NSCHBC Edge Podcast

You have less than one month to submit your thoughts or questions about the proposed 2027 Medicare physician fee schedule to CMS. The comment period will end Sept. 14, 11:59 p.m., ET. To be part of the reimbursement process you need to be heard!  CMS must read every comment it receives by the deadline and include a response in the final rule. Therefore, submitting a comment is more than a way to s...

Welcome to NSCHBC Edge Podcast, where we separate facts from assumptions in the world of revenue cycle management. Today we're talking about what it really means to be evidence-based. In healthcare, that phrase gets used a lot, but in RCM it has a simple meaning: show your work. Otherwise, you're just making confident guesses. Too many billing and compliance decisions are still driven by tribal kn...

Artificial intelligence is rapidly transforming healthcare, and it's a topic that's on everyone's mind. As consultants, we believe it's our responsibility to ask the tough questions as this technology reshapes the industry. In this episode, Terry is joined by Vinod ("Vinny") Sankaran for a candid discussion about the opportunities and risks of AI in healthcare. Together, they explore the real-worl...

A commonly cited concern regarding Telehealth utilization is that it may not provide an equivalent experience—or may even offer an inferior one—for both patients and providers, due to the absence of shared physical presence. For example, one concern that has been raised includes missing patient non-verbal cues as the provider may not be able to view all of the physical manifestations of the patien...

HHS and CMS will use its statutory authority to control unnecessary increases in the volume of covered outpatient department services to align payments for certain services delivered in hospitals and off-campus facilities. This is called “HHS Transparency”. As of April 1st, 2026, many regulatory rules took effect and Terry and her guest Tim Jodway, from RubinBrown Consulting, discuss the details a...

Healthcare attorneys can encourage physicians to adopt best practices without defaulting to legal statutes by focusing on clinical quality, risk management, efficiency, and peer-benchmarking. By rephrasing compliance as "patient safety" or "practice efficiency," attorneys can make best practices more palatable than just regulatory mandates. Terry discusses this an more with fellow NSCHBC member an...

Many medical practices hire marketing firms — but the why isn’t always clear. Are you promoting new services, trying to attract more patients, or working to strengthen trust within your existing patient base? In this episode, Terry Fletcher and member Carl White break down the difference between marketing and promotion for medical practices, and what practices should evaluate before bringing on a...

The No Surprises Act (NSA) continues in 2026, protecting patients from surprise bills for emergency care and certain out-of-network services, with key developments involving extended enforcement discretion for the Qualified Payment Amount (QPA) calculation (possibly to August 2026) and ongoing regulatory focus on GFE’s and IDR’s. However, there are Congressional stalls with legislation to also pro...

Healthcare consultants face challenges including managing client expectations and internal pressures like competition and staffing shortages, navigating complex client needs, and staying ahead of industry trends and regulations. They must also address operational issues like legacy systems, data security, and workforce management, as well as the complex task of balancing financial goals with ethic...

This week on the Edge Podcast, our host and NSCHBC member Terry Fletcher, will give our listeners, a few updates for your medical practices that came out of the 43-day government shutdown that ended on November 12th. As you know as of October 1st, many services were stalled or expired without Congress in session including Telehealth, Hospital at home, and funding for many government services inclu...

When securing the patient’s share of cost for medical services, what is the minimum that should be done, and should this also be taught to back-office staff not just f/o or billing? How does the NSA impact financial agreements for patients? Who enforces these policies? and what if a 3rd party billing service is involved? All of these questions and answers are addressed today in this month’s episod...

This month on the Edge Podcast, Terry welcomes NSCHBC member Janet Velazquez of JV Practice Solutions for a timely discussion on what it really takes to retain top talent in today’s healthcare landscape. It’s not just about competitive pay and benefits. Companies must foster a positive, inclusive, and supportive work environment—but what does that look like in practice? Are healthcare organization...

