Author: eddies099

There were a lot of meetings this morning, so I was kind of on my own.  I spent most of the time writing and working on my presentation for tomorrow.  I also spent quite a bit of time talking with some of the financial people again in a more informal setting.  It was nice to see them a bit more relaxed outside of their normal “work” setting.

This afternoon, I took everyone in the office to lunch as a thank you for the past two weeks.  Each of them was incredibly kind and helpful to me and I wanted to pay them back for that.  Though lunch was a small gesture, it was nice to get everybody together one last time.  I also had never been with everyone in the office at once, so it was cool getting to talk to each of them outside of the work environment.  The food was fantastic and it was a good bonding opportunity both for me and for them with each other.  They’ve had several new employees who have come in in the past couple months, and it was a good chance for them to really get to know the other employees better.

The second part of the afternoon, I went around to the different locations again with the office manager.  I really enjoyed going around last week so I was happy to do it again.

I finished the day by speaking with Shawn West, the head of the office.  We talked all about his business model and how he got into this profession, and it was a nice way to end the experience.

I had a fantastic two weeks over here at RMA.  Everybody here is so incredibly kind and above all, good at their jobs.  I will definitely remember this experience for a long time.  I’m sad to see it end!

I came in about 40 minutes late this morning as I had a dentist appointment.  I was a bit peeved that I missed the first part of the day and was glad to get started.  I started off the day by doing more MIPS work and learning about the way it works.  I also spent some time looking at the specific measures that are required for physicians to report when doing procedures.  It was pretty cool to see the “inner workings” of how the physicians are paid and how they have a sort of figurative “oversight.”

I then spent the rest of the morning with the billing manager, which was a highly enjoyable experience.  She has been with the practice for around 28 years, and seems to have had a wonderful time with it.  I really appreciated her incredibly positive and welcoming attitude.  That’s certainly not to say that the others I’ve worked with weren’t welcoming as well, but I was quite impressed with her warmth.  While I was with her, she was working on credentialing for all the physicians and CRNAs, which I quickly realized is a highly complicated and involved process which requires significant focus and attention to detail.  However, it was clear with all of her years of experience that she’s become quite the expert.  There were literally several thousand papers that she has to keep up with at all times, all filed very neatly into cabinets, and I’m positive that she must’ve known where exactly every single paper was located.

The credentialing process for each physician and CRNA is very important, as it is what allows them to get reimbursed for their services.  The process involves acquiring a significant amount of information from the physicians and CRNAs and then sending that information off to each of the insurance companies with which Regional Anesthesia is in network.  In network essentially means that they work together.  It is highly important that she receives all of this information, because then she has to create individual credentials for each individual CRNA and physician and then for individual insurance company.  So, in essence, she has to keep track of a ton of different documents to make sure they get sent to each insurance company and that they are formatted correctly for that specific company.  She told me that the most difficult part is making sure that they are fulfilling all of the requirements for each insurance company, as she said that all of the requirements are different.  As such, each physician has upwards of ten different sets of lengthy packets of documents.  This all seemed extremely daunting and overwhelming to me, but with her experience, it seemed to be almost second nature to her.

The afternoon was a little bit more low key, and I spent most of the time going over reconciliations and collections with the office manager and one of the financial people.  It’s crazy it has almost come to an end!

 

I spent the first part of the morning going over MIPS, which in a nutshell is a program through Medicare that physicians can choose to participate in.  It is an incentive-based program that encourages the physicians to not see patients for unnecessary visits.  Their performances are measured, and based on the criteria that are given, they are then reimbursed for their services.  Though it is technically optional, Medicare will automatically reduce the physicians’ reimbursement by 4% if they choose to not participate.  So, in conclusion, there’s really no reason not to.

I then went to the hospital where I attended another meeting, this time again with some very important people.  I can’t really recall the specifics, as there was a lot going on at once.  I know some of it had to do with transitions in leadership, and some of it I know I can’t discuss.  Even as I look at my notes, right now, I’m going, “What???” in my head.  Still, it was a highly informative meeting and I enjoyed it.  I looked at the practice’s business model, which, while somewhat confusing, actually made pretty good sense.  Clearly, the practice works well and has worked well for a long time.

There wasn’t quite as much for me to do today after everything from yesterday, but it was still very exciting!

Today was a bit different, as I spent almost the entire day over at the hospital.  I began the morning by meeting with the CFO and CEO of the hospital, which was a highly intriguing experience.  I was apprehensive going into it, as I knew I was going to be meeting some pretty important people.  However, that apprehension quickly disappeared, as both of them immediately put me at ease with their charisma and character.  It became very evident to me as to why they were in their respective positions- both seemed to be fantastic leaders.

I then sat with the office manager over at the hospital for an hour or so, and she explained to me what she does on a daily basis.  It was a nice change of pace being over at the hospital, where all of the action was happening.  I then met briefly with the OR Director, who, much like the CEO and CFO, humbled me with her leadership skills and charisma.  Though our meeting was short and was interrupted by frequent thunder and lightning, I was impressed by her ability to be a strong leader while also clearly showing immense compassion for those who work with her.

I ended the day by meeting with the associate chief nursing officer.  This was probably the most entertaining meeting of the day, as he seemed to have a relatively expansive life story.  In a nutshell, he’s lived everywhere, worked everywhere, and seems to have done every job under the sun (in the medical field).  As an administrator, he has quite a few duties he must carry out on a daily basis.  I thoroughly enjoyed hearing about the career path he has taken over the years.

Tomorrow, I think I am headed back to the hospital again.  It has definitely been a nice change of venue, and I look forward to it!

Today’s post is short, as I was only in for a couple of hours.

