WEBVTT
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00:00:01.747Hey everyone, thanks for coming back to the channel.
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00:00:03.867I am here today with Missy Kirshner.
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00:00:13.348She has been involved in the healthcare world for over 30 years, with experience in billing and coding, auditing, education and practice management and risk adjustment.
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00:00:24.425She has been a very passionate educator for the AEPC for their live instructor programs as well as for private certified professional coder students.
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00:00:40.850Melissa was the inaugural chair of the AAPC Documentation Advisory Committee and is a founding member of the Novi Michigan chapter, where she has served in basically every officer capacity that they have and now functions as the chapter education officer.
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00:00:43.301So thank you for coming on the channel today, missy, so excited.
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00:00:43.722Education officer.
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00:00:45.383So thank you for coming on the channel today, missy, so excited.
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00:00:59.012So, missy, your background began back in 1995 as a reimbursement specialist at Detroit Medical Center and now it's evolved into your current role is executive director at Olympia Medical.
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00:01:05.236So can you share what has driven your career progression and what you are passionate about in health care?
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00:01:13.400Absolutely so.
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00:01:13.864It's interesting.
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00:01:35.367So when I was with the DMC back in 95, and I actually I don't even have my earlier stuff on my LinkedIn profile or anything else but when I was there in 95, it was my father's practice oh God, my father was an OBGYN and my father worked for the Detroit Medical Center, and I had just finished my father's practice oh God, my father was an OBGYN and my father worked for the Detroit Medical Center, and I had just finished my master's in public health, in hospital policy and administration, right when he sold his practice to DMC.
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00:01:39.021Right when he sold his practice to the Detroit Medical Center.
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00:01:57.432Okay, so they immediately brought me into their administrative team and I worked on the administrative team for DMC for years, working with all of our providers and working on what can we do to lessen the burden for the physicians and still be putting out good quality care?
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00:01:59.313And that was in the 90s.
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00:02:05.219That was in the 90s Because that was way before practices were really getting bought up by these large healthcare organizations.
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00:02:08.860But that was when we were still doing everything on Well.
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00:02:16.248So it was the second round of hospitals purchasing practices, but we were still doing everything on paper.
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00:02:26.652We were still doing your triplicate claim form Right, trying to make sure that the insurance carriers got them trying to follow those dollars.
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00:02:41.420There's a lot of work that was happening in the practices that was burdening the staff in the office, which then was putting the pressure on the physicians, so my job was to take that off of them.
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00:02:43.185And it was 95.
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00:02:50.407It was when all of those new E&M guidelines were coming out and the physicians were all completely freaking out about the guidelines.
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00:02:56.807So the clinical burden that we've had has that not necessarily been a new thing?
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00:03:17.430It's more so just morphed over the years, it's morphed, it changed over the years and as we've gotten more technology and we've gotten more things thrown on the physicians, they're just getting diverted to other pieces of burden and it's my job and the job of my team to do as much as we can to take that off of the providers.
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00:03:23.512Yeah, I've kind of felt recently like when we first started getting the emergence of AI and medical coding.
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00:03:25.287There was like that little bit of panic inside me.
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00:03:26.344I'm like, oh my God, what is this?
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00:03:42.454But the more I'm seeing it kind of like slowly roll out, I'm like this is kind of feeling reminiscent of electronic medical records coming on and I'm like you know what, I'm not going to worry about this too much because when it's time for me to learn this new software, whatever it is that we're going to get, I'll get training.
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00:03:43.593I'm not going to worry about.
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00:03:45.814Oh my gosh, I need to panic about this.
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00:03:56.158I vividly remember I can like picture it in my mind the EMR vendor that came into one of the practices while I was there and I heard them talking to the physicians.
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00:03:58.544My system's going to do everything for you.
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00:04:06.292You just put your information in and my system will bill it, It'll code it, It'll post all of the payments.
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00:04:08.664You're not going to need all of those people.
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00:04:11.611Yeah, I'm here.
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00:04:15.367My job has evolved.
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00:04:19.247Ai is never going to take over our world.
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00:04:22.339It's going to enhance our world or change our world.
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00:04:27.487There's definitely going to be some structural changes, absolutely, but not, I don't think, elimination.
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00:04:31.831I don't think that there's any way that AI could take over what we do, yeah.
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00:04:47.005Now, one of the interesting things about you, missy, is you mentioned that you have your master's in public health, and I have so many people that are going for master's, but in health administration, so I'm very fascinated by, like the public health master's.
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00:04:52.305I'm starting to see the more people getting their master's in public health, though, versus health administration.
