro

Technology Integration

Healthcare Process

Quality Improvement

Join us for an enlightening episode of SoundPractice featuring Lisa Kern, MD, MPH, a national expert, distinguished professor of medicine, and associate chief for research at Weill Cornell Medicine. In this episode, we explore Kern’s unique career path — from her early fascination with communication as a psychology major at Harvard to her impactful research on healthcare delivery in the United States.

Her journey reveals an enduring commitment to understanding and improving the healthcare system, driven by the impact of external factors like insurance and policy on patient care. This episode not only sheds light on the complexities of the American healthcare system but also underscores the importance of inter-professional collaboration and patient engagement in shaping the future of medicine.

Key Takeaways:

1. Understanding Healthcare Fragmentation: Kern explains the concept of fragmentation, when patients see multiple providers without coordinated care, and the potential harm caused by a lack of coordination.

2. A Patient’s Role in Healthcare Delivery: Fragmentation can lead to communication gaps and poor outcomes, particularly for older adults and minority populations. Kern provides tips for incorporating real-time patient input to enhance care coordination and satisfaction.

3. Inter-Professional Collaboration: Explore proposed policy changes to improve care delivery that focus on value over volume. Kern highlights alternative models for healthcare payment and delivery to better serve patients and reduce provider burnout.

4. The Future of Healthcare Delivery: Identify future challenges and opportunities in healthcare, including the integration of AI. She identifies the importance of ongoing dialogue and proactive measures to shape healthcare to meet the needs and expectations of the American population.

Tune in for a thought-provoking discussion that challenges the status quo and explores innovative solutions for a more integrated and effective healthcare system.

Learn more about the American Association for Physician Leadership at https://www.physicianleaders.org/.


Tackling Healthcare Fragmentation: A Conversation with Dr. Lisa Kern

Lisa Kern, MD, MPH

Strategy and Innovation

Environmental Influences

Join us for an enlightening episode of SoundPractice with guest Jennifer Clark, MD, as she delves into the profound topic of suffering in healthcare. As an allopathic physician specializing in internal medicine, pediatrics, hospice, and palliative care, Clark’s journey from the bedside to the boardroom has been dedicated to healing, education, and innovation. Now volunteering as a medical liaison, she fosters a compassionate learning environment for students and professionals interested in community-based end-of-life care. In her forthcoming book, Suffer, she reflects on nearly 25 years of practice and passion to promote well-being.

Tune in as Clark shares her journey from a career in business to medicine, highlighting the importance of finding purpose and meaning in one’s vocation.

Episode Highlights:

- Purpose and Passion: Discover how Clark’s transition from corporate life to medicine was driven by a search for purpose and influenced by her family’s background in healthcare.

- Understanding Suffering: Clark discusses the importance of defining suffering and understanding its impact. She outlines how reframing pity into compassion can aid in the healing process.

- Art and Science in Medicine: Amidst technological and systemic pressures, Clark outlines the seemingly diminishing role of art in medicine. She addresses the disconnect between healthcare systems and the human aspect of medicine, advocating for compassionate care.

- Looking Ahead: Clark shares her optimism about the potential for healthcare professionals to use the understanding of suffering to improve patient care and clinician well-being.

Don’t miss this compelling conversation that explores the intersection of medicine, compassion, and the quest for meaning in healthcare.

Learn more about the American Association for Physician Leadership at https://www.physicianleaders.org/.

The Art of Suffering: A Conversation with Dr. Jennifer Clark

Jennifer K. Clark, MD

Self-Awareness

Motivate Others

Dos and Don’ts of Physician Documentation

RECENT EPISODES

From Small Town to Surgeon General: Dr. Jerome Adams on Leadership, Public Health, and Trust

Care Boss: Leadership Strategies and Resources for Family Caregivers with Jennifer O’Brien

Physician Contract Negotiations: The Landscape and Predictions with Ron Howrigon

Hospital Walls May Have Ears? Ambient Listening Tech with Laura Landro and the WSJ

Tackling Healthcare Fragmentation: A Conversation with Dr. Lisa Kern

The Art of Suffering: A Conversation with Dr. Jennifer Clark

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