Leaders in Medical Billing Chanie Gluck

In this insightful episode of "Leaders in Medical Billing," I had the pleasure of hosting Landon Tooke, the COO and Chief Compliance Officer at Impact Healthcare Solutions. Landon shared his unconventional journey from working in healthcare since 2001 to founding a rural health medical billing and consulting firm, and eventually pursuing a law degree to deepen his expertise in healthcare compliance and law.
Landon discussed the evolution of his career, highlighting his transition from clinical roles to founding Impact Healthcare Solutions in 2009. His firm specializes in rural hospital billing, and over the years, they have increasingly focused on compliance-related issues, prompting Landon to gain further qualifications in healthcare law.
A significant portion of our conversation delved into the pressing issues of cybersecurity and the legal implications of using artificial intelligence (AI) and automation in the medical billing industry. Landon emphasized the high value of medical records, making healthcare providers and RCM companies prime targets for cyberattacks. He stressed the importance of continuous education, robust cybersecurity measures, and the need for a proactive approach to protect sensitive data.
Furthermore, Landon provided a critical analysis of the current landscape of AI and automation in RCM, distinguishing between true AI and more common automation processes used today. He cautioned RCM companies about the potential legal liabilities when deploying these technologies, especially as they become more sophisticated and autonomous.
Listeners can find more about Landon and Impact Healthcare Solutions at their website or connect with him on LinkedIn for more updates on healthcare compliance and cybersecurity.
This episode is brought to you by 4D Global, which specializes in empowering medical billing companies to expand through offshore staffing solutions. For more episodes and insights, visit our podcast website at leadersinmedicalbilling.com.
 
Timestamped Chapters  00:00:00 - Introduction and Background
Chanie introduces the podcast and her guest, Landon Tooke, discussing their backgrounds and the focus of the episode.
00:01:04 - Landon's Journey into Medical Billing and Law
Landon shares his unconventional journey from healthcare to founding Impact Healthcare Solutions and eventually pursuing law.
00:04:00 - Legal Education and Compliance Expertise
Landon discusses his legal education and how it complements his role in medical billing and compliance.
00:05:45 - Cybersecurity in Medical Billing
The conversation shifts to the importance of cybersecurity in the medical billing industry, highlighting the threats and necessary precautions.
00:10:09 - Practical Cybersecurity Measures
Landon provides practical advice on enhancing cybersecurity within medical billing companies.
00:15:45 - AI and Automation in Medical Billing
Discussion on the role of AI and automation in medical billing, distinguishing between AI and other technologies like RPA.
00:22:16 - Legal Implications of AI in Healthcare
Landon talks about the potential legal challenges and liabilities associated with deploying AI technologies in healthcare.
00:27:17 - Comparisons and Future of AI
The conversation explores the future implications of AI in healthcare, comparing it to other industries like autonomous vehicles.
00:30:45 - Impact Healthcare Solutions Services
Landon details the services offered by Impact Healthcare Solutions, emphasizing their consulting and compliance capabilities.
00:32:26 - Closing Remarks and Contact Information
The episode wraps up with thanks to Landon and information on how to connect with him and Impact Healthcare Solutions.

In this insightful episode of the Leaders in Medical Billing podcast, host Chanie Gluck talks with Matt Riter, Principal at Capitol Associates, about key changes in healthcare legislation affecting the revenue cycle management (RCM) industry. They delve into critical provisions of the No Surprises Act and the challenges arising from recent cyberattacks affecting healthcare providers.
 
Key Topics Covered:
 
Change Healthcare Cyberattack (02:15):
Matt provides an overview of the Change Healthcare cyberattack, its impact on UnitedHealthcare services, and the challenges faced by providers in accessing payment and data.
No Surprises Act Updates (18:45):
Discusses the Advanced Explanation of Benefits (AEOB) and Good Faith Estimate (GFE) provisions, emphasizing the importance of preventing surprise medical bills and promoting transparency.
Medicare Reimbursement Challenges (32:20):
Insights into the complexities of Medicare reimbursement, upcoming payment cuts, and how providers are affected by shifting policies.
Legislation & Advocacy (45:30):
Matt discusses pending bills in Congress addressing payment issues, virtual credit card fees, and EFT charges to support healthcare providers.
FTC Antitrust Investigation (58:10):
An analysis of the Federal Trade Commission’s investigation into UnitedHealthcare’s market dominance and the implications for the healthcare sector.
 
Below you will find the bills referenced in the episode
H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which permanently ties annual Medicare reimbursement updates to MEI.
 
H.R. 6371, the Provider Reimbursement Stability Act of 2023, which reforms how CMS budget neutrality adjustments are calculated.
 
H.R.6487/S.3805, the No Fees for EFTs Act, which closes the loophole that payment vendors exploit to charge EFT transaction fees.

