NSCHBC Edge Podcast
National Society of Certified Healthcare Business Consultants (NSCHBC)
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Leading the way in the business of medicine
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Sep 12, 2023
Credentialing vs. Contracting for OMS, Dental and Medical
In Healthcare, is credentialing the same thing as contracting?
No, credentialing is the process of reviewing the doctor's qualifications while contracting. Payer enrollment is the process of applying for and obtaining participation contracts with insurance plans for your provider or entity.
Award-winning podcast host Terry Fletcher and Healthcare Consultant Scott Graham navigate through these differences while giving tips on how to be successful in payer contract negotiations and provider credentialing.
Join us for these important business of medicine tips.
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Aug 8, 2023
MSO's vs ACO's: Healthcare Administrative Services
An MSO is a company that provides non-clinical services to medical practices, ambulatory care facilities, or other healthcare providers.
Services provided by an MSO may include some or all of the following: Billing and Collection. Accounts Payable. RCY, Contracting and Credentialing, and Staffing.
What can an MSO do for your practice? Can you create your own?
In this episode, Terry discusses all options with Healthcare CPA and Financial Consultant Jacki Jacox. Don’t miss this important topic that could provide many practices with administrative relief.
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Jul 11, 2023
Physician Practice Mergers
Is your practice considering a merger? Is the phrase “bigger is better” a true statement when it comes to private medical practices?
Join us on this episode of the NSCHBC Edge podcast as SME Reed Tinsley CPA discusses the complexities of practice mergers.
It’s not an overnight process to be successful in a merger. Reed offers tips to work your way through the myriad of issues and processes.
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Jun 13, 2023
Should physicians have a CPA or handle financials themselves?
On this episode of the Edge Podcast, Terry welcomes fellow NSCHBC member Sandy Shecter. Sandy is a CPA and the Director of Solutions for Rehmann, a fully integrated, professional advisory and asset management firm working to empower success for businesses of all sizes and industries.
Our topic today is physicians and medical practices who manage their finances in-house. Should they outsource to a CPA who knows the healthcare environment?
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May 9, 2023
Google and SEO Presence for Medical and Dental Practices
In today’s world of marketing, the healthcare provider is sometimes overlooked.
Have you asked these questions?
* What is it about Google that is important to know in the healthcare space?
* What does SEO presence mean and can anything alter those algorithms?
* How can a medical or dental practice be sure they are being found in the right space but also the most positive light?
In this month’s NSCHBC Edge podcast, Marketing Consultant and SME Expert Carl White joins Terry Fletcher to discuss the best strategy for marketing your practice and where to start.
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Apr 11, 2023
Keeping healthcare employees motivated during a national staff shortage crisis
Is your staff suffering from spring fever? And how can you motivate the “keepers” with the nationwide landscape of staffing shortages?
In this episode, Terry Fletcher is joined by healthcare consultant and fellow NSCHBC member Merikay Hunt to discuss the employer-employee relationship, and how to keep the staff you not only want, but also need.
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Mar 14, 2023
The Secret to Maximizing your Reimbursement
On this episode of the NSCHBC Edge Podcast, Terry welcomes NSCHBC member and Certified Healthcare Business Consultant, Jackie Coult, who doubles as an SME in practice and revenue cycle transparency and negotiations.
Physicians: we have your back! Jackie shares her expertise on how to set gross charges, and what the best practice methods are for setting rates so revenue isn’t lost.
The hosts also discuss how practices and providers should monitor the payor reimbursement annually so that changes don’t harm your bottom line.
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Feb 14, 2023
Compliance Plans or Compliance Programs: Internal Policy Management
This month on the NSCHBC Edge Podcast, Terry welcomes a new member, Healthcare Consultant Christine Hall, to discuss the importance of Compliance Programs, Policies, and Accountability for actions in a physician’s practice.