Production represents the services rendered and the value created by a dental and/or medical practice. Without adequate production, there wouldn't be anything to collect, regardless of how efficient the collections process is. Terry welcomes Dental consultant, Callie Ward, to discuss that robust collections are absolutely crucial to translate production into actual revenue and profit. A practice w...

Automating medical coding presents significant challenges due to the intricate nature of health information management, particularly medical records, which form the bedrock of healthcare coding and billing. Protected Health Information (PHI) exists in various formats, including handwritten notes, patient intake forms, and dictated lab reports. This lack of standardization poses a considerable hurd...

In this episode of the Edge Podcast, Terry and her guest, NSCHBC member and consultant Joe Lessard, discuss how to advise clients on critical business decisions for medical and dental practices. They cover topics such as: Insurance acceptance: What insurance plans should practices accept? Hiring strategies: When is the right time to hire new associates or partners? Location expansion: Should new l...

In the context of medical and/or dental insurance, ADR refers to Additional Documentation Request. This is a request from an insurance payer (like Medicare) for additional records to support a claim. It's not a sign of wrongdoing, but rather a way to ensure compliance with policies and verify the validity of claims.  Ignoring these requests, or failure to meet their deadlines, can result in a loss...

In-house billing offers enhanced internal control and potential return on investment but entails higher costs and staffing challenges. Conversely, outsourcing is cost-effective, transparent, and consistent but may result in skewed control of financial operations and introduce hidden costs. Terry discusses this important topic with healthcare consultant Donna White, covering the best option for dif...

On this edition of the Edge Podcast, Terry welcomes Healthcare Compliance Consultant, Stephanie Allard. The hosts discuss objectives when hiring an external consultant, such as budgets, objectives, outcomes, expectations, and more. Tune into this important and informative episode to make sure you are prepared

Are Dental Billing and Medical Billing the Same Thing? Terry Fletcher discusses the similarities, differences, and where crossover between dental and medical billing. Tune in for advice that can assist clients on both sides to be accurate in their coding and billing processes.

This month on the NSCHBC Edge Podcast, Terry welcomes back, NSCHBC member, Merikay Hunt CHBC, to discuss the pros and cons of a remote versus in-person versus hybrid workforce. When comparing corporate and healthcare sectors, remote work generally tends to be a better option for corporate roles due to the nature of many corporate jobs being more easily adaptable to digital platforms. However, heal...

On today’s NSCHBC Edge Podcast, Terry speaks with healthcare attorney and fellow NSCHBC member, Ericka Adler, to identify suspected theft in a medical practice. Terry and Ericka discuss how to identify and prevent theft, plus educate your staff and providers so you are aware of potential red flags. Some areas to focus on include cash handling, prescription drug inventory, and billing practices. Th...

CPA versus bookkeeper: what is the role comparison in Healthcare, and medical practices? What does a physician or a physician practice need and why? A bookkeeper, although helpful for day-to-day accounting, payroll, and expenditures accounting. When the medical provider needs tax breaks information, provider relief funding accounting and deadlines, and retirement planning, what’s the better option...

In this episode of the NSCHBC Edge podcast, Terry welcomes back David Zetter of Zetter Healthcare to discuss Ambulatory Surgery Centers (ASCs) versus Office Based Labs (OBLs). Topics of discussion include: Which one is easier to get funding for? Are there differences in OSHA safety protocols? Is there an approved list for each that differs? And finally, which one have you seen as more profitable?

The NSCHBC Edge Podcast welcomes fellow NSCHBC member, Rozmin Bapat to the show to discuss remote workers. Rozmin joins us from CodeRite Healthcare Consulting, based in Allen, TX. They are a billing, consulting and RCM company specializing in physician billing services. Terry and Rozmin define what it means to be a remote worker. What are some of the pros and cons of remote work and managing it. A...

Many practices hire nurse practitioners and physician assistants (known as mid-level providers) along with RNs, MAs, and other clinical staff. Still, sometimes the lines get blurred on what services they can individually provide. Terry Fletcher, with fellow healthcare consultant and industry expert, Betty Hovey, discusses these compliance issues and gives medical practices insight into the pros an...