Dive deep into the world of insurance claims with our podcast, newly rebranded as "The Art of Adjusting®"—a title echoing the revered book of the same name. This revamped podcast is not just a beacon for professionals navigating the adjuster landscape but also a wealth of insights for those curious about the intricacies of the industry. We're thrilled to announce that Bill Auten, owner of Auten Claims Management, will now share the mic with a stellar co-host, Chantal Roberts. Chantal isn’t j ...
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Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals. The show features interviews of industry leaders, government officials, and others helping to shape the healthcare landscape. Sean M. Weiss (AKA – The Compliance Guy) has been an industry respected name for more than 25-years. A physician and health system ...
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Concierge Medicine Today's "DocPreneur Leadership Podcast" has become a trusted voice and is a recorded history of membership medicine in all it's various forms. From Concierge Medicine to Direct Primary Care (DPC) and everything in between it unpacks unique entrepreneurial insights in healthcare ranging from hospitality in healthcare from a patient perspective to interviewing healthcare leaders, Physicians, PAs, NPs, insurance and payor connections, attorneys, interior designers and more. T ...
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Season 7 - Episode 42 - Defending Your Claims Action
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This one is a head-scratcher for The Compliance Guy for so many reasons... Not going to give it away but this is a really good episode you are gonna want to catch!
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Season 7 - Episode 41 - Monday Auditing, Coding and Compliance Roundtable
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We had a great program on Monday with Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM Christine Hall Stephanie Allard, CPC, CEMA, RHIT Scott Kraft and John Paul Spencer and their take on some hard-hitting issues: 1. Practices wanting to use RNs or MAs to do post of visits after 90-global surgery 2. Medical necessity for E/M servic…
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Leaving your 🥼 job on a high note [and with gratitude!]
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You can’t control how they left you. You can control how you leave them. Consider sending a thank you note. By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today/Host, Concierge Medicine Forum Hear me out … Experts say finishing well requires expressing gratitude — even to those you’ve worked next to, for, and around for the past few year…
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Level Up: Your Guide to Becoming an Expert Adjuster
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Join Chantal and William on this episode of The Art of Adjusting® Podcast as they dive deep into the journey of becoming an expert claims adjuster. They break down the career path from novice to seasoned professional, emphasizing the value of experience, continuous learning, and self-education. You'll hear them discuss the importance of communicati…
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One task only you can do, not on A.I.'s to-do list.
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A concierge medicine doctor recently called me out of the blue on my cell phone. She followed up with a phone call a few weeks later with another text with a helpful link to something we had discussed earlier. As you might imagine, it made my day! Can the Physician do something like this FOR everyone or every patient? No, but as author A.S. says, “…
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Season 7 - Episode 40 - #TerryTuesday - G2211 and Some Payors Refusal to Pay
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Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM and #TheComplianceGuy, addressed critical issues in the latest #TerryTuesday episode. In this episode, we delved into current events affecting our country, marking a significant departure from our usual content. Listeners can fast forward to the 15-minute mark for an insightful discu…
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Transforming Doctors Compensation for a Fairer and More Rewarding Life
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1:11:47
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Meet Ethan A. Nkana, the visionary behind Rocky Mountain Physician Agency (RMPA), and a potential disruptor for The DocPreneur Leadership Podcast. Back in 2019, he saw that doctors were getting paid unfairly based on factors like where they went to school or their race and gender. TO LEARN MORE OR CONNECT WITH ETHAN, visit: https://rmpa.co/ Amidst …
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Season 7 - Episode 39 - Dana McMahon Chief Compliance Officer / Stryker
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Sean sat down with Dana McMahon, Chief Compliance Officer for Stryker to discuss all the great things she and her team are doing to ensure a culture of compliance and to lead Stryker into the future. Beyond that Dana is the Global President for Stryker Women's Network (see bio below)! This is one great discussion you do not want to miss! Bio Dana s…
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Terry and Sean sat down to discuss credentialing vs contracting. What are the main differences, how do you handle various aspects of each and the pitfalls to avoid.
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Season 7 - Episode 37 - Monday Auditing, Coding and Compliance Roundtable
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The full panel was back this week taking on an array of topics impacting healthcare organizations across the country! Join Stephanie, Paul, Scott, Christine and Terry as they discuss and debate HCC Coding Issues, No Charging Physicians and others who refer to the practice and so much more...