Join Chanie Gluck as she navigates the complex aftermath of the Change Healthcare cyberattack alongside Landon Tooke, COO and Chief Compliance Officer at Impact Healthcare Solutions. In this insightful episode, they discuss the latest developments and strategies for strengthening cybersecurity in the healthcare sector.
Show Notes:  Chanie sets the stage, discussing her experience and the focus of today’s episode—the Change Healthcare cyberattack.  Landon, a seasoned healthcare attorney, gives an update on the current situation regarding Change Healthcare, explaining the sequence of events that led to the recent data breaches and the implications for healthcare providers and revenue cycle management (RCM) companies. Detailed breakdown of the cyberattacks by Black Cat, subsequent responses by Change Healthcare, and the emergence of Ransom Hub, a new threat actor claiming possession of sensitive data.  Discussion on how the breach has sparked debates over healthcare data security, antitrust concerns, and the potential reevaluation of large healthcare mergers. [Cybersecurity Focus]: Emphasis on the importance of maintaining cybersecurity vigilance, investing in protective measures, and considering cybersecurity insurance as essential parts of healthcare operations. Conclusion: Chanie and Landon reflect on the broader implications of the cyberattack and stress the need for continuous improvement in cybersecurity strategies within the healthcare industry. ---
We're thrilled to announce that "Leaders in Medical Billing" has been recognized by Feedspot as one of the Top 15 Medical Billing and Coding Podcasts on the web, currently ranking in 5th place! Learn more about this honor here https://podcasts.feedspot.com/medical_billing_and_coding_podcasts/

In this enlightening episode, Benjamin Riegel, founder and host of the Revenue Cycle podcast "My Good Friends" and CEO of Tarpon Health, takes us through his journey from co-founding Health Rise Consulting Firm to establishing a unique community that fosters innovation and support among healthcare leaders. With a wealth of experience in enhancing healthcare systems and a deep dive into the complexities of healthcare changes, Benjamin shares his insights on the importance of community, the power of learning from failures, and the impact of technology in healthcare. Join us as we explore the evolution of healthcare through the lens of a seasoned expert who believes in the power of collaboration and innovation to drive positive change.

Benjamin Reigle, founder and host of the Revenue Cycle podcast "My Good Friends," shares his extensive experience in the healthcare industry, including co-founding Health Rise Consulting Firm and leading initiatives at companies like McKinsey & Company and Accredited Health (now R1). He is also the CEO of Tarpon Health, a community driving automation for healthcare providers. In this episode, Benjamin dives into the topic of healthcare change, emphasizing the importance of understanding industry shifts. Stay tuned to gain insights into the evolving landscape of healthcare.
The Change Healthcare breach, as discussed in the podcast episode with Benjamin Reigle, has had a profound impact on the healthcare industry. The breach resulted in challenges with claim submission, cash flow, and data security, affecting not only the operations of Change Healthcare but also having a ripple effect on healthcare providers, payers, and patients.
The breach led to issues with claim submission, as some payers who relied solely on Change as their intermediary were unable to process claims. This created a backlog of claims and disrupted the revenue cycle for many healthcare organizations. Some providers resorted to manual processes, such as printing and mailing claims, which added complexity and delays to the billing process.
Cash flow was significantly impacted by the breach, especially for smaller healthcare entities like physician groups and community hospitals. With claims not being processed efficiently, these organizations faced financial strain due to delayed payments and uncertainty about when the situation would be resolved. The lack of cash flow threatened the financial stability of these smaller entities, highlighting the importance of having contingency plans and backup systems in place.
Data security concerns arose as a result of the breach, with questions about the extent of the data compromised and the potential implications for patient privacy. The breach raised questions about the adequacy of security measures in place and the vulnerability of healthcare systems to cyber threats. The need for enhanced data security protocols and proactive measures to prevent future breaches became a pressing issue for healthcare organizations.
Experian Health Client Communication
February 23, 2024

Experian Health is aware of Change Healthcare’s (Optum’s) announcement on February 21
about a cybersecurity incident affecting its systems. Experian’s Cyber Incident Response team and Cyber Threat Intelligence teams have been engaged and are closely monitoring the situation. We have not seen evidence of a threat to Experian. Out of an abundance of caution and consistent with Experian’s security practices, Experian has temporarily severed connectivity to Change Healthcare. During the period of this severed connectivity, there will be an impact to batch and EDI authorizations, claims and remits, claim status, eligibility, and notice of care transactions that Experian Health sends to Change Healthcare. Experian will resume connectivity to Change when it receives assurances from Change Healthcare that it has adequately contained the threat.
Payers work with a variety of clearinghouses to process data. In many cases, multiple payer connections are available although sometimes payer connectivity may be limited or even exclusive to a single clearinghouse. In the majority of cases, transactions from Experian Health route directly to the requestedpayer.
When connectivity is limited or certain routes are unavailable, however, it is common to route
traffic through another clearinghouse.
Below is a list of potentially impacted payers. Our teams are actively evaluating and rerouting
transactions when an alternative route is available and will provide an update to this list as soon as possible.

BCBS-MA Blue Cross Blue Shield of Massachusetts
Claims
13162 1199 National Benefit Fund
93044 A & I Benefit Plan Administrators
37

In this insightful episode, we dive into the heart of medical billing and coding with Beth Schleeper, CEO and founder of TNT Consulting and Advanced Coding Services. Beth shares her inspiring journey from starting a billing service as a new mother to fulfilling her dream of opening a coding school. Along the way, Beth emphasizes the importance of community, trust, and continuous learning in the healthcare industry. She also touches on the challenges and triumphs of acquiring billing companies and the evolving landscape of healthcare technology. Through her story, Beth illustrates the power of determination, innovation, and giving back to the industry that has shaped her career.