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 of revenue and trigger additional payers' audits and ADR’s.

Terry outlines the ADRs and best practices to make sure your staff is on top of these requests, which helps save your revenue.

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 different-sized practices.

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, healthcare often requires in-person patient interaction, making remote work less feasible in most cases.

The best choice depends on the specific role and individual needs within each sector.

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. The hosts also talk about what to do if you find suspicious activity, how you can further investigate with the use of proper documentation, and the potential involvement of external auditors or legal counsel.

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 and why?

Terry talks with Healthcare CPA and NSCHBC President Shane Pickett on the best option for success.

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?