Coffee with Coker Coker

This episode of Coffee with Coker delves into the complex and nuanced topic of Modifier 25, a coding nuance critical for healthcare professionals to understand for billing and documentation.
Hosts Erika and Jaci unpack the definition, significance, and proper application of Modifier 25, emphasizing its opinion-based nature and the importance of clear, detailed documentation. They provide examples from healthcare scenarios, including preventive visits, urgent care, and procedures like cerumen removal, discussing the implications for billing and compliance.
The conversation highlights how insurance companies' interpretations can vary, impacting the application of Modifier 25. Further, they explore the challenges healthcare providers face in ensuring their documentation supports the use of Modifier 25, pointing out common pitfalls and offering guidance on best practices.
This discussion underscores the vital role of accurate coding and documentation in healthcare billing and the ongoing need for education and dialogue among practitioners.
00:32 Diving Deep into Modifier 25 01:49 Understanding the Definition and Application of Modifier 25 05:33 Exploring Real-World Scenarios and Challenges with Modifier 25 08:33 Navigating Documentation and Billing Challenges 15:04 Specific Cases and Auditing Insights 27:36 Concluding Thoughts and Future Topics 29:54 Engaging the Audience and Closing Remarks  
Links to other resources:
AMA | Reporting CPT Modifier 25 (https://www.ama-assn.org/system/files/reporting-CPT-modifier-25.pdf) Podcast covering Medicare Annual Wellness Visits (https://www.cokergroup.com/podcasts/episode-122-understanding-annual-wellness-visits-for-healthcare-organizations/)

In this episode, the discussion focuses on annual wellness visits, IPPE, and their implications for healthcare organizations. The conversation covers the requirements, coding, documentation, and common audit findings related to annual wellness visits. The speakers emphasize the importance of proper documentation, the use of resources, and a team approach to ensure compliance and successful reimbursement.
 
·        Jaci Kipreos and Erika Fisch discuss annual wellness visits (00:18)
·        Medicare's yearly benefit for beneficiaries called annual wellness visits (01:25)
·        Initial Preventative Physical Exam (IPPE) and annual wellness visits (02:32)
·        Difference between annual wellness visits and preventative physical exams (05:34)
·        Resources for understanding annual wellness visits (08:06)
·        Common audit findings for IPPE and annual wellness visits (14:16)
·        Handling patient refusal to answer questions during the visit (18:57)
·        Separate coding for additional services during the visit (22:58)
·        Screening EKG and its requirements (25:12)
·        Importance of a team approach to ensure proper documentation and billing (28:58)
·        Checking with your MAC for additional requirements or recommendations (32:52)
·        Next episode to cover the 25 modifier (34:55)
 
Extras
·        Medicare Learning Network – Medicare Annual Wellness Visits (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html)
·        Medicare Preventive Services Quick Reference Chart (https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html)
·        Medicare Claims Processing Manual (https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf)
·        Streamline Workflow to Perform a Thorough AWV (https://edhub.ama-assn.org/steps-forward/module/2757861)
 
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. 
·        Please email us: feedback@cokergroup.com
·        Connect with us on LinkedIn: Coker Group Company Page
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·        Follow us on Instagram: @cokergroup
·        Follow us on Facebook: @cokerconsulting

In this insightful podcast for leaders of physician enterprises, we delve into the dynamic landscape of staffing trends within the healthcare sector. The discussion kicks off with a comprehensive exploration of both physician and non-provider staffing trends, providing valuable insights into the evolving workforce dynamics. The conversation then navigates through the intricate factors that contribute to staff turnover, shedding light on the challenges faced by physician enterprises in retaining their crucial personnel.
 
Episode Synopsis 
The podcast guides leaders in analyzing their physician enterprises with a data-driven approach, offering practical strategies to create staffing targets aligned with the unique characteristics of their practices. As the discussion progresses, listeners gain actionable solutions to common staffing challenges, including addressing salary increases in a declining market and handling healthcare turnover amidst current market conditions. The podcast also explores staff retention tactics and best practices essential for physician enterprise success. 
The latter part of the podcast delves into the impact of various technologies on staffing for physician enterprises, exploring the integration of AI and workforce automation. The discussion concludes by highlighting the crucial link between staffing, ROI, and the overall functionality of physician enterprises, providing valuable insights for leaders navigating the intricate landscape of healthcare management.
·        Physician and non-provider staffing trends (2:05)
·        Factors contributing to staff turnover (4:20)
·        How to analyze your physician enterprise using a data-driven approach (4:50)
·        How certain practice characteristics impact staffing levels (6:30)
·        Create staffing targets that make sense for your practice (7:22)
·        Solutions to staffing challenges (8:14)
·        Addressing salary increases in a declining market (8:30)
·        How to handle healthcare turnover in the current market (11:02)
·        Staff retention tactics (13:39)
·        Best practices for physician enterprise success (16:35)
·        Critical issues plaguing independent medical practices (20:12)
·        Embracing new trends and adjusting to patient expectations (21:30)
·        Other technologies affecting staffing for physician enterprises (23:45)
·        Addressing AI and workforce automation for your practice (25:00)
·        How staffing impacts the ROI and functionality of the physician enterprise (26:40)
 
Extras
·        Address Community Need with Physician Income Guarantee Arrangements (https://cokergroup.com/physician-income-guarantee-arrangements/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-121&utm_content=physician-income-guarantee&utm_campaign=performance-transformation&utm_source_platform=&utm_creative_format=&utm_marketing_tactic=)
·        Lawmakers Grapple with Artificial Intelligence Regulation as Popularity and Utilization Grow (https://cokergroup.com/lawmakers-grapple-with-artificial-intelligence-regulation-as-popularity-and-utilization-grow/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-121&utm_content=ai&utm_campaign=performance-transformation&utm_source_platform=&utm_creative_format=&utm_marketing_tactic=)
·        Quantifying Patient Access: Utilize Data to Identify Improvement Opportunities and Monitor Performance (https://cokergroup.com/quantifying-patient-access-utilize-data-to-identify-improvement-opportunities-and-monitor-performance/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-121&utm_content=performance-improvement&utm_campaign=performance-transformation&utm_source_platform=&utm_creative_format=&utm_marketing_tactic=)
 
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Chris Torregosa interviews Louis Sallerson, the CEO of Converse Health, about their generative AI assistant for orthopedic surgery clinics.
 