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00:04:59.721How have you integrated your knowledge of that public health policy and administration into your work, especially in things like medical billing and coding?
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00:05:03.367So because of what I do on a day-to-day basis.
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00:05:27.882I run a large physician organization in our state and really a lot of what we do is working with our health plans to develop medical policy and to develop programs that will work well for our providers and for our patients and for our patients.
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00:05:31.658The public health aspect so my degree is public health policy with a focus on hospital administration, public health policy and hospital administration.
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00:05:36.692So it really helped me see the back end of what was happening in our hospitals and our physician practices.
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00:05:46.060But the public health aspect really has lent itself very well to all of the social determinants of health work and all of the epidemiological stuff.
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00:05:47.567Did you know we just went through a pandemic?
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00:05:48.848Oh, did we.
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00:05:58.591I must have missed it there was like this pandemic thing, so understanding kind of the social impact that we were seeing with the epidemic and how it was impacting our patient population.
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00:06:11.012Yeah, I did a lot of work as part of my master's with our health behavior health education team because that was another concentration and while I didn't pursue it, I did a lot of work with them as well.
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00:06:37.509A lot of my very good friends are part of the health behavior health education team and a lot of what we do right now, a lot of the programming that I do is focused specifically on our diabetic patient population and working with those patients who are maybe less fortunate, who may have some significant social determinants, even just the cost of some of these medications and what can we do to get better adoption.
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00:07:01.322I heard the most fascinating infectious disease presentation a few years ago where the physician said that it's gotten to the point now where his patients that have HIV AIDS are much easier to manage than his patients that have diabetes because of just all of the components that are going into this diabetic population and some of the social determinant of health barriers that they have versus the patient who has HIV.
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00:07:05.105And now it's almost to the point sometimes that they are just like you get this pill and you take that pill every day and you're fine.
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00:07:16.427So I was one of the first organizations in my state to employ ambulatory care clinical pharmacists on the outpatient physician side.
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00:07:20.221We've had them in the hospitals, we've had them on the inpatient side.
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00:07:43.798But I employ ambulatory care clinical pharmacists who are pharmacists who have done a two-year residency in ambulatory care and they work directly with my diabetic patients, my hypertensive patients, my hyperlipidemia patients, my Medicare Polypharm patients, all to enhance the patient's life.
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00:07:48.261To enhance the patient's life to.
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00:08:03.283We've had patients that we've been able to get from an A1C way up here down to controls in three or four months just because we've got that extra pair of hands on that care team who's working with those patients and understands the medications and all of the clinical components.
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00:08:13.545So for those that are still trying to find their way in the health care sphere, who would you kind of recommend might get a master's in health administration, Public health, you said right yeah.
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00:08:24.872Yeah, so public health, so someone who is really focused in on more of the administrative aspects of what we do.
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00:08:35.163Understanding the billing and coding is great and you have to understand it.
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00:08:51.793But if you really want to understand kind of the workings of what we do and understand you know, I understand the policy that the health plan has and that the providers have and I can see the balance that we have to reach between the two, and a lot of that comes from the masters that I have in public health and hospital administration.
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00:08:52.701That's awesome.
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00:09:03.152So you've been deeply involved with education with the AAPC for a good period of time, from being documentation committee chairperson to instructing the remote courses.
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00:09:09.812So what inspires you to teach and what do you find most rewarding about mentoring those future professionals in our field?
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00:09:10.280Love it.
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00:09:11.703I love it.
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00:09:16.721I love working with the students, I love bringing that education to them.
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00:09:24.777I love seeing when the light goes on and the spark hits and they understand what they're talking about and we can go back to.
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00:09:24.958Okay.
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00:09:32.806Do you remember like three or four weeks ago, when you were so frustrated with all this, like, just trust me, it all will make sense.
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00:09:46.068And then when they reach out to me afterwards I just got my first job, or I just got my next job, or I just got my next certification, or I'm getting ready to do this, and I've got a couple of students that have kept in touch with me over the years.
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00:09:49.374You know I'm moving into risk adjustment now.
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00:09:50.514Can you give me any tips?
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00:09:51.041Can you give me?
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00:09:55.090Or I get to come to HealthCon and I get to network with them.
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00:09:57.881Yeah, which is such a cool experience.
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00:10:00.907You know, this is a great industry.
00:10:00.907 -->
00:10:11.950It's not the same thing all day, every day, and there are so many different places that you can go and you don't have to be a biller or a coder in an office.