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By Editor, Concierge Medicine Today I have a unique seat on the bus in our healthcare culture to speak to Physicians from all walks of life. From early startups to late retirements, it's a fun job for the most part, pouring into Physicians' lives and sharing their thoughts on running a successful practice with you. Once a quarter, we write a letter…
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Episode #45 - On Two Wheels: The Insurance Dynamics of E-Bikes
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Happy Independence Day! We think you will find this to be an educational episode. William and Chantal discuss several challenging subjects related to motor vehicles and homeowner policies. They explore car classifications, modernizing policies, and the roles of claims adjusters. They analyze how changing policyholder needs and new technologies like…
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This episode Terry and Sean take on adding services to your revenue mix and the costs for doing so if "Medical Necessity" is not met. There is a ton to unpack in the episode. Sean also blogged about this topic on LinkedIn Monday, July 1, 2024... take a look at that blog!
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Taking Your Business From Best Kept Secret To Household Name.
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1:03:17
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Helping doctors build profitable businesses so they can live life and practice medicine on their terms. Our guest this week is AUTHOR and Physician-Entrepreneur and my friend, DR. UNA! Dr. Nneka Unachukwu is a board-certified pediatrician and the founder and CEO of Ivy League Pediatrics outside of Atlanta, Georgia. She graduated from the University…
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Empower Sleep: The world's most personalized sleep care experience.
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There are approximately 70 million Americans suffering from sleep disorders - most of whom are undiagnosed. As sleep providers, we founded Empower Sleep to deliver more personalized care so everyone can benefit from the effects of better sleep. Our guest today is Dr. Sahil Chopra, MD, Harvard Medical School Loma Linda University University of Calif…
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Terry and Sean are back at it once again taking on the big issues impacting healthcare providers! It's all about risk mitigation and creating a culture of compliance!
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Season 7 - Episode 34 - Monday Auditing, Coding and Compliance Roundtable
1:02:47
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The Monday Roundtable is back with all new segments and compliance centered topics. Join Sean, Terry, Christine, Scott, Paul and Stephanie as they tackle the biggest issues in healthcare.
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The ethics of AI in health data management: Balancing innovation and patient privacy
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Our next guest is Dr. CAROLYN WARD, Director Of Clinical Strategy, Particle Health. Dr. Carolyn Ward is a dynamic and driven internal medicine physician with a passion for physician empowerment and data-driven decision making. With over eight years of experience in healthcare, including as Chief Resident at Rutgers Robert Wood Johnson Medical Schoo…
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Episode #44 - Adjusting to AI: The New Frontier in Claim Management
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Hosts Bill and Chantal are joined by special guest Luis Diaz, a thought-provoking entrepreneur with a passion for technology and insurance claims. https://www.linkedin.com/in/luisarturodiaz/ https://www.gobeyondroadmap.com/ In this episode, they explore the transformative impact of artificial intelligence on the insurance claims process. Luis intro…
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Considering a Career in Concierge Medicine?
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By Concierge Medicine Today sources, with Contributions From CMT, Editor-in-Chief UPDATED FOR JUNE 2024 | ATLANTA, GA—For almost two decades now, Concierge Medicine Today (CMT) has been reporting, discussing, writing, documenting, observing, and talking directly with you (i.e., Physicians) about all the various nuances the concierge medicine indust…
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Season 7 - Episode 33 - #TerryTuesday - Employment Requirement of Incident-To
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Don't let the title fool you... this is not just another incident-to podcast. This episode focuses on the employee/employment requirement(s) and how organizations continue to make significant mistakes.
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Season 7 - Episode 32 - Monday Auditing, Coding and Compliance Roundtable
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Terry, Christine, Stephanie, Paul, and Scott were all back for this new episode of the Monday Roundtable. It was quite the discussion on various payor guidelines regarding G2211, The Anatomy of CPT Codes, Split/Shared Services, EMR as a Tool, and so much more...
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Revitalizing Growth: Transformative Strategies for Healthcare and Insurance Companies
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My guest today is Mike Murphy, Managing Partner, Sunstone Management Advisors Mike is an experienced growth leader with an impressive track record of building, growing, and improving the financial performance of healthcare and insurance companies across the service, technology, and payer sectors. With more than 30 years of experience as a C-level e…
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Episode #43 - Balancing Tech and Touch: The Heart of Claims
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In this episode, Bill and Chantal explore the human element in claims adjusting. They discuss the importance of empathy, effective communication, and cultural sensitivity in the profession. Bill shares personal stories that highlight the need for adjusters to remember that for many claimants, this is their first and only experience with a loss. Cha…
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Medical A.I. in healthcare and the escalating threats of cyberattacks in healthcare.
