Contempo Coding Podcast

Unlocking Success in Medical Billing & Coding: Expert Insights with Christine Hall

• Victoria Moll • Season 2 • Episode 5

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Ever wondered how someone transforms their passion into a thriving career? Christine Hall, President and Senior Consultant at Sterling Global Solutions and instructor for the AAPC, Florida Atlantic University, and more, has done just that. Starting from a humble job in a hospital billing office, she climbed her way up to lead her very own healthcare consulting firm. Christine's journey is not just inspiring; it's a testament to how dedication and a deep love for the industry can lead you to places you've never imagined.

But that's not all Christine is here to talk about. Throughout her illustrious career, she has championed the importance of medical practice compliance, ensuring fairness in the revenue cycle process. With an extensive background in transitioning to practice management systems, Christine offers invaluable advice on formulating an effective compliance plan. So, if you're in the healthcare industry, especially in the realms of medical coding and billing, you wouldn't want to miss this episode. Tune in as Christine unfolds her inspiring journey and shares her wealth of knowledge that promises to enlighten and educate.

Speaker 1:

It's time for the Contempo Coding Podcast Discussions knowledge and insight to help you succeed in the medical coding industry. And now, here's your host.

Speaker 2:

Victoria. Hey, everyone, Welcome back to the channel. Today I have with me Christine Hall. You may know her from Coding with Christine Hall. She is the president and senior consulting of Sterling Global Solutions and she has some instructor work for the AAPC as well.

Speaker 1:

I'm a virtual instructor-led training course instructor.

Speaker 2:

I teach CPC, cpp, cpma, crc, that's a lot, yeah, and you teach at a school too.

Speaker 1:

Florida Atlantic University. I teach their executive management program for practice administrators. Yeah, okay.

Speaker 2:

Okay. So yeah, you kind of cover the South Florida area. That's where my I have family down there. I have two cousins that run a. They own an operator brewery Boiton Beach called Nobo.

Speaker 1:

No kidding.

Speaker 2:

Yeah, that is awesome. So, yeah, I haven't been down there yet because I'm always in Orlando, which is not close to like there. No, it's not People think Florida.

Speaker 1:

Oh yes, I'm coming to Florida. I'd love to connect with you. I'm going to Tallahassee and I'm like I am so incredibly far away from that.

Speaker 2:

It looks kind of small, but when you realize how much it goes from North to South, it's a long distance. Absolutely yeah. So can you tell us about your journey into healthcare and how that evolved into your current role as the president? Senior consultant of Sterling.

Speaker 1:

Well, it all started one beautiful after. No, just it was. I was actually 16 and I was looking for a job and my father said open the phone book and find something. It opened. I mean, yeah, what a unique perspective, right it?

Speaker 2:

opened up to the hospital, not open the classified end. No, open the phone book. Open the phone book.

Speaker 1:

Yes, so phone book opens and it's the hospital. So I go down to the hospital and they say, well, we have a position in the billing office. I have no idea what that is because, again, I'm so green, but I got to work with the cashier who at the time that title also did all the postings, okay. So they got to see the denials for the hospital. And I got to see the denials because really when you're the assistant to anybody, you're the one who does the work, right, right, you know, make them look good. So I got to see these denials and I really enjoyed them and I liked working with them. That position took me to another hospital position, took me to a practice management assistant position, took me to a director of medical records, and then I had my baby, my youngest son, and I fell in love with this trend. I love the other one too. They're all. I love them, I love you all equally.

Speaker 2:

She knows I have all of her children, all of her students. Yes, yes, I love you all.

Speaker 1:

However, this little bitty guy I had a beautiful job to go back to and he was breaking my heart. So I actually went to the unemployment office. I thought, well, I'll go there and see if they can they have any suggestions? I don't know what I'm going to do, but I have a job to go back to. And the gentleman sitting in the booth Next to adjacent to the man I was talking to, he stood up and he says I'm sorry, I didn't mean to overhear you, but there's a lady in another office whose sister owns a billing company and I don't even know if they're hiring. So, long story short, we met, we fell in love with each other and I started working for the billing company that she owned and she had a health scare. So she sold me the company oh gosh, yeah. And it just evolved from there, had the billing company 17 years and then you transition into more of a consultant role. At that point, after you've had that much experience.

Speaker 2:

So I have to ask what was then your educational background, Because it sounds almost like you graduated high school, looked in the phone book, found a job.

Speaker 1:

Like was there any college involved? Yes, yes. So I had gone to college and immediately I had started off in just a business program. And then, of course, as I got into healthcare, they had a health information management program. So I went into that initially, but then when I went to school, there was nothing past that. So I went into sociology, and so that's where my background is in. Education was starting with health information management, went into sociology, and now I have applied fingers crossed Florida State's masters in healthcare law.

