It’s often been said that the only constant in life is change. And the mid-revenue cycle is no exception.

As new regulations emerge and new technologies develop, professions get radically transformed—or even erased altogether. The antidote is a commitment to lifelong learning, and embracing the discomfort that accompanies growth.

That describes the mindset of Crystal May, my colleague and a Risk Adjustment Consultant for Norwood.

This program was originally broadcast as a webinar interview but was just too good not to share with a broader audience. So I’m pleased to publish it on the podcast.

On this show we discuss:

• Crystal’s unique career path that began in transcription, profee coding, and ultimately risk adjustment
• Her current work including audits of organizational documentation and code assignments
• Common documentation and coding pitfalls (strokes are a major source of error—hear why)
• How organizations can use findings from audits to drive continuous learning and improvement
• MEAT criteria—examples of adequate MEAT criteria (and what happens if you’re MEAT-less)?
• Getting comfortable with discomfort to grow your skillset and insulate yourself from industry layoffs
• Our joint heavy metal obsession and recommended bands

What the heck is a trauma registrar, anyway?

Once upon a time even my guest asked that question. After starting a career in nursing in 1987, Stefanie Arp became a trauma nurse specialist in 2001. And quickly became tasked with the responsibilities of trauma coordinator, a position she knew very little about but found herself immersed in, whether she wanted to or not.

Trauma registry opened up a new world of data abstraction, quality improvement, trauma center designation, high-pressure American College of Surgeons site surveys, and much more, including medical coding and the use of trauma activation codes. And opened Arp’s eyes (and now, mine) to an under the radar profession that plays a huge impact on patient outcomes and organizational quality.

We get into all of that on today’s Off the Record, covering:

• What is a trauma registry professional and why should an organization invest in them?
• The nitty-gritty of the role including data abstraction process, record review and productivity expectations
• American College of Surgeons and facility specific requirements, including trauma center designation levels
• Revenue implications including the use of trauma activation HCPCS code G0930
• Arp’s fascinating origin story, from nurse to national consultant
• What makes for a good trauma registrar--desired background, skills, and mindset, and Arp’s advice for folks looking to break in
• Finding meaning in her work (no shortage of that)

Earning your RHIA (Registered Health Information Administrator) is a huge accomplishment, and for some marks the end of a four-year academic journey and an entry into HIM.

For Richelle Marting, it was only the beginning.

In pursuit of her RHIA, which she eventually earned, my guest on today’s episode took a class on the legal aspects of HIM. That course planted the seed for a career in law—and eventually led her to start her own law firm.

All while raising two twin girls.

I don’t know how she managed all this, but that’s why I got Richelle on Off the Record.

On this show we discuss:

• Richelle’s story from RHIA to JD. How difficult was the bar exam?
• Becoming an entrepreneur and starting her own law firm
• Most frequent type of healthcare cases: Clinical validation audits and DRG validation
• The coding guidelines she sees most frequently ignored or twisted to the payer’s benefit, and other shady tactics
• What do healthcare organizations make too big a deal out of—and what are they not worried about enough?
• Qui Tam and the recent spate of cases initiated by organizational whistleblowers, in particular Medicare Advantage organizations
• Managed care contracting: Legal issues around contract negotiation, how claims get paid, timely filing, and payment policies. How quickly must plans respond to appeals, and should you put a diagnosis definition in a payer contract?
• What advice would she give to someone who is in HIM and considering a career in law—what does she know now that she wishes she knew then?