Advertise on podcast: NSCHBC Edge Podcast

In this month’s episode of the NSCHBC Podcast Terry welcomes Healthcare Consultant Brian Williams of Moxie Healthcare Solutions to discuss a new concern on the healthcare horizon and that is “Silent PPO Networks”. What are they? How does it affect physician reimbursement and who’s running them? Join us for this important topic.

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 share your opinion: you can make suggestions and ask questions. The fastest way to submit a comment is online at www.regulations.gov/docket/CMS-2026-2377. Click the “Open for comments” button on the left, scroll down to the “Comment” button on the lower right and follow the instructions. Terry goes over some of the Final Rule 2027 highlights and encourages all stakeholders to send in your comments now!

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 knowledge, office habits, or someone's gut instinct instead of actual data. But data should be driving every operational and financial decision.

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-world benefits, potential pitfalls, and the practical guardrails every healthcare organization should have in place to protect patient care, preserve operational integrity, and ensure responsible business practices as AI becomes part of everyday healthcare.

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 patient during a video visit.  While the patient and provider may not be in the physical presence of one another, the environmental elements at both ends of the interaction can still influence the effectiveness of a Telehealth visit. In this episode of the NSCHBC Edge Podcast, Terry Fletcher, discusses the newly gathered information that patients' have shared that would make for a more conducive Telehealth encounter.

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 and how it impacts provider practices and hospitals.

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 and PA Healthcare Attorney Colin Callahan on today’s episode of the NSCHBC Edge Podcast.

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 marketing consultant.

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 protect providers. In this episode of the Edge podcast, Terry welcomes back Healthcare attorney Amanda Waesch, to discuss the current NSA policy enforcement and when is it time to contact an attorney?

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 ethical patient care.

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 including $40 billion for rural health centers. Many of those COVID ERA flexibilities that ended October 1st, and were restored 11/13, were only extended again through 1/30/2026. Join us for some quick insights.

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 episode of the Edge Podcast, with host Terry Fletcher and fellow NSCHBC member Laureen Murphy of MedCycle Solutions.

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 organizations offering growth opportunities, flexibility, and a culture that inspires long-term loyalty? Terry and Janet dive into the nuances of employee experience, exploring how workplace culture impacts retention, performance, and overall success. Whether you're a practice owner, manager, or consultant, this episode offers valuable insights into building a team that stays and thrives.

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 with excellent production but weak collections will struggle financially and how to make sure practice success.

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 hurdle for AI systems. Revenue Cycle Management (RCM) professionals—such as coders, billers, and auditors—possess the contextual understanding necessary to interpret and extract crucial information from diverse and sometimes illegible records. The complexity of abstracting documentation is further compounded by ambiguous acronyms, localized jargon, and specialized medical language. Additionally, a substantial portion of the information provided to coders is subjective, demanding a level of interpretation that current AI technology may not yet possess. For AI to acquire these essential skills, medical coders will need to train the systems, and auditors will be responsible for verifying their accuracy. This technological shift is inevitable, so RCM professionals should consider developing these skills to remain competitive in the evolving IT landscape. Join us as host Terry Fletcher welcomes Sirisha Bommireddipalli to the show for an insightful discussion on this important topic.