They discuss how to start the process of implementing a Compliance Program, and what departments need to have clear rules and best practice policies to be successful. Don’t forget the ACA and OIG state clearly that to collect government funds (Medicare payments, PRF, etc.), as it is “required” to have a compliance program in place.
Also, commercial insurance contracts now require some kind of compliance program as part of a your contract participation. Are you prepared?
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Jan 10, 2023
Self-Reporting: Last Minute Federal Regulations of 2022
Terry welcomes back, our own “compliance guy” and NSCHBC member, Sean Weiss, to discuss the last-ditch regulatory add of CFR 42, on self-reporting, and the proposed changes to the 60-day rule for Medicare.
This means that if you find an overpayment from a federal payer, what is your responsibility to identify it, return it, and what is the timeline?
Terry and Sean discuss the ins and outs of this process and the importance of being proactive in your compliance and self-auditing policies.
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Dec 13, 2022
PRF Single Audit Act Requirements
In this episode of the NSCHBC Edge podcast, Terry welcomes back Healthcare attorney and NSHCBC member Amanda Waesch Esq, to discuss the Single Audit Requirements, for providers and recipients that spent $750,000 or more in federal funds, including Provider Relief Fund (PRF) payments.
There is some confusion on who has to report, when and why. Amanda and Terry try and clear up this confusion, and give you the tools and cited references for compliance.
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Nov 8, 2022
Private Equity Pros and Cons in the Medical and Dental Space
What is PE? At its core, PE is an alternative investment class consisting of capital that is not listed on a public exchange.
PE is comprised of funds and investors that directly invest in private companies. Most PE firms invest in companies and then look to sell their stake in 3 to 5 years for a substantial profit.
So how does this translate to the Healthcare field with Medical and Dental practices being courted daily by PE investors?
Listen to the NSCHBC Edge Podcast this month to get insights from healthcare attorney Bill Kalogredis and podcast host Terry Fletcher to consider your pros and cons options.
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Oct 11, 2022
Retirement Planning for Physicians and Dentists
How much does the average physician retire with? When is too soon to start planning? What age does a physician usually retire? Did the pandemic change the retirement mindset? Are physicians retiring early due to financial readiness or burnout? Traditional 401(K)s? Pensions? IRA's? What is the right fit for a physician and/or dentist?
Listen to this edition of the NSCHBC Edge podcast for all of the answers to these important questions, as Terry talks with fellow NSCHBC member and Healthcare CPA Marc Lion.
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Sep 13, 2022
RCM Staffing: Right people in the right job?
Many practices will hire coders for coding jobs or billers for the billing department, relatives or newbies for the front desk, or hire from within to fill RCM positions in Medical and Dental Practices.
But when mistakes are made, or updates are not realized, the RCM suffers.
Host, and Healthcare Coding and Reimbursement Consultant, Terry Fletcher, joins fellow NSCHBC Member and industry expert, David Zetter of Zetter Healthcare, to discuss staffing issues and problems that can arise when the wrong people are in the wrong job: and the positives and expectations when the right fit happens.
Listen to this episode of the NSCHBC Edge Podcast for answers to the right questions.
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Aug 9, 2022
Revenue Cycle Management Tips for Physician Practices
In this edition of the NSCHBC Edge Podcast, Terry Fletcher invites NSHCBC members Vinod Sankaran and Misty Haralson for an RCM Round table discussion.
Hear fellow healthcare consultants in the RCM space discuss physician and dental practice pain points and how to be efficient in your Revenue Cycle Management efforts.
Join us for this important discussion focusing on verifying eligibility, billing errors, denial management, and IT.
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Jul 12, 2022
When a Physician or Practice ponders the idea of selling their business
This edition of the NSCHBC Edge Podcast targets Physician Practice Valuations.
Are you asking yourself: "Is it time to sell my practice?", "How do I get started?", or "How long will it take to sell my practice?"