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RXNT is a trailblazer in ambulatory medical software and we caught up with Randy Blodyga. Under the leadership of Randy Boldyga, a visionary in the healthcare industry since the 90s, RXNT stands at the forefront of healthcare innovation. RXNT isn't just another name in healthcare; it offers a comprehensive suite of solutions, from practice manageme…
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Private Equity and Your Practice: Knowing what to do before you start the PE discussions
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"I value my long-term client relationships and always strive to meet and exceed their expectations by being responsive to their requests, listening to their needs, and providing direct access to other Rehmann advisors.” ~The Rehmann Team, Danielle L. Ambrozy, CPA, MBA, CHBC Danielle is responsible for providing accounting and tax services to small …
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Season 7 - Episode 31 - Brian Lobley - CEO Tango
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Brian Lobley brings over 20 years of experience leading healthcare businesses, operations, and strategy. Prior to joining tango, he served as the executive vice president, chief operating officer, and president of Health Markets at Independence Health Group, the parent company of Independence Blue Cross, LLC. He was responsible for leading Commerci…
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Episode #42 - The Navigation of Litigation: The Adjuster's Role and Challenges
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In this episode, William and Chantal explore the world of litigation and its impact on claims professionals. They discuss the role of adjusters in the litigation process, the importance of effective communication with clients, and the unique challenges faced by elderly individuals on Medicare when filing claims. The episode also covers the 'duty to…
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In this episode Sean and Terry take on Addendums, Corrections, and Late Entries, and when you can make them, when you shouldn't, and when clinical summaries are a better options.
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Bookkeeping Best Practices FOR Doctors: Meet Coal Creek Ledgers Founder, Katie Rhodes
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"My mission is to transform the lives of physician entrepreneurs by creating a relationship delivering absolute excellence, and bringing clarity and understanding to your financial information so you can achieve the kind of life you envisioned when you decided to practice medicine." -Katie Rhodes, Founder, Coal Creek Ledgers By Concierge Medicine T…
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Sean and Terry are back with an all new #TerryTuesday episode that you are not going to want to miss!
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Season 7 - Episode 28 - Monday Auditing, Coding, and Compliance Roundtable
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The full panel! Scott Kraft, John Paul Spencer, Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM, Stephanie Allard, CPC, CEMA, RHIT and Christine Hall CHC was back with all new topics! 1. Weight loss drugs and all the confusion on medical necessity 2. Physician disclaimers and the misnomers 3. Developing the next generation of code…
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Combatting Maternal Health Stats – Female Biracial Health Tech Executive, Meet Dana Medema
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About Dana Medema Dana Medema is Senior Vice President of Personal Health for Philips North America where she leads the growth and transformation of the Personal Health business across the U.S. and Canada. With more than 20 years of global experience in health and beauty categories, her experience spans both innovation and commercial roles, leading…
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Season 7 - Episode 27 - Non-compete Agreements - "The Road Ahead"
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Bryan Meek of Brennan, Manna, and Diamond joins Sean to discuss last weeks final rule issued by the Federal Trade Commission and what it means at this point, where things are headed and how to navigate through all the noise. Don't miss this episode!
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Episode #41 - Deciphering Damages: A Comprehensive Guide to Claim Settlements
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Welcome to Episode #41 of "The Art of Adjusting® Podcast" - your go-to resource for expert insights and practical tips on navigating the world of claims adjustment. In this episode, join hosts William Auten and Chantal Roberts as they discuss the challenges of assessing damages in insurance claims. To read more on the topic of determining the value…
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Sean and Terry are at it again, taking on the most perplexing and head-scratching auditing, coding and compliance topics and bringing a sense of sanity to insane situations!
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Season 7 - Episode 25 - Monday Auditing, Coding and Compliance Roundtable
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Most of the all star team was back for this one and it was an outstanding discussion of the G2211, Medical Necessity vs. Correct Coding, SNF Visits and Medical Necessity, and so much more!
