Auditing Antics: Navigating Medical Coding and Auditing

Stephanie Allard Consulting, LLC

Stephanie Allard, CPC, CEMA, RHIT has 20 years of experience in the medical industry and knows the complexities that the professional world is facing on a daily basis. She also knows the lack of public education about our healthcare industry in the United States which contributes to the inability for patients to advocate for themselves. Her Auditing Antics Podcast will explore the healthcare industry from the viewpoint of a medical coder, medical auditor and the patient perspective as a consumer. This series will provide insight to various services in the medical/dental industry and help you n

  1. 2 DAYS AGO

    Spravato® Workflow: What Actually Has to Happen Clinical vs Billing

    Visit the etsy shop at sallardconsulting.etsy.com Spravato treatment includes a required two-hour observation period, but many clinics are unclear about what that time should actually involve. In this episode, we explore what needs to happen during the monitoring period and how clinical care responsibilities differ from billing and compliance expectations. We discuss patient monitoring, staff roles, physician involvement, and documentation, along with common workflow approaches that can unintentionally create compliance or billing risk for practices.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact Sign up for our updates and the latest compliance news here!  https://www.stephanieallardconsulting.com/ Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership  View our Etsy shop here! https://sallardconsulting.etsy.com

    36 min

  2. 11 MAR

    It Paid for Years… Until It Didn’t

    Go to https://www.stephanieallardconsulting.com/online-shop/p/peripheral-vascular-lower-extremity-interventions-coding-and-compliance-essentials-1 and use code VASC15 at checkout for a discount on the upcoming Peripheral Vascular Lower Extremity Interventions: Coding and Compliance Essentials Event! There’s a phrase in compliance that should make every practice pause:“We’ve always done it this way.”In this episode of Auditing Antics, Stephanie and Michele unpack one of the most dangerous patterns in healthcare billing — the normalization of deviance. A coding practice that started small. A billing habit no one questioned. Claims that paid for years without issue. Until one denial. One probe. One data review changed everything.We walk through how long-standing habits become compliance blind spots, why teams genuinely believe they’re doing it right, and how the math of recoupments can unravel years of “routine” billing in a matter of months.Because payment history is not proof of compliance.And comfort is not a compliance strategy.If you’ve ever heard “but it’s always paid,” this episode is for you.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com

    57 min

  3. 4 MAR

    The Algorithm Already Saw You: Audit Triggers Hidden in Your Data

    Most audits don’t start with a complaint.They start with a pattern.Long before a human reviewer opens a chart, payer analytics are scanning utilization trends, benchmarking providers against peers, and flagging statistical outliers. Sudden shifts in coding levels. High-frequency services. Modifier usage patterns. Even documentation that looks too consistent.In this episode of Auditing Antics, Stephanie and Michele break down how data science drives audit selection and why many providers are flagged without ever realizing their billing trends stand out. We’ll talk about outlier patterns, utilization spikes, and the quiet metrics payers monitor behind the scenes.Because in today’s compliance environment, you’re not just being reviewed by auditors. You’re being watched by the numbers. If you’ve ever thought an audit felt random . This episode will change how you look at your data.Reach Out For Compliance Help Now!https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our Etsy shop here! https://sallardconsulting.etsy.com

    36 min

  4. 25 FEB

    Physician vs. Medical Coding Auditor: Different Minds, Same Medical Record

    Physicians document to reflect clinical care. Auditors review to validate compliance and billing accuracy. Same chart with a completely different lens.In this episode of Auditing Antics, we break down the mindset gap between providers and medical coding auditors. Why does something that feels clinically obvious sometimes fail an audit? Why does intent not always translate to compliant documentation? And what are auditors actually trained to look for that providers may not realize?We’ll explore how clinical thinking and compliance thinking intersect, and where they often disconnect, plus practical ways to bridge that gap. In compliance, it is not about questioning care but instead discussing what the record supports.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact Sign up for our updates and the latest compliance news here!  https://www.stephanieallardconsulting.com/ Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership  View our Etsy shop here! https://sallardconsulting.etsy.com