If so, you’ve come to the right place! Terry Fletcher, along with fellow NSCHBC member and certified valuation consultant Alex Nechay, CVA CHBC, will be talking about knowing when it is the right time, the process of valuation, and who to go to, to begin the process.
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Jun 7, 2022
Is this the right time to open an ASC or OBL? Pros and Cons from the experts
In this month's NSCHBC Edge Podcast, Terry dives into the ASC (Ambulatory Surgery Center) and OBL (Office Base Lab) start-ups and what the market is telling us now when it comes to giving patients options when having their procedures and surgeries.
As we all know hospital costs have risen and continue to do so, so what are the pros and cons and options for physicians when considering opening an ASC? What are the Costs? What are the legal challenges?
Terry welcomes back NSCHBC members, Healthcare Business Consultant David Zetter, and Healthcare Attorney Amanda Waesch to discuss this topic and help you make that decision.
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May 10, 2022
Integrating Behavioral Health Services into your Practice
Can Behavioral Health and Mental Health services be integrated into all specialty practices? Or are they limited to General Practice, Family Practice, Internal Medicine, Psychology Practices, or Psychiatric Practices?
In this episode of the NSCHBC Edge Podcast Terry welcomes back Adam Middleton, SME, to talk about this topic.
The hosts also discuss how to look at financials and staffing for the Behavioral Health specialty.
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Apr 12, 2022
Physician's getting back to private practice from Hospital System Employees
To date, there has been a swing toward physicians becoming employed by hospitals. Initially, joining an academic medical center or hospital system can be a great start for physicians coming out of training. But we NEED private practice providers.
Private practice, as we know it, will progressively evolve with new restrictions as we see the consolidation of practices under equity buyout models.
Talking about this is Terry Fletcher and Debra Phairas, NSCHBC, Certified Healthcare Business Consultant and owner of Practice Liability Consultants in Napa, CA.
The hosts chat about how physicians can get back to private practices, and how to understand the entrepreneurial mindset needed for success. This is the best time in history to be self-employed and be your own CEO of your life, CEO of your medical and/or dental practice, and find that work-life balance model everyone wants.
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Mar 8, 2022
PRF and Reporting: Are you prepared for tax season?
This important and timely episode of the NSCHBC Edge Podcast focuses on Provider Relief Funding, plus all of the money spent over the past year during the COVID-19 pandemic to assist physicians, dentists, and hospitals.
Are you ready for TAX season? Chris Hundt CPA joins Terry Fletcher to discuss all things Provider Relief Funding.
It’s time to make sure you've met reporting deadlines, and have documentation of COVID losses, expenses, and funding distributions. Plus, the hosts discuss a surprising source of income with the Employee Retention Credit.
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Feb 8, 2022
Self-Disclosures and Self-Reporting
Back in 2010, the OIG and HHS established a Medicare self-referral disclosure protocol (SRDP) that sets forth a process enabling providers of services and suppliers to self-disclose actual or potential violations of the physician self-referral statute.
Along with self-referrals, CMS published a final rule for the reporting and returning of overpayments that fall under the SRDP protocols.
In this episode of the Edge Podcast, Terry Fletcher welcomes back healthcare attorney and NSCHBC member Amanda Waesch, to discuss these topics and how this process works: and what could happen if it’s not followed.
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Jan 11, 2022
Social Media for Medical and Dental Practices
Welcome to the first NSCHBC Edge Podcast of the new year. Terry Fletcher is joined by Maureen Uy of Associated Marketing, to explore the topic of social media for medical and dental practices.
What is necessary to make sure you are on top of the information highway?
A social media platform can generate both good and bad reactions, but it can also help you grow your patient population.
The hosts share their insights on what content to publish and how often, plus what platforms are best suited for healthcare entities, and how to respond to the messages they can generate.
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Dec 14, 2021
Are compliance manuals required for physician practices?
In this episode of the NSCHBC Edge Podcast Terry Fletcher welcomes fellow NSCHBC Member and Consultant Sean Weiss to discuss compliance plans for physician practices.