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00:10:29.044We've got compliance, we've got auditing, we've got documentation experts, we've got People that are masters of Epic, right, right, and now they're going to be more positions, I'm sure, opening for programming and working with all this AI technology that we're getting as well, design an EMR system.
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00:10:30.046What did I do after that?
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00:10:30.985I went to work for a law firm.
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00:10:58.836A law firm yes, they have a healthcare compliance team that was doing healthcare compliance for hospitals all over the US underneath the attorneys, and they needed billers, not billers.
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00:11:03.765They needed coders and auditors and compliance folks who could work right alongside the attorneys.
00:11:03.765 -->
00:11:04.986I did that for several years.
00:11:04.986 -->
00:11:09.273There's so many different ways that you can go with this.
00:11:09.352 -->
00:11:13.648This is a great industry to be in, and there's always going to be a place for people that they're like.
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00:11:19.014I just want to work from home and do my job and sign out at the end of the day Awesome.
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00:11:22.344But if you want more opportunities, they are out there.
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00:11:24.610They are 100 percent.
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00:11:30.908They are out there and you just you get your foot into the door, you network, you talk to people.
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00:11:38.941You can't be afraid to not be out there and talking to people and tell people what you want people, what you're looking for, that's you know.
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00:11:40.783We just took a picture downstairs.
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00:11:52.047Some of my best friends are people who I met at HealthCon years ago, just from going up and talking to them and starting those conversations.
00:11:52.047 -->
00:11:56.283But now you have that network and I want to do something a little bit different.
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00:11:59.902Let me throw it out to my network and see who knows about things that are going on.
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00:12:03.169Or I've got a question about something I've never experienced before.
00:12:03.169 -->
00:12:06.489Throw it out to my network and see who's got information for me.
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00:12:08.625Yeah, and it doesn't have to be the jump from.
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00:12:13.706You know, you just passed your CPC and now I'm going to HealthCon Connect with your local chapter.
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00:12:16.750Absolutely, the local chapters are the best.
00:12:16.750 -->
00:12:30.206I mean, we started my local chapter in 2014, so 10 years ago because there was a need, because we had so many people and the chapters were overfilled, overflowing.
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00:12:48.203Getting involved in the local chapters has been great, and as an officer, especially when we had more of the in-person meetings although it's happened in the Zoom meetings as well where I've had somebody come in and say I'm looking for a job, I'm ready to make the leap, can you help me find a job?
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00:12:49.288Yeah, absolutely.
00:12:49.288 -->
00:12:51.927Give me your resume and then someone will come in 10 minutes later.
00:12:51.927 -->
00:12:55.524I need a person for this.
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00:12:57.730Yes, fantastic, barb meet Amy.
00:12:57.730 -->
00:12:58.773Amy meet Barb.
00:12:58.773 -->
00:13:03.932Barb and Amy still work together today, four or five, six years later.
00:13:08.139 -->
00:13:11.639I mean, yeah, I'll have people that will come and be like oh well, I'm looking for a job and I'm like we're about to get approval for three positions.
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00:13:13.950So hold tight, because they're coming.
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00:13:22.054And that's what's nice about the local chapters is because the local chapters have their pulse on what's happening in your local area.
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00:13:26.582Pulse on what's happening in your local area.
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00:13:35.527It doesn't take away from that networking that we do with chapters across the US and going to those meetings and jumping into their Zooms, but getting to know your local chapter and getting involved.
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00:13:37.751Most of them have a Facebook page.
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00:13:40.243Most of them have their meetings.
00:13:40.243 -->
00:13:47.438A lot of them are doing meet and greets outside of local chapters, just so we get FaceTime, so we can see each other.
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00:13:50.477The local chapters are fantastic.
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00:13:56.261I have all new officers this year and two of my three officers are here at Health Cut.
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00:13:56.864Oh, that's cool.
00:13:56.864 -->
00:14:07.885And I was just right before we started this, I was downstairs with one of them helping her to get registered for next year, because she's like there's no way I would not come to this in the future.
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00:14:09.174She's like this is fantastic.
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00:14:10.220Yeah, no way.
00:14:10.240 -->
00:14:11.746I would not come to this in the future.
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00:14:16.030It's like this is fantastic, yeah.
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00:14:18.626So I'm like an hour and a half, maybe an hour depending on how traffic is west of Philadelphia, which is where our regional conference is this year.
00:14:18.626 -->
00:14:26.753So I'm like I better see all of you people at regionals this year, all of you that I worked with at Lehigh and Lancaster were not that far.
