Breaking the Mold: A Game-Changing Approach to Billing with Robert Kowalik

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.

Catherine Keegan, a seasoned professional with 34 years in the RCM space, shares her journey in academic healthcare and community medicine at East Carolina University. As the Director of Revenue Integrity, she discusses the vital role her team plays in revamping the revenue cycle process, ensuring compliance, and driving positive change appreciated by the entire community. Keegan's responsibilities include overseeing the Charge Description Master, fee schedules, charge reconciliation, and clinical denial management, showcasing her passion for making a difference in healthcare.

Drained by constant business travel, Heidi Ritton said enough was enough and formed her new business LLC on a layover in the Charlotte airport. Five years later Behavioral Health Billing Services is thriving. It wasn’t easy, but failure wasn’t an option with two small children and a husband who went back to school. In this episode, Heidi shares the tenacity it takes to be a successful entrepreneur and the tools and tricks she’s used to build her business.

In this insightful episode, we had the pleasure of speaking with Ken Hogue, a seasoned professional in revenue cycle management. Ken shared his deep-rooted connection to healthcare, influenced by his family's background in the field, and his passion for being a mediator and executive in the space.

Ken's journey began with a desire to improve the healthcare system without being directly involved in patient procedures. He has worked with notable organizations like Change Healthcare and Rochester Regional Health and is currently the Senior Director overseeing the entire revenue cycle for both hospital and physician sides.

During our conversation, Ken recounted the challenges of implementing Epic EMR during the pandemic and the transition to virtual operations. He emphasized the importance of advancing the organization in growth and proficiency, grooming future leaders, and ensuring financial success.

Ken manages a staggering $1.4 billion in revenue, five hospitals, hundreds of physician practices, and leads a team of 540 individuals. He discussed the evolving landscape of healthcare regulations and the need for effective communication and compliance to navigate these changes.

We delved into the intricacies of the No Surprises Act and price transparency, exploring how Ken's organization is publishing information online and providing patient estimates to meet compliance and improve patient engagement.

Ken also highlighted the role of business intelligence (BI), artificial intelligence (AI), and automation in healthcare. He shared success stories of increased efficiency and the importance of understanding workflows to ensure the effectiveness of automated processes.

[00:02:09] Implementing Epic during the pandemic.

[00:04:24] Administrative burdens and communication.

[00:08:35] Healthcare regulations and patient education.

[00:15:30] BI, AI, automation.

[00:18:39] Automation and workflow design.

[00:20:17] Success through automation.

[00:25:36] Implementing over 100 ideas.

[00:29:00] Creating a career ladder.

[00:32:30] Advancement and work-life balance.

[00:35:37] Career paths and mentorship.

• [00:00:02] Introducing Denise Corbisiero, COO of Integrity Billing
• [00:00:20] Choosing Mental Health Industry: Challenges & Struggles
• [00:08:10] Tough Recovery & Insurances Hurdles
• [00:11:34] Embracing Change: AI’s Role in Reducing Workload
• [00:13:38] Underlining Customer Relationships: Turnover and Internalization
• [00:16:00] Accelerating Benefit Verification: Leveraging SaaS
• [00:19:21] Future of Automation: Streamlining the Appeals Process
• [00:21:54] Preferred Systems for Behavioral Health
• [00:23:21] Defining Success and Making Connections

• [00:00:03] Introduction to Ryan O'Hara and Acclara
• [00:00:27] Discussing Healthcare Costs and Outcomes
• [00:02:04] Tackling Adversarial Relations in Revenue Cycle
• [00:05:06] Power of Data in Healthcare Conversations
• [00:08:07] Identifying Talents to Improve Healthcare Practices
• [00:14:15] Essential Traits for Leadership in Healthcare Sector
• [00:16:40] Advocating for Better Patient Centric Healthcare
• [00:24:00] Ryan's Vision for Bridging the Gap between Insurance and Health Systems
• [00:30:37] Key Performance Indicators in Healthcare, A New Perspective
• [00:32:30] Critique on AR Days and Measuring Absolute Revenue Returns
• [00:33:47] Importance of Measuring Aging by Payer
• [00:35:25] Monitoring Costs in Healthcare Sector and Vendor Management.

Frank Corcino, has been in healthcare for the past 38 years. Starting in the healthcare debt collection business, he made a strategic shift into cash acceleration with early-age receivables. Currently Frank serves as a National Market Leader for Financial Operations in OnPoint Healthcare Partners, a boutique consulting firm in Texas. He acknowledged the ongoing struggles of hospitals with expense management, automation, and the need for a hybrid model of operations. As hospital operating incomes are at an all-time low and claim denials are growing, Frank sees technological solutions such as AI and NLP as vital to streamlining processes and reducing issues in revenue cycles. He mentions the successful use of software programs like OnPoint's virtual assistant in transcribing clinical notes for doctors, saving valuable hours each day. The episode ended with Frank discussing how he sees the future of healthcare, the likelihood of more outsourcing in the future.

Show notes

• [00:00:00] Introduction: Frank's 38 Years of Healthcare Experience
• [00:00:17] Early Career: From Collections to Cash Acceleration
• [00:02:34] Current Role: National Market Leader at OnPoint Healthcare Partners
• [00:04:09] Challenges in Healthcare: Seeking Efficiency amidst Struggling Automation
• [00:06:23] Solutions to Cash Flow Issues: Better Management of CDM
• [00:08:52] Staff Shortage: Transition towards Younger, Low-cost Managers
• [00:10:27] Addressing Hospital Financial Struggles: The Role of Technology
• [00:14:07] Streamlining Process: The Impact of Robotics and OCR Scanning
• [00:16:56] Impact of AI and NLP: Accurate Clinical Notes for a Smooth Revenue Cycle
• [00:18:51] Patient-Physician Separation: Unique Technologies to Enhance Care and Payments
• [00:24:22] Future in Healthcare: Openness to Alternative Solutions
• [00:26:00] OnPoint's Virtual Assistant Tool
• [00:28:50] Frank's Future Plans

IRIS - https://info.onpointhealthcarepartners.com/iris-virtual-clinical-assistant-0