Having a compliance program in place to address detected offenses and take corrective action is necessary with the advent of the Omnibus vaccine mandates, OSHA regulations for safety, and the OIG's requirement for Medicare and Medicaid providers.
It is imperative practices take a look at their corporate compliance programs and how to respond to potential regulatory infractions.
Also discussed is the difference between job descriptions versus compliance manuals, and how payer contracts are now included in their agreements.
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Nov 9, 2021
Telehealth Now: Compliance and Regulations
Nearly two years into the current pandemic, Telehealth continues to make headlines.
In the latest episode of the NSCHBC Edge Podcast, Terry Fletcher chats with healthcare consultant David Zetter, CHBC, of Zetter Healthcare, about a number of topics.
Among those discussed include 1135 Waivers still in place, Patient Consents that have expired, Audio and Video Encounters, and the CARES Act. The hosts also mention individual states that have either extended or waived their state mandates for Telehealth.
Are you on top of the current rules? Listen to find out!
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Oct 12, 2021
HIPAA/HIPPA, plus vaccine mandates: are they legal?
In this episode of the NSCHBC Edge podcast, host Terry Fletcher is joined by NSCHBC member and healthcare attorney Amanda Waesch.
They discuss the "realities" of HIPAA and what it means in terms of your privacy and rights. For example, can anyone ask you if you're vaccinated? And do you have to reply?
This leads to a polarizing discussion of COVID-19 Vaccine Mandates. Is this legal to enforce? Why this virus and not others? And can this have an impact on a physician's status as a participating provider with Medicare?
Listen in this month to find out the straight answers.
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Sep 7, 2021
Best practices for hiring medical practice staff
In this episode of the NSCHBC Edge Podcast, Healthcare Business Consultant Chris Zaenger of Z Management Group, Ltd. joins host Terry Fletcher to discuss hiring the right people in management positions in your practice.
Among those decisions is whether your spouse or relative should be on the hiring list!
Also on the agenda, is salaries, remote workers, and staff members who look good on paper: but are they the best fit?
Join us for this fun and lively topic!
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Aug 10, 2021
Practice Start-ups and Feasibility
Practice start-up services can be very tedious to get a medical practice off to a solid start and firm foundation.
This episode of the Edge Podcast discusses startups and practice feasibility, going to work for an established private practice, or joining a Kaiser-like model or ACO to get a new physician's feet wet.
Joining Terry is NSCHBC member and Doctor's Management Healthcare Business Consultant Valora Gurganious.
Valora serves clients in all medical specialties. She works with the intricacies in starting a medical practice, feasibility studies, contract, and credentialing services, and more.
This podcast discusses what could be best for the new physician, or one looking to make a change: and the details that go into making this transition.
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Jul 13, 2021
Adding NPP's to make your practice cost-effective and profitable
It has been reported that Medical Practices with NPP/APP's and other non-physician providers are more profitable and productive.
In this episode of the NSCHBC Edge Podcast, Terry welcomes NSCHBC member and Business Consultant Adam Middleton to discuss how NPPs can increase access, hours expansion, value-based services, and profitability.
Listen in to this discussion to help you make an informed decision to add NPPs or not into your practice!
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Jun 8, 2021
Should you outsource your medical billing? Or keep it in-house?
Whether you are an independent, small or large practice, it is important to think about the pros and cons of outsourcing your medical billing.
On this episode of the Edge Podcast, guest Cyndi Walker CHBC joins Terry Fletcher to help you determine if outsourcing is right for your practice – and what factors go into making that decision.
Cyndi and Terry also discuss the difference between outsourcing and offshoring: do you know the difference? Tune in as the hosts provide the answers for all of these important questions and whether keeping your billing in-house may be the best option.
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May 11, 2021
When should I hire a healthcare consultant?
Have you sprung a leak in your RCM? Do you renegotiate or review your insurance contract language regularly? What about EOB review?
