VillageMD Working Smarter

Surprise! In this episode, we are sharing the key features of the new federal Surprise Billing Rules. In general, a “surprise bill” happens when a patient isn’t given a choice of provider and receives an out-of-network charge. Some recent research have illuminated the scope of this problem, and were the catalyst for this new bill. The concepts are simple, but the rules are complex. The first phase became effective as of September 13, 2021. Tune in for the details!VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. We do have closed captioning and transcripts that are now available for our podcast!Thank you to all of our loyal listeners, or as we call them, Smarties! If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, or wherever you get your podcast. Our references and other show notes are on our website: vmdworkingsmarter.com/conversations/

We have surveyed topics you wanted to hear more about, and overwhelmingly our listeners said "telemedicine." In the first half of this week's episode, we are joined by Megan Harkins, one of our VillageMD experts to discuss telemedicine requirements and how they have changed as a result of COVID-19. During the second half, we sat down with those working on the front lines of telemedicine, Dr. Karen Wetherell, one of our VillageMD physicians and Stacy Gabrysz, a VillageMD Regional Practice Administrator. They share their thoughts, success, and struggles with telemedicine. VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. Reminder, we have closed captioning and transcripts that are now available for our podcast! If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, any other podcasting apps, or our website: https://vmdworkingsmarter.com/conversations/

“That’s not my job”. This was a common refrain in healthcare when there was a clear separation between staff who treated patients and others who were responsible for billing. But as healthcare evolves further into value based care, the gap between billing rules and clinical care requirements is converging. In this first episode of 2022, we invite Megan Harkins to talk about the slow creeping convergence of billing and clinical rules and the impact this has on the various skills needed by the healthcare workforce. Buckle up folks, this episode dives into the bumpy road of change as the healthcare industry makes the shift from volume to value-based care.VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. Reminder, we have closed captioning and transcripts that are now available for our podcast!If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, any other podcasting apps, or our website: vmdworkingsmarter.com/conversations/

The cost of prescription drugs can take a significant toll on patients and impact their drug adherence and overall health. Primary care providers, historically, have been unable to do much to help patients manage this problem, but recent regulatory changes are adding price transparency which may help. Experts Michael Adelberg and VillageMD’s very own Adam Chesler discuss the details of new transparency initiatives for both Medicare Advantage and commercial drugs and predict the potential impact for patients and providers.VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. Reminder, we have closed captioning and transcripts that are now available for our podcast!If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, any other podcasting apps, or our website: vmdworkingsmarter.com/conversations/

In recent years, we have heard more attention being focused on the social factors that complicate health and medical care. One of these factors is access to transportation, which has long been an issue in Medicare coverage. In this episode, We are joined by Andrea Osborne, VMD Senior VP of Delegated Services to discuss the complicated rules for non-emergency ambulance transportation. Andrea shares with us some recent changes that may have an impact on patients and some guidance for the primary care workforce on how to address these issues.VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. Reminder, we have closed captioning and transcripts that are now available on our podcast!If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, any other podcasting apps, or our website: vmdworkingsmarter.com/conversations/

The tide may be turning on medical malpractice trends and I think we should explain what this means. Primary care physicians have historically not had high rates of malpractice claims, but we see this trend changing. Not to worry, however, because Kelley Smits, the Director of Risk Management at VillageMD, discusses how to prevent these problems with VillageMD’s National Medical Director Dr. Torontow. In Part 1 we will discuss the data that’s coming out on these trends, where to find it, and how to avoid becoming one of these statistics. Stay tuned for Part 2 for Case studies and additional best practices!VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. Reminder, we have closed captioning and transcripts that are now available on our podcast! If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, any other podcasting apps.

We’re back with Kelley Smits and Dr. Torontow with part 2 of Medical Malpractice Trends! If you haven’t heard part one, we highly encourage you to check out that episode first. In this episode we will be looking at some case studies on malpractice trends, lessons we can take away from these studies, and best practices on how to avoid becoming a part of a medical malpractice lawsuit in your practice.VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. Reminder, we have closed captioning and transcripts that are now available on our podcast! If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, any other podcasting apps.