I started off the morning today with going to the office’s sort of “weekly wrap-up.”  In this wrap-up, usually several employees come in to the office manager’s office and discuss various issues that have arisen throughout the week.  In this case, it was an issue with a program called MedSuite not appropriately populating the correct categorization for patient need.  Though this was a seemingly simple issue, to me, I began to realize that it was actually very significant.  The classification for the needs of the patient is extremely important, and especially important when handling the patient’s medical records.

There was another, even more important meeting happening at the hospital today, so there wasn’t a whole lot for me to do.  I sat with one of the financial people for almost the entire morning, which was intriguing at first but began to get a bit mundane after about hour 3.  She worked on reconciliations, which I didn’t entirely understand but was still interesting to learn about.  Fridays aren’t usually a particularly busy day, so there wasn’t too much she could show me.

I’m looking forward to next week!

I began the day today by being sent to Narnia by my brilliant phone.  There was traffic on my way so I thought it would be a good idea to try a different route, but ended up nowhere near where I wanted to be and completely unsure of where I was.  Luckily, I had left early enough and wasn’t late.

I started off the day sort of “debriefing” the meeting from yesterday.  There were a lot of numbers and figures and medical terminology that were all being fired off at once, which made it a bit hard to understand.  After having gained a better understanding of it, I then was sent to one of the account reps to look at the ways in which payment claims are processed.  It was cool to see how much work is put in for what most people would likely think is a seemingly simple task.

I did a few other things throughout the day, but my favorite had to be going to all the different locations to pick up the charge tickets.  This may sound boring, but we went to a number of different surgery centers and hospitals, and it was very interesting to get to see what each of the different locations do on a daily basis.  At one of the locations, we also had to be in the pre-op and post-op areas, which I originally thought would be mundane but actually proved quite fascinating.  I had thought that this little “field trip” would be a waste of time, but I actually quite enjoyed meeting a number of the physicians and office staff at all of the different places.  In addition, getting to actually go back where the patients were held wasn’t something I thought I would do, but it was intriguing nonetheless.

One of the more humorous events of the day was when we were at the location in which the office manager and I were back in the pre-op and post-op areas.  One of the things we had to do was pick up patient records in addition to picking up the charge tickets.  At this location, the patient records were actually kept in the “Operating Suite,” where all of the operating rooms are housed.  When we reached the door to the suite, she very quickly pressed the door button, reached her arm through the door as far as she could without actually walking in, then yanked her arm back out and shut the door.  She laughed, somewhat embarrassed, saying that it always makes her a bit uncomfortable to have to pick those sheets up without wearing any kind of sterile clothing.  She told me that she has had dreams in the past where she was sucked into the suite through a vortex or tripped and fell right into someone’s procedure.  Though her dreams were a bit far-fetched and comical, I understood her point perfectly.  Literally right on the other side of the door, the operation suite began and there was an operating room probably no more than 20 feet away, which was a bit daunting.

This has been a fantastic week so far, and I am looking forward to bringing Week 1 to a close!

I began the day to day by learning that I would be going to a meeting with some of the physicians this afternoon.  Though I was a bit apprehensive, I was also excited to see what goes on in true, professional meetings.  I moved on to the next step of the Basic Revenue Cycle and started learning about payments and the way that medical bills are sent back from insurance companies.  These payments, along with the procedures and patients, come back in a bundle of sorts called an EOB, which stands for Explanation of Benefits.  I learned all about what an EOB is and the ways in which insurance companies return them for their patients.  Though it was a little bit daunting to see all the names of patients and all the procedures they’d had done, I found this process to be one of the most fascinating so far, as entering the payments and checking the EOB’s is such an in-depth process.

Suddenly, it was 2pm, and I was told it was time to head to the hospital for the meeting.  My stomach clenched, as I knew I would be in a room with some very important people making some very important decisions, but I was also incredibly excited.  Though I can’t really talk about what was discussed in the meeting, it was intriguing to see the way that meetings at this level are run.  Everyone seemed to do a great job handling crises and crunching numbers in rapid-fire fashion.  There was a lot going on at once, so it was a bit difficult for me to keep up.  However, I still was able to pick up on some things and thoroughly enjoyed the experience.  Two hours later, it was finally over.

I’m feeling pretty tired as I write this, but I’m excited for tomorrow!

Today, I began the day by learning all about the ins and outs of HIPAA, which is the guidelines everyone in the medical field has to abide by when dealing with patient confidentiality.  Because I was eventually going to be seeing patient records, I had to go through a 36 slide presentation about HIPAA and then take a test.  As one of my hosts explained with genuine regret, this was government mandated and not their decision.  Even though I was promised extremely dry, boring information, I actually found the expectations and origins of HIPAA to be rather interesting, though I did reach a point where I was ready to be done with learning about the Hippocratic Oath and Enforcement Rules and PHI.

Once having completed the test, I was explained the idea behind the “Basic Revenue Cycle,” which is the process in which patients are billed and physicians are paid for their services.  I was told that I would be going through each of the different parts of the basic revenue cycle and the respective employees who completed different tasks associated with the cycle.

I sat with two of the individuals who are involved in the first two steps of the cycle for most of the day, and it was very interesting to learn about what it is they do and why each step of their job is so important.  For instance, I sat with one of the medical coders, who told me all about the process she goes through for medical coding.  In a nutshell, every procedure and diagnosis in the medical field has a code.  These codes have to be entered and checked for every patient who comes through in order to make sure they are being billed for the correct procedure, and also to make sure that their medical record is accurate.  I very quickly realized how important this step is, because of one of the codes is off in some way, it can mess up the entire system.  This made me think of the process as a sort of metaphorical assembly line; if one step of the cycle gets off course, the whole process can be compromised.

I had a great first day and look forward to what is coming!