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Artwork for Auditing Antics: Navigating Medical Coding and Auditing

Auditing Antics: Navigating Medical Coding and Auditing

Stephanie Allard Consulting, LLC
Medical Coding
Telehealth
CMS
Medical Auditing
Centers For Medicare & Medicaid Services
Skin Substitutes
Medical Necessity
Unitedhealthcare
Medicare
Healthcare Compliance
E&M Guidelines
Stress
FDA
E/M Coding
Auditing
Burnout
Work-Life Balance
Data Analysis
Spravato
E&M Coding

Stephanie Allard, CPC, CEMA, RHIT has 20 years of experience in the medical industry and knows the complexities that the professional world is facing on a daily basis. She also knows the lack of public education about our healthcare industry in the United States which contributes to the inability for patients to advocate for themselves. Her Auditing Antics Podcast will explore the healthcare indus... more

PublishesWeeklyEpisodes58Foundeda year ago
Number of ListenersCategory
Health & Fitness

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Artwork for Auditing Antics: Navigating Medical Coding and Auditing

Latest Episodes

A focused episode answering the most common and highest-risk telehealth questions coming in right now. This episode cuts through confusion around what is actually allowed versus what is temporarily permitted, and where organizations are making assump... more

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In this episode of Auditing Antics, we recognize Stress Awareness Month with an honest conversation about the mental load and stress that comes with working in medical coding, billing, and compliance, where there is constant pressure to be accurate, ... more

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In this episode of Auditing Antics, we ask the questions every practice should be asking, but many are not, when it comes to their risk adjustment and HCC coding processes. Are your workflows built around accuracy and clinical integrity or are they d... more

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This is not just a policy update, it is a shift in workflow. In this episode of Auditing Antics, we break down what UnitedHealthcare (UHC) is really changing and why so many providers are at risk without realizing it. If you are reviewing imaging on ... more

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Recent Guests

Claudia Valdez
Influencer from Cuba referenced in discussion
Episode: Coding the Future: Bridging English and Spanish in Healthcare
Ron Chapman II
Federal criminal defense attorney
Safe Harbor (collaborator)
Episode: When Healing Meets Scrutiny: UPIC Enforcement in Skin Substitutes

Hosts

Stephanie Allard
Host of Auditing Antics, educator and consultant in medical coding/auditing
Michele
Co-host/guest engaged in interviews, Q&A style discussions, and industry insights related to audits and coding

Reviews

5.0 out of 5 stars from 15 ratings
  • Great Insights for Medical Coding & Auditing Professionals

    I really enjoy Stephanie Allard’s weekly live sessions with Michele. They provide clear explanations of current issues in medical coding, billing, and auditing, along with helpful guidance on avoiding costly billing mistakes. Their discussions are timely, practical, and very relevant for professionals in the revenue cycle and compliance space. Highly recommended for anyone in the industry.

    Apple Podcasts
    5
    adeane75
    United States2 months ago

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Talking Points

Recent interactions between the hosts and their guests.

Straight Talk on Coding & Compliance: Q&A Edition
Q: Question 5: If a telehealth patient is insured through the state where the provider is located, can the patient be in another state during the visit?
State licensing and legal requirements dictate that the provider must be licensed in the state where the patient is located during the encounter; compact licenses or multi-state licensing arrangements can help, but compliance depends on state rules and patient location.
Straight Talk on Coding & Compliance: Q&A Edition
Q: Question 4: Why is it not compliant to bill a Level 3 in a residency program when the faculty physician was unavailable to precept physically?
Because CMS guidance requires that when there is a primary care exception, the resident's independent evaluation and plan must be documented and precepting cannot be inferred from partial involvement; downcoding or GE use without proper justification leads to denials and audit risk.
Straight Talk on Coding & Compliance: Q&A Edition
Q: Question 3: How do you handle split shared scenarios where the physician and NPP see patients together, and the NPP writes the majority of the note?
In outpatient settings, the clinical workflow must reflect proper incident-to rules; if the physician did not independently evaluate and develop the plan of care, incident-to cannot be used, and documentation should clearly show independent evaluation and plan development by the physician or a properly credentialed provider.
Straight Talk on Coding & Compliance: Q&A Edition
Q: Question 2: Can a certified CPC coder change the CPT and ICD-10 codes?
Yes, a coder can update codes if supported by documentation, but the coder should be aligned with their primary role and the practice's workflow and governance, ensuring providers sign off and that changes are appropriate within the billing process.
Straight Talk on Coding & Compliance: Q&A Edition
Q: Question 1: Is it okay to bill a physical therapist under a physician in the same group while we are waiting for credentialing to go through?
No, it is not appropriate because the physical therapist cannot autonomously act and the physician or sign-off requirements and incident-to rules must be followed; otherwise it creates compliance and workflow issues.

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Frequently Asked Questions About This Podcast

What is This Podcast about and what kind of topics does it cover?

The show concentrates on practical, ethics- and policy-driven discussions about medical coding, auditing, and healthcare compliance. Across episodes, the hosts tackle real-world challenges such as proper documentation and billing workflows, upcoding risks, payer policy updates, and the evolving role of AI and EMR systems in coding accuracy. There's a recurring emphasis on collaboration between clinicians, coders, auditors, and administrators, with hands-on tips for avoiding common pitfalls, improving governance, and ensuring medical necessity drives appropriate reimbursement. A standout theme is empowering practitioners and office staff with clear workflows, templates, and evidence-based strategies to navigate complex regulatory environment... more

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Which podcasts are similar to this podcast?

These podcasts share a similar audience with this podcast:

1. The Compliance Guy
2. CodeCast | Medical Billing and Coding Insights
3. Paint The Medical Picture Podcast
4. Talk Ten Tuesdays
5. Monitor Mondays

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this podcast launched a year ago and published 58 episodes to date. You can find more information about this podcast including rankings, audience demographics and engagement in our podcast database.

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Recent guests on this podcast include:

1. Claudia Valdez
2. Ron Chapman II

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