You may have payment posters, but who in your practice is deciding to appeal or write off denials - or work those denials? Have you checked in on your E/M documentation and coding with the new 2021 rules for office visits?
If you are a primary care are you utilizing your NPPs by adding value-added services, like AWV or CCM?
Terry Fletcher talks with David Zetter, of Zetter Healthcare, to determine when you should hire a healthcare consultant to assist with these tasks and help achieve long-term practice success.
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Apr 13, 2021
Financial planning in 2021 for medical practices: now and after PHE
This edition of The Edge Podcast focuses on the financial challenges most medical practices have faced during the last year: what did we learn from the pandemic to pivot our Medical Practices Financial Profile to a more profitable future?
Terry welcomes Practice Consultant Ginny Martin to the program to discuss extending hours, APNs, Medicare wellness services, and working AR with our remote RCM staff.
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Mar 9, 2021
PPP, EDIL, HHS funding :are you prepared for tax season?
During the COVID-19 pandemic a lot has happened: the shutdowns, the halting of elective surgeries and procedures, the pivot to telehealth, and a decline in patient encounters.
The healthcare community had to figure out how they would financially stay afloat during the PHE. Provider Relief Funding came in the form of HHS Funds, EIDL, PPP, AAP and more.
In this episode of the Edge Podcast, Terry Fletcher welcomes Jennifer Pemble CPA CFE, CHBC, of Warren Averett, to discuss all of the offerings and answer pertinent questions.
What is a loan versus a grant or forgiven funding? And what are the rules and regulations on keeping it?
Also, Terry and Jennifer discuss the second round of PPP2, and other SBA options, to determine your possibilities due to economic uncertainty versus necessity.
Join us for this important topic in the Business of Medicine and provider-relief funding.
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Feb 9, 2021
Are you taking Telehealth seriously? Or is this a "stopgap" during PHE?
The Edge Podcast welcomes Doctor's Management Consultant Grant Huang to the show. Grant joins host Terry Fletcher to talk about Telehealth during the PHE and what to expect post-PHE.
With changes to the 2021 Medicare PFS and the CARES act flexibility set to roll back once the PHE ends, the two discuss the future of FaceTime and Skype as an approved platform, how to ready your practice to go all-in on Telehealth for your patients, and what you can do now to prepare for potential changes in reimbursement and coverage.
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Jan 12, 2021
Employee Terminations: simple, aggressive, and contract employees
Today's topic focuses on employment terminations. From simple terminations to aggressive employees, this episode focuses on how to handle challenging situations: including contract employees with a non-compete clause.
Attorneys Amanda Waesch and Brian Meek role-play these real-life employer situations which could occur during or after the pandemic.
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Dec 8, 2020
Fee for Service Medicine and Front Desk Collections
Welcome to the latest NSCHBC Podcast where our topic for discussion is "Fee for Service Medicine and Front Desk Collections".
Is Fee for Service Medicine here to stay? Is socialized medicine or a bundled/capitated payment system on our horizon or even a remote possibility?
Also, we discuss being proactive when it comes to front desk collections and payments.
Terry's guest contributor on this episode is the President of NSCHBC David Zetter, of Zetter Healthcare LLC. Together they will tackle these topics and give the current industry reality for a profitable practice during a pandemic and in the future.
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Oct 21, 2020
NSCHBC Edge Podcast - Premiere Episode
The National Society of Certified Healthcare Business Consultants decided it was time to join the podcasting community to bring you healthy business principles, and conversations on what it takes for a medical or dental practice to be successful.
We are bringing the Business of Medicine to you. Taking the time to understand the Business of Medicine is crucial for building a successful career and providing great patient care.
We hope you will join us each month, as we tackle new topics, and breakdown the factors that can affect your practice in all ways, positive and negative, contributing to the stability and profitability of your practice and your long-term success.
Become a member and learn more about NSCHBC at https://www.nschbc.org/
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