In this episode we explore the new CMS framework for health equity.  Health equity as a regulatory mandate is a new concept.  We’ve long had some related requirements including a) ADA physical environment rules, b) ant-discrimination and c) language assistance.  But until now, we have not seen a regulatory focus on health equity. Join us for this episode with Cris Lopez, VillageMD Vice President of Diversity, Equity & Inclusion, and Gary Jacobs, Executive Director of VillageMD Center for Public Policy, as we dive into what this means and what’s to come from this within healthcare in the future. VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics.  If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, and any other podcasting apps.

We’re back with an all new format! In this episode we return to Patient Attribution and dive deeper into not how, but why this works. Join us as Wendy Rubas, General Counsel of Village MD, reviews the ins and outs of patient attribution and its effects amongst the patients and workforce with VillageMD’s Genelle Nkwocha and Emily Guthrie.VillageMD's Working Smarter podcasts are concise healthcare compliance conversations that are never boring and sometimes funny. We provide practical information about complex legal and regulatory topics. If you enjoy the podcast, we want your help in spreading the word! Share this episode with your friends and colleagues. We are available on Apple, Spotify, and any other podcasting apps.

Changes are coming from CMS that are going to impact healthcare providers at all levels! We want you to be prepared for what these are and how these will impact your practice. If you enjoy this content, please subscribe and stay tuned for more exciting compliance conversations from your favorite Legal Team at VillageMD.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

In the news last week, Sarah Silverman tweeted out a complaint deriving from a physician’s exam by stating: “This is not a date.” In this episode, we review the impact of #MeToo on healthcare and give practical guidance on how to manage this risk. VillageMD Chief Medical Officer and Co-Founder, Dr. Clive Fields, joins us to discuss the “Stay Safe” guidelines circulating on the internet that guide patients on what to expect when they go to the doctor. We hope this will help spark the conversation for you and your staff about this important topic.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

The DEA says it has taken on the war on drugs from the streets to the pharmacy. On this episode, we explore the government response to the opioid epidemic. We talk with Hazel Manzano, MD, and Ed Rickert, BS Pharm, JD about DOJ enforcement against physicians for over-prescribing and the CDC guidelines for appropriate use of opioids.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

Starting January 2019, CMS has approved new codes for services that primary care physicians perform. This episode provides more detail on these services, which were previously introduced in our first episode. This will provide you information on how and when these codes relate to your practice.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

Fax machines are dinosaurs, phone calls are a thing of the past, and texting has become the king of communication. On this episode, answer the question: “can you text your patients?” It probably won’t surprise you that the answer is complicated.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

What exactly is an avoidable emergency department (ED) visit, and how can we prevent it without discouraging proper ED use?Anywhere from 20% - 44% of patients will visit the ED this year. While some of these visits are for life-threatening emergencies, many could be safely treated in a primary care setting or prevented with timely services. VillageMD is working with Primary Care Physicians to implement tools that decrease these avoidable ED visits while improving patient care. This episode, we talk about key ways to share ED avoidance information with patients while preventing unintended consequences.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

Have you ever questioned what E&M level you should assign to a patient? Do you think it is too difficult so you just give up and assign the same level 3 like always? On this episode, we discuss some background context of E&M and what exactly is required for different levels. We are joined by Kristi Lee, VillageMD’s Director of Revenue Cycle, who lends her physician billing expertise!If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

Starting in 2010, CMS “Let The Sunshine In” and now reports data about financial relationships between physicians and pharmaceutical companies (and others). In the episode, we explore the policy behind this change, advise you how to find what is reported about your practice, and discuss the impact of these rules.

We know Medicare is complicated and dense, and nobody has time to read all 1000 pages. In this episode, we give a brief overview on different elements within Medicare that matter the most to your practice.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

In March 2019, the Sackler Deposition was unsealed and the American public learned of the level of deceptive marketing with opioids over the last decade. This week, we are joined by one of the Texas Assistant Attorney Generals, Pat Stein. She provides us with some inside information on the previous wave of litigation, the litigation that is currently ongoing, and how physicians can stay compliant in this rapidly changing environment.If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/

Have you been confused by modifier 25 and 59 in the past? Trapped between a rock and a hard place with use vs not use? During this episode, we dive into when these modifiers can be used and give you context on how they may appear during your practice. We are joined by the VillageMD Director of Revenue Cycle, Kristi Lee, who lends us her physician billing expertise!If you have a question, comment, if you want one of the samples we reference, or if you want to be a guest on Working Smarter, visit our website at: https://vmdworkingsmarter.com/