Speaker 2:

Oh wow, bullseye Exciting. I always think it's so interesting because I remember when I was starting out I would ask some of the higher ups in the revenue cycle because I wanted to move up the ladder and I would say, oh well, how did you get into your role? And it was always the story I was told was well, I graduated high school and I went for my bachelor's degree and then I became manager of the department and now I'm director and I'm like, oh no.

Speaker 1:

Okay, mine was a little grass rooty because it took me a long time. Now I had a slew of kids. Their needs came before my needs did, but I needed to be in a position that I could support them. So it wasn't like that it was. I climbed that ladder hard and earned every ream of the ladder because I didn't have the luxury of going to college. I made different choices in life, but I was always in love with this industry.

Speaker 2:

Yeah, so you've been involved in training and educating a lot of others in medical coding. So, as you love the industry, what's the most rewarding part of that? The light bulb moment.

Speaker 1:

It's got to be the light bulb moment. I don't know if that's cliche and if other people say that, but when I see someone go from furrowed brow to like, for me that's the highest high you could possibly achieve, and I was talking with Myra Simmons recently, who does a lot of teaching as well.

Speaker 2:

I said you know, the two topics everyone seems to always cover have problems with cardiology, and evaluation and management. Those are the things, evaluation and management, though but it's one of those ones where you have a lot of the light bulb moments because you read it and you read it, and you read it, and then something like I don't know if maybe someone explains it a different way or you look at it in a different way and it's like oh, now it clicks, so I share with my students.

Speaker 1:

I'm also an equestrian, I ride horses and I have all my life and there was a woman once that gave me the best advice and she said you have to learn from everybody. You learn from the good, you learn from the bad. Someone is finally going to say something in a way that hits you. So, whether it's me, whether it's Myra, whether it's you, whether it is any other instructor out there, my recommendation is learn, even if it's somebody bad. You learn what you don't like. You learn. That's not your learning style.

Speaker 2:

You know, yeah, and we're in such a lucky era now because there's just so much information out there and to share and I think we're still getting better quality information now, like a few years ago, there used to be blogs and it was like this was some billing ladies opinion on things, but we're starting to see an emergence of some really good quality information being shared, absolutely.

Speaker 1:

And I think we also have to remind people that good information should always have a backing to it, a source yes, never, ever say Christine told me. You should say Christine showed me where it says yeah, that this is the rule, this is the guide this is how we do it, yeah, and people don't realize.

Speaker 2:

Sometimes they can change, Like you know, the MAC jurisdictions. In one it might say, oh yeah, prescription, drug management or refill is okay for moderate risk, Others no Right. All right, you know so.

Speaker 1:

Some MACs have time limits for documentation, while other MACs are well, it's, you know, we would like this, we recommend Others have firm timelines.

Speaker 2:

So yeah, so what are some of the common misconceptions you've encountered in the medical billing and coding field?

Speaker 1:

Well, what's interesting is because I go so far back in this industry and I think the largest misconception is that you will have great success in a short amount of time. Oh yeah, and I think that there is great success in this industry. Oh yeah, it takes a time and it takes a lot of work. Yes, and it's not something. You're gonna take a certificate course and tomorrow be making you know six figure income Not that you can't, yeah, I think it's possible, right?

Speaker 2:

I think there's some hyperbole surrounding that, absolutely.

Speaker 1:

The reality is you have to start somewhere. I always give the analogy of medical billing and coding is kind of the equivalent to giving your accountant a full run of your finances, and that's really what we're doing, for the providers is running their finances for them, so there is some responsibility behind that. It hurts if you fall, and how do you pick yourself back up?

Speaker 2:

Yeah, yeah, and I saw some things that looked suspicious moving around on my accounts. I'd wanna be like what the hell's going on? Right, right.

Speaker 1:

You just got out of school and you wanna take over my bank account and my finances, right, so people need to be realistic about that. Not that it can't happen, but it's gonna take a little time.

Speaker 2:

Yeah, so we've seen a lot of movement in the industry lately with people that are getting certified in medical coding and they're either not staying in the field or they can't even like get started in the field, especially those entry level positions. How do you think that the medical coding industry can better attract and retain the right talent?

Speaker 1:

We need to have more externship type of arrangements where there's actually an organization that does a coding university for the first 90 days of employment. I think employers are gonna have to realize that those first 90 days are crucial and you've got to give people the opportunity to learn, but to learn in a comfortable environment how your organization does that. So I think that the industry itself needs to start being a little bit more accepting. Again, there's a fine line because we're talking about there's a huge cost to learning to the provider's office or to the organization, right, and but we've gotta find a happy median somewhere there to bring those coders in and to retain them. I think that's what's disappointing for some coders is that they get their certificate and they've passed this really tough exam and