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Listen Up: Navigating the Future of Audiological Advancements with Dr. Keith Darrow, PhD, CCC-A
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Currently only 1 out of 5 people with hearing loss seek treatment (and it is estimated that 48 Million people in the U.S. suffer from a disabling form of hearing loss!). Dr. Darrow’s passion is helping patients, Audiologist, and future Audiologist, understand the positive benefits of treating hearing loss that include improved quality of life, incr…
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Spotlight: Concierge Oncology, Chad Levitt, MD - Radiation Oncologist
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Concierge Medicine is unique in so many ways and impacting the lives of Patients and Physicians in multiple specialties. Today we sit down with Dr. Chad Levitt, a Radiation Oncology and Founder of ONCare. Dr. Levitt strives to put himself “in his patients’ shoes” as he considers all aspects of their care plan. Central to his philosophy is the inter…
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Episode #40 - Unpacking Negligence - Key Concepts in Liability and Insurance Claims
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Join William Auten and Chantal Roberts in this insightful episode of The Art of Adjusting® Podcast as they examine key legal concepts of negligence in the insurance industry. This episode explores topics such as negligence per se, premises liability involving trespassers, licensees, and invitees, along with the principles of strict liability. Disco…
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July 12-13 in Atlanta, GA - Revolution Practice hosts "The Business of Medicine & Tools to Improve Patient Outcomes" Live Event
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Learn from the experts at Revolution Practice this July 12-13, 2024 as they present to you the best kept secrets of their success! Come and gain confidence at our 2 day event to make shifts in operations by engaged learning, practice building tips, Functional Medicine tidbits, contract and cosnet writing, dealing with difficult people & more! At Re…
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Modern Patient Expectation Workflow: "Care, Serve, Treat. Repeat."
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By Editor, Concierge Medicine Today It has been a minute since my wife and I watched Mad Men. I still remember a few quotes, though. I recall Roger Sterling's sage marketing and business advice (above) with ease. Unrelated, my wife and our close family friends recalled just last week how we found Betty, a fun character with a few quirky phrases of …
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Episode #39 - Policy and Practice: Depreciation of Labor
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Exploring Depreciation of Labor and Materials In this episode of The Art of Adjusting® Podcast, William Auten and Chantal Roberts navigate the complexities of depreciation in insurance claims, focusing on labor and materials. They kick off with an examination of depreciation, from wear and tear to obsolescence, highlighted by insights from Deprecia…
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Sean and Terry are back at it with another great episode focusing on the most challenging issues facing healthcare providers and their organizations.
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Season 7 - Episode 23 - Monday Auditing, Coding and Compliance Roundtable
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1:01:36
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The all star panel is back together again with an all new episode. 1. Clean Claims 2. Misapplication of Diagnosis Codes 3. Change Healthcare Debacle
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Dr. Joseph is the co-author of “Designing for Health: The Human-Centered Approach”
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Dr. Joseph is the co-author of “Designing for Health: The Human-Centered Approach,” a book that promotes the intentional application of design to the particular needs of clinicians, hospital staff, and patients. We caught up with him in today's Concierge Medicine Today's DocPreneur Leadership Podcast. Craig Joseph, MD is the Chief Medical Officer o…
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Episode #38 - Rising Tides, Rising Challenges: Beyond the Floodline
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In this episode of The Art of Adjusting® Podcast, Chantal Roberts and William Auten dive deep into the complexities surrounding water damage, storm surges, and their implications on insurance policies. They shed light on the critical role of flood-certified adjusters and the nuanced limitations within flood policies, especially in the context of hi…
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Season 7 - Episode 22 - #TerryTuesday - IPPE and AWE (Medicare)
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Terry and Sean take on Medicare's IPPE and AWV and all the misinformation and dos and don'ts! Hear directly from a Medicare Auditor on her thoughts and opinions on direct supervision / incident-to regarding these services.
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Season 7 - Episode 21 - Monday Auditing, Coding and Compliance Roundtable
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The Panel takes on the most pressing issues facing healthcare providers today! 1. Medicare Physician Fee Schedule Update 2. G0136 - SD0H HCPCSII Code Dos and Don'ts 3. TPE Targeting Level II and IV EM Services
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Season 7 - Episode - 20 - Christine Hall - Coding and Compliance
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It was such a treat to have Christine Hall of Stirling Global Solutions (https://www.stirlingglobalsolutions.com/) join The Compliance Guy Podcast to discuss compliance and coding issues surrounding Chronic Care Management (CCM), Providers Failing to Issue Voluntary Refunds, and so much more!
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