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. 
·        Please email us: feedback@cokergroup.com
·        Connect with us on LinkedIn: Coker Group Company Page
·        Follow us on Twitter: @cokergroup
·        Follow us on Instagram: @cokergroup
·        Follow us on Facebook: @cokerconsulting
 
Episode Synopsis
Throughout the interview, Louis shares his passion for the healthcare industry and dedication to improving medical practice operations using generative AI. The heart of their product is communication, and their goal is to streamline patient navigation and communication for orthopedic surgeons.
 
Click to listen to the episode.
 
 
Extras
Learn More about Converse Health (https://www.converse.health/)

In this podcast episode, we delve into the critical topic of patient access and operational throughput. With growing demand for medical services and a looming physician shortage, it's essential to reframe patient access as a pivotal aspect of healthcare production, not merely patient satisfaction.
 
Episode Synopsis
Join us as we discuss current patient access challenges, highlight key focus areas for effective management, and explore the differentiation between patient access and operational throughput, emphasizing role clarity, optimizing staff utilization, and improving communication.
The episode also delves into trends in patient access management, including the role of Advanced Practice Providers and the strategic integration of technology to enhance access. Patient access has never been more vital, as patient demand is projected to exceed provider supply. We offer practical strategies for healthcare organizations to excel in patient access and operational throughput. 
·        Patient access and throughput in healthcare (0:11)
·        Patient access and physician shortages in U.S. healthcare (4:37)
·        Streamlining patient access and scheduling (9:20)
·        Patient access and appointment metrics (12:01)
·        Improving patient access and organizational performance (15:52)
·        Improving medical practice efficiency (20:15)
·        Improving patient access in healthcare (26:16)
·        Improving patient access and reducing no-shows (32:03)
 
Extras
·        Overcoming Obstacles with Performance Improvement for Critical Access Hospitals (https://cokergroup.com/overcoming-obstacles-with-performance-improvement-for-critical-access-hospitals/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-119-navigating-patient-demand-and-physician-shortages&utm_content=patient-access&utm_campaign=physician-services&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=solution)
·        Quantifying Patient Access: Utilize Data to Identify Improvement Opportunities and Monitor Performance (https://cokergroup.com/quantifying-patient-access-utilize-data-to-identify-improvement-opportunities-and-monitor-performance/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-119-navigating-patient-demand-and-physician-shortages&utm_content=patient-access&utm_campaign=physician-services&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=solution)
 
 
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. 
·        Please email us: feedback@cokergroup.com
·        Connect with us on LinkedIn: Coker Group Company Page
·        Follow us on Twitter: @cokergroup
·        Follow us on Instagram: @cokergroup
·        Follow us on Facebook: @cokerconsulting

This episode delves into the complex world of compensation design within the healthcare industry, focusing on traditional hospital/employed provider models. We explore the common pain points experienced by clients of all types when incentivizing strategic goals.
 
Episode Synopsis
Join us as we discuss the various considerations hospitals and health systems face, including concerns about provider compensation spending and fair market value. We also examine incentive structures designed to foster growth and meet strategic objectives, all while ensuring that compensation plans remain competitive in the challenging recruitment landscape.
But it's not just about the financial aspect. We'll also explore how compensation design can be a powerful tool, acting as a 'carrot' to drive productivity and achieve organizational goals. And when compensation design isn't enough, we'll delve into the other factors influencing low provider productivity.
Tune in for an insightful conversation on the critical intersection of compensation design and healthcare strategy. 
·        Aligning physician incentives with organizational goals (4:25)
·        Designing physician compensation models (8:54)
·        Analyzing audio transcript for insights (14:39)
·        Redesigning physician compensation models (19:48)
·        Designing and implementing fair and equitable compensation (26:30)
·        Physician compensation model design (33:37)
·        Provider compensation and performance improvement (37:15)
 
Extras
·        Episode 111: The Intersection of Provider Compensation and Value-Based Reimbursement (https://cokergroup.com/episode-111-the-intersection-of-provider-compensation-and-value-based-reimbursement/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=podcast&utm_marketing_tactic=awareness)
·        Case Study: Provider Compensation Misalignment (https://cokergroup.com/case-study-provider-compensation-misalignment/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=case-study&utm_marketing_tactic=solution)
·        Compensation Best Practices for Physician Enterprises (https://cokergroup.com/compensation-best-practices-for-physician-enterprises/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=white-paper&utm_marketing_tactic=solution)
·        Compensation Methodology Best Practices: True-Up Payments (https://cokergroup.com/compensation-methodology-best-practices-true-up-payments/?utm_source=libsyn&utm_medium=podcast&utm_term=episode-118-how-provider-compensation-design-impacts-performance&utm_content=performance-improvement-compensation&utm_campaign=finance&utm_source_platform=podcast-app&utm_creative_format=blog&utm_marketing_tactic=awareness)
 
Podcast Information
Follow our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review!
We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes. 
·        Please email us: feedback@cokergroup.com
·        Connect with us on LinkedIn: Coker Group Company Page
·        Follow us on Twitter: @cokergroup
·        Follow us on Instagram: @cokergroup
·        F