    40 min

  5. 18 FEB

    From Burnout to Billing Errors: Protecting Performance Under Pressure

    Burnout impacts morale and accuracy.In this episode of Auditing Antics, Stephanie and Michele unpack how exhaustion, staffing strain, and constant regulatory shifts quietly increase compliance risk. When teams are stretched thin coding patterns may change. Small oversights turn into denials, downcoding, or audit findings.We’re connecting the dots between human fatigue and operational exposure because compliance mistakes can happen when energy is depleted and teams are struggling to focus.Reach Out For Compliance Help Now!https://www.stephanieallardconsulting.com/contactSign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry!https://www.stephanieallardconsulting.com/auditing-antics-podcastView our compliance consulting, auditing, and education services here! https://www.stephanieallardconsulting.com/servicesView our Coding Compliance Connection membership here! https://www.stephanieallardconsulting.com/membership View our online shop here! https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com

    1 hr

  6. 11 FEB

    Auditing Antics Q&A: Real-Time Healthcare Coding & Billing Answers

    Find the Medical Coding Workroom Here! https://www.stephanieallardconsulting.com/medical-coding-workroom-1 Find the Membership (that includes the Medical Coding Workroom) Here! Use code AUDITINGANTICS26 for a 26% discount https://www.stephanieallardconsulting.com/membership Got coding questions you’ve been sitting on because the answer isn’t quite clear? This live Auditing Antics Q&A is where real-world healthcare coding and billing questions get real-time, audit-focused answers. We’re breaking down E/M leveling, documentation defensibility, payer downcoding, modifier misuse, and high-risk billing patterns before they turn into denials, takebacks, or audit findings.

    57 min

  7. 4 FEB

    No Vaccine Given, Still Billable? Immunization Counseling Explained

    What happens when a vaccine visit ends with education, but no immunization is administered? In this episode, we break down when immunization counseling may be reportable, what documentation is required, and the audit risks when vaccines are refused or deferred. Join us to learn about the new 2026 vaccine counseling codes. Reach Out For Compliance Help Now! ⁠https://www.stephanieallardconsulting.com/contact⁠ Sign up for our updates and the latest compliance news here! ⁠https://www.stephanieallardconsulting.com/⁠ Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! ⁠https://www.stephanieallardconsulting.com/auditing-antics-podcast⁠ View our compliance consulting, auditing, and education services here!  ⁠https://www.stephanieallardconsulting.com/services⁠ View our Coding Compliance Connection membership here!  ⁠https://www.stephanieallardconsulting.com/membership⁠  View our online shop here!  ⁠https://www.stephanieallardconsulting.com/online-shop⁠View our Etsy shop here!⁠https://sallardconsulting.etsy.com⁠

    26 min

  8. 29 JAN

    E/M Levels Under Fire: The Rise of Automatic Downcoding

    Automatic E/M downcoding has become an increasingly common, and often unquestioned, practice in payer reviews and internal audits. In this episode of Auditing Antics, we break down what automatic downcoding is, why it happens, and when it crosses the line from compliance review into improper reimbursement reduction. We discuss how payers apply internal “rules” that override documented medical decision-making, the compliance risks this creates for providers, and how organizations can identify, challenge, and defend against inappropriate downcoding. If you’ve ever seen well-supported E/M services reduced without explanation, this episode will help you understand what’s happening and what to do next.Reach Out For Compliance Help Now! https://www.stephanieallardconsulting.com/contact Sign up for our updates and the latest compliance news here! https://www.stephanieallardconsulting.com/ Find our AUDITING ANTICS PODCAST for regular updates and discussions related to compliance in the medical coding and billing industry! https://www.stephanieallardconsulting.com/auditing-antics-podcast View our compliance consulting, auditing, and education services here!  https://www.stephanieallardconsulting.com/services View our Coding Compliance Connection membership here!  https://www.stephanieallardconsulting.com/membership  View our online shop here!  https://www.stephanieallardconsulting.com/online-shopView our Etsy shop here!https://sallardconsulting.etsy.com

    35 min
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About

Stephanie Allard, CPC, CEMA, RHIT has 20 years of experience in the medical industry and knows the complexities that the professional world is facing on a daily basis. She also knows the lack of public education about our healthcare industry in the United States which contributes to the inability for patients to advocate for themselves. Her Auditing Antics Podcast will explore the healthcare industry from the viewpoint of a medical coder, medical auditor and the patient perspective as a consumer. This series will provide insight to various services in the medical/dental industry and help you n

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