00:14:26.753 -->
00:14:28.256You go over and go to HealthCon.
00:14:28.256 -->
00:14:33.089Yeah, I'm already booked for HealthCon next year because it's a Disney and I can't resist.
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00:14:33.409Disney.
00:14:33.409 -->
00:14:38.822So HealthCon for next year, albeit I'm not going to make regional this year and I'm so sad.
00:14:39.630 -->
00:14:44.643So you talked about your passion for education and helping people prepare for their exams, and medical billing and coding.
00:14:44.643 -->
00:14:51.003Can you share an impactful story or turning point in your career that highlighted the importance of education in this field?
00:14:51.510 -->
00:14:55.642Oh my gosh, there's so many examples on it.
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00:15:03.484On every day there's something that could possibly come up that that points to the importance of the education.
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00:15:37.025You know, unfortunately, I do have a couple of providers who are in quite a bit of legal trouble because they don't follow the education and the advice of those of us around who can advise them, which winds up being worse, because I've had some providers, even in my local area, where they found out to have some billing issues and they were exacerbated by the fact that, well, we can also prove that you had consultants in that told you specifically not to do this and you still did it anyway.
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00:15:38.027Uh-huh.
00:15:40.230 -->
00:15:43.000And then they'll call and they'll say do you have document?
00:15:43.000 -->
00:16:03.041I have that, can I?
00:16:03.041 -->
00:16:05.302How do I what?
00:16:05.302 -->
00:16:09.384I love it because then we can.
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00:16:15.107If I don't know what it is, I have the opportunity to look at it, get the information and teach them.
00:16:15.931 -->
00:16:22.604One of the things that I think the pandemic has really helped us with is when we did have to switch to so much virtual and everyone was kind of pushed onto it.
00:16:22.604 -->
00:16:29.250There's so much more sharing now of the education, the education.
00:16:29.250 -->
00:16:41.793It used to be that if you were like, oh well, you're going to be a cardiology coder now, you would have to be like, okay, well, either I have to find someone in my chapter that I know maybe knows cardiology, I have to buy a you know a Dr Z book, or I have to go toa conference to learn you know cardiology coding.
00:16:41.812 -->
00:17:06.023And now it's oh look, terry Fletcher is speaking on June 6th and I can just sign on to their virtual chapter meeting and learn what I need to do Absolutely, or you can just reach out to them, because all of our information is available and any one of us, like anybody who's a coder I haven't found anybody yet who would refuse to answer a question for somebody, who would refuse to help somebody else.
00:17:06.023 -->
00:17:09.233So hey, I heard Terry speak at a conference.
00:17:09.233 -->
00:17:13.102I'm just going to email her because I've got a couple of questions, and that's.
00:17:13.102 -->
00:17:22.880I think one of the things that we learned during the pandemic was not to be afraid sitting on the other side of our computers, and we can reach out and we can make those connections.
00:17:23.301 -->
00:17:28.798I try to help where I can, but sometimes people ask questions and I'm like I'm sorry, I don't know what's going on with denials right now.
00:17:28.798 -->
00:17:30.221I really don't.
00:17:30.480 -->
00:17:32.992I don't have a pulse on that, I'm sorry.
00:17:35.036 -->
00:17:39.902Now, given your leadership roles, how do you approach leadership during these major tech implementations?
00:17:39.902 -->
00:17:43.165So we've gone from you know the paper we talked about to the EMRs.
00:17:43.165 -->
00:17:45.653Now we're integrating AI and medical coding.
00:17:45.653 -->
00:17:52.061What kind of lessons have you learned about driving change in these healthcare settings when we're adopting these big technologies?
00:17:52.343 -->
00:17:53.805Oh my gosh, we have to have buy-in.
00:17:53.805 -->
00:18:03.116You have to have buy-in not only from your clinicians, but from the staff that's going to be implementing it in the office.
00:18:03.116 -->
00:18:14.253We just went through this with one of my practices, where the physician was gung-ho on he wants this EMR in the office, but the staff didn't buy in for it.
00:18:14.253 -->
00:18:16.358The staff didn't like it.
00:18:16.358 -->
00:18:18.892It was very difficult, it was very complex.
00:18:18.892 -->
00:18:27.539So I went and I spent about four and a half hours in the office and I talked to every person in the office Tell me what you like, tell me what you don't.
00:18:27.579 -->
00:18:28.823Tell me what's going on.
00:18:28.823 -->
00:18:29.492Just physicians not here.
00:18:29.492 -->
00:18:30.086Your office manager's not here, it's just you and me.
00:18:30.086 -->
00:18:30.415Tell me what you like, tell me what you don't.
00:18:30.415 -->
00:18:30.703Yeah, tell me what's going on.
00:18:30.703 -->
00:18:30.929Just physicians not here.
00:18:30.929 -->
00:18:32.835Your office manager's not here, it's just you and me.
00:18:32.835 -->
00:18:33.818Tell me what's going on.
00:18:33.818 -->
00:18:35.674Yeah, get the buy in.
00:18:35.674 -->
00:18:39.661And what if we did this or what if we tweaked then?
00:18:39.661 -->
00:18:41.654Now it can work.
00:18:41.654 -->
00:19:12.163I think you have to understand everyone's motivation and we're not going to make everybody happy, right, right, right Like we're not going to make everybody happy, but everybody has to feel like they have a say in what's going on and you, as the clinical leader or the administrative leader, need to understand the nuances of what it is that you're about to undertake, and they're expensive decisions, so you don't want to wind up buying the wrong system, correct, and then, two years down the road, you're like, oh my gosh, I really want to switch to something else.
00:19:12.222 -->
00:19:15.346But now we've got everything already in place and it's just going to be way too much.
00:19:15.346 -->
00:19:19.398And now we're going to have to incur extra expense to try and switch to something else.
00:19:19.680 -->
00:19:21.310Make sure that you have in writing, though.
00:19:21.310 -->
00:19:33.026If they're promising you the sun, the moon and the stars, I want to see the sun, the moon and the stars in my contract, and not the sun, the moon and or stars.
00:19:33.026 -->
00:19:44.221Right, and I was just negotiating with a vendor and all the way through their contract it said and, or and or, and I went back to them and I redlined all of it and I'm like why did you do that?
00:19:44.221 -->
00:19:47.471I said because it said and or and.
00:19:47.471 -->
00:19:53.510I'm a very specific person and or does not work for me in a health care contract I'm sorry.
00:19:53.530 -->
00:19:59.662Yep, so I love that they didn't, but that was okay.
00:19:59.662 -->
00:20:01.424Yeah, oh, I'm I don't doubt that.
00:20:04.316 -->
00:20:10.271So, as an executive director and an influential figure in medical billing and coding, I think everyone knows missy kirschner in some way or another.
00:20:10.271 -->
00:20:13.513How do you envision the's going to be a lot of need for?
00:21:03.181 -->
00:21:16.828additional education by our billing and coding staff to really understand what the system is trying to pick up and how it's getting coded or how it's getting dropped onto claims.
00:21:16.828 -->
00:21:39.444There's a company that just came in and presented with AI in cardiology and how they're helping the physicians to interpret the strips and write the reports, and then we're going to give you the codes and I'm like let's talk about it first, let me see how it's going to work, before we're just going to drop something like that in on the staff.
00:21:39.444 -->
00:21:55.637I think that you know, as we move towards more electronic means of testing, I think people are going to be very hesitant about it, especially the more seasoned coders.
00:21:55.637 -->
00:22:01.307Change is hard, but change is also necessary.
00:22:01.327 -->
00:22:19.566Yeah, so I think it's healthy, though, to have a fair amount of reluctance and apprehensive and to have some questions about it, because I'm sure we're all concerned about things like bad actors, people that might just think, oh, I'm a biller and coder and the computer is going to do it for me now and I'll just click approve on everything and say that it looks fine.
00:22:19.926 -->
00:22:26.529You know there is there is definitely a lot of that, and those are the bad actors that we end up having to sort of weed out.
00:22:26.529 -->
00:22:32.291You know there was always a lot of talk about are we going to go to fill in the blank on the exam?
00:22:32.291 -->
00:22:41.317There's a lot of scare about that and a lot of hesitation, but if we think about it, I want people to be tested like that.
00:22:41.317 -->
00:22:58.201I want to be able to be tested like that myself, because that just proves that I earned those certifications that I have, I can do the job that I was hired to do, and it makes my credential, I think, a little bit stronger.
00:22:58.561 -->
00:22:59.063Absolutely.
00:22:59.063 -->
00:23:05.042And I do get a lot of questions about the fill in the blank, especially people like well for 2024, how many fill in the blank questions are there?
00:23:05.042 -->
00:23:07.809There aren't any this year, there's none.
00:23:07.809 -->
00:23:14.231Next year maybe, but for now none of the study materials have filled Well for the practice exams.
00:23:14.231 -->
00:23:15.682They don't have fill in the blank questions.
00:23:15.682 -->
00:23:19.432They're not preparing you, they're not going to just spring it on you that you're going to get fill in the blank questions.
00:23:19.432 -->
00:23:25.903It's not that this week it's going to be all multiple choice and next week, hey, we've gotten those off, you have to fill in the blanks.
00:23:25.903 -->
00:23:36.326We're going to get some way advanced notice, I'm sure, once that implementation happens In this industry we cannot be stuck in our own cubbyholes.
00:23:37.308 -->
00:23:49.450We are constantly changing and constantly evolving, and if that's something that makes you uncomfortable, if change is not something that you're good with, this may not be the best industry for you, because we are constantly changing.
00:23:49.450 -->
00:23:52.260Thankfully, things have slowed down a little bit.
00:23:52.260 -->
00:23:57.045During COVID, things were changing like on an hourly basis.
00:23:57.045 -->
00:24:15.366We're back to our quarterly changes, but even our health care systems, even our EMR systems, our billing and management systems those are changing constantly and you have to be able to roll with it or you may be left behind, and that could be problematic.
00:24:15.366 -->
00:24:22.425So be open to educating yourself, be open to asking those questions, be open to learning something new.
00:24:23.234 -->
00:24:32.306I remember I used to have a coworker when a piece of the magazine I think it used to be Coding Edge or maybe it was during that short period it was Cutting Edge, I can't remember.
00:24:32.306 -->
00:24:41.182But she would get so frustrated because she's like I'm a coder, I just want to do coding, and now there's all this non-coding stuff in the magazine and I don't want to know that.
00:24:41.182 -->
00:24:45.787I'm like I just want to do coding and I'm like we can't do that anymore.
00:24:45.787 -->
00:24:51.152We got to know at least enough to be dangerous about other things that are going on beyond the world of coding.
00:25:00.015 -->
00:25:02.036And if you're one of those people now.
00:25:02.036 -->
00:25:03.477That's like I just want to do the coding.
00:25:03.477 -->
00:25:05.356I just want to look things up in the book and know how to code.
00:25:05.356 -->
00:25:06.077You might get left behind.
00:25:06.077 -->
00:25:07.638I was one that was really scared of the online books.
00:25:07.638 -->
00:25:09.439I was really scared of the online books.
00:25:09.439 -->
00:25:11.079I like my paper books.
00:25:11.079 -->
00:25:20.523I just made the switch because I teach, so I had an overhead camera that I would use as I was teaching so people could see my books and I could point things out.
00:25:20.523 -->
00:25:25.106And my overhead camera died and I was just getting ready to go teach a class.
00:25:25.106 -->
00:25:31.269So I quickly switched up to my e-books, because I have them.
00:25:31.269 -->
00:25:33.450I just was always a little hesitant.
00:25:33.450 -->
00:25:34.590I would use them every once in a while.
00:25:34.590 -->
00:25:36.991I will never go back.
00:25:36.991 -->
00:25:39.133I love my e-book.
00:25:39.133 -->
00:25:39.532They're great.
00:25:40.675 -->
00:25:48.114You just click the code and it goes right to the description and I'm like, oh wow, I didn't have to accidentally look up the wrong code.
00:25:48.114 -->
00:25:56.596It's like I sometimes will look it up and it'll be a K code and somehow I'm over in the J's and I'm like what the hell was I thinking?
00:25:56.615 -->
00:26:00.344I can see it, I can highlight it, I can do all my different colors that I highlighted in my books already.
00:26:00.344 -->
00:26:07.826But that was a learning lesson for me, because that was something I've been really hesitant to do.
00:26:07.826 -->
00:26:11.883I remember Catherine telling us last year get used to those e-books.
00:26:11.883 -->
00:26:18.616So I've done a little bit, but now I'm like full bore into them and it's fantastic.
00:26:18.616 -->
00:26:22.184So I had to open my mind and get ready to do it.
00:26:22.945 -->
00:26:41.369But now we're there and that's another thing we need to kind of keep our eyes out with the exam is that now we're also looking at transitioning over to allowing e-books for the certification exams, because employers especially with the virtual, remote and remote workforce that we have now, they don't want to have to ship out stacks of books to 50 different people across the nation.
00:26:41.369 -->
00:26:47.621They're going to give you some kind of digital tool or resource and e-book encoder or something, and that's what they're going to want you to use.
00:26:47.621 -->
00:26:52.002If you like a paper book, that's fine, but you're probably going to have to buy it yourself.
00:26:52.977 -->
00:26:54.905You have to get used to that electronic way.
00:26:54.905 -->
00:27:09.583So actually, because we were just talking about this here at conference, I will be doing a presentation coming up for, I think, four or five different chapters on those e-book tools and Codify and how do you use this in your day-to-day work?
00:27:09.583 -->
00:27:22.730Because people are scared, People don't understand, and when it's something you don't understand, you don't understand, and when it's something you don't understand, you don't want to use it and it can make our lives so much better.
00:27:22.688 -->
00:27:24.778Yeah, part of those tools that we have to learn to start using, yeah, but it's.
00:27:24.778 -->
00:27:26.376I think it's going to be interesting to see the transition.
00:27:26.376 -->
00:27:46.202We have certain people and companies that like doing their processes for how to highlight and how to circle things and underline this, and then put a little note here and it's like, okay, well, that all is great, but now we're going to have to transition that into an electronic form of some kind.
00:27:46.202 -->
00:27:50.278The tabs are not going to work the same way that they used to.
00:27:51.039 -->
00:27:53.266Now I'm not even sure that we'll be able to do those.
00:27:53.686 -->
00:28:16.050That's what I'm hearing and that was one of my concerns at the beginning, because there's some applications within the e-books to share notes and share your highlights and I'm like, well, that could be problematic in an exam if someone is perhaps you know again bad actors making some notes on some things in the exam or kind of questions they're getting and then saving it and then sharing it off to other people.
00:28:16.050 -->
00:28:20.855You know we have to protect the integrity of the exam, otherwise our certifications aren't worth anything.
00:28:20.977 -->
00:28:26.456My students think I'm crazy when I tell them this, and maybe viewers are going to say the same thing.
00:28:26.456 -->
00:28:28.681Coding is not about the codes.
00:28:28.681 -->
00:28:30.202It's not.
00:28:30.202 -->
00:28:34.356Coding is about understanding how to apply the codes.
00:28:34.356 -->
00:28:46.903Coding is about how to read the codes, understand the differences in them and understand the guidelines, whether the guidelines are just before the codes or in parentheticals underneath.
00:28:46.903 -->
00:28:49.167That's what makes you a good coder.
00:28:49.167 -->
00:28:53.701Yeah, not your bubbles and your highlights and I'm a bubble and highlight person.
00:28:53.701 -->
00:28:54.483I am.
00:28:54.734 -->
00:29:02.517My joke is that my books look like the Crayola Rainbow threw up in them, because everything is highlighted and bolded and notes all over the place.
00:29:02.517 -->
00:29:05.248But that doesn't make me a better coder.
00:29:05.248 -->
00:29:06.491That doesn't make me a better.
00:29:06.491 -->
00:29:12.234It just proves that I've forced myself to sit down and read the book so that I could see the differences.
00:29:12.234 -->
00:29:16.020And when you take all of those away, guess what?
00:29:16.020 -->
00:29:20.287If you've learned how to code, you can still figure it out.
00:29:20.287 -->
00:29:22.029You still understand what you're doing.
00:29:22.029 -->
00:29:29.528Right, and that's where we're going to be transitioning, because that's what the workforce is going to have to do, right, right.
00:29:29.929 -->
00:29:36.650So, missy, you've been involved with lots of different sections of health care, billing and coding compliance.
00:29:36.650 -->
00:30:02.579How did these experiences give you a unique perspective on the challenges and how that's going to impact the risk adjustment and how that's going to impact the compliance and how it's going to impact the quality and all of those different things.
00:30:02.640 -->
00:30:19.051I think it's important to be well-rounded and I'm not saying that you have to go out and do all of those different pieces, but it's important to understand how it all sort of fits together, kind of like what you were saying earlier, that somebody just to be heads down, I just want to be doing my code and we can't do that.
00:30:19.152 -->
00:30:30.876We really have to understand if somebody at the front desk doesn't do x, how is that going to impact y and what is that trail that it's going to take all the way through?
00:30:30.876 -->
00:30:44.349Um, I was just talking to somebody here yesterday who said that her billers and coders are the ones who are verifying insurance after the patient is seen.
00:30:44.349 -->
00:30:51.275After I said what happens if the insurance changed?
00:30:51.275 -->
00:31:01.369Well then my doctors are probably going to lose money because we may not have gotten something prior authorized that we were doing and it was a specialty practice.
00:31:01.369 -->
00:31:07.287I really think you need to transition that and to look at some workflows.
00:31:07.287 -->
00:31:16.503Definitely, you know, part of that is just from working in the industry for so long and seeing all of the different pieces and understanding.
00:31:17.175 -->
00:31:27.017One of the areas that I struggle with is there's some components that I don't understand and without finding a position in that or getting someone to sit down with me, I'm not sure how to learn it.
00:31:27.017 -->
00:31:34.942Like credentialing I don't know much of anything about credentialing and provider enrollment, but I'm not quite sure how to learn that at this point.
00:31:34.942 -->
00:31:37.727Right Like I know, there's organizations and things.
00:31:38.248 -->
00:31:38.828Networking.
00:31:38.828 -->
00:31:41.243I'm telling you, it's all about networking.
00:31:41.243 -->
00:31:46.760I had somebody in my organization who's credentialing for a long time.
00:31:46.760 -->
00:31:54.323She left so I brought in somebody new who'd never done a whole lot of it but she was kind of familiar with it.
00:31:54.323 -->
00:32:01.346I'm like well, here's my friend who I met, rue AAPC actually who does a whole lot of credentialing.
00:32:01.346 -->
00:32:04.824Let's get on the phone, let's call her, let's ask her some of those questions.
00:32:04.824 -->
00:32:08.717It's what do we always say about this industry?
00:32:08.717 -->
00:32:15.016It's about research, it's about connections, it's about networking, not being afraid to ask those questions.
00:32:15.016 -->
00:32:18.337If it's something that I need to know, I'll pick up the phone and I'll call.
00:32:18.337 -->
00:32:28.344I'm not afraid to pick up the phone and call and ask somebody and look dumb, you know, because it's not dumb, it's a valid question and credentialing is the worst.
00:32:29.564 -->
00:32:36.067We're hearing about the Pico system and how it was supposed to be updated and now it's never not been updated.
00:32:36.067 -->
00:32:38.108And I'm like, oh, I know, I know what that is.
00:32:38.108 -->
00:32:40.509I've never had to use it, I know what it is.
00:32:41.871 -->
00:32:45.373I just had to use it for the first time in a very long time, and it was.
00:32:48.506 -->
00:32:48.807Yeah.
00:32:54.840 -->
00:32:57.875So, lastly, what are you working on now or working on soon in the future that you are most looking forward to?
00:32:59.795 -->
00:33:00.196Oh, how much can I so?
00:33:00.196 -->
00:33:01.924Have you been tapped on the shoulder, maybe for some things?
00:33:02.366 -->
00:33:07.583Been tapped on the shoulder, maybe for a couple of things that are coming up that I'm really excited about.
00:33:07.583 -->
00:33:10.916That kind of go along with a lot of the things that we're talking about.
00:33:10.916 -->
00:33:23.432We're going to transition to more using e-books and how do we bring those into our coders' hands, especially the ones who are a little bit afraid of those e-books.
00:33:23.432 -->
00:33:32.609I'm doing a lot of speaking right now, developing a lot of different presentations that I'm excited about.
00:33:32.609 -->
00:33:34.883A couple of changes going on at the office that I'm excited about.
00:33:34.883 -->
00:33:36.934A couple of changes going on at the office that I'm excited about.
00:33:36.934 -->
00:33:39.080There's always something going on.
00:33:39.080 -->
00:33:42.701Yeah, if I get a dull moment, I'm not sure I would know what to do with myself.
00:33:42.875 -->
00:33:44.020I'm excited to see more.
00:33:44.020 -->
00:33:48.124I'm talking to a couple of the girls that are in the Emerging Leaders program.
00:33:48.124 -->
00:33:50.479Yeah, and I can't wait to see how that goes.
00:33:50.479 -->
00:33:53.684I'm so excited and I keep just like gently nudging them.
00:33:53.684 -->
00:33:55.989I'm like so what are you planning on getting out of Emerging Leader?
00:33:55.989 -->
00:34:01.440Have you thought about?
00:34:01.480 -->
00:34:03.873joining the board of directors or the chapter association, maybe.
00:34:04.095 -->
00:34:06.920Applications are opening for both.
00:34:06.920 -->
00:34:08.563So thank you so much, Missy.
00:34:08.563 -->
00:34:11.468If my audience wants to connect with you anywhere online, where can they find you?
00:34:15.515 -->
00:34:16.905So I'm on LinkedIn, but always feel free to email me.
00:34:16.905 -->
00:34:23.307My website is melissacodingcom and my email is melissacoding at gmail, and I would love to connect with folks.
00:34:23.307 -->
00:34:25.474Well, thank you for coming on the show today, melissa.
00:34:25.474 -->
00:34:26.760Absolutely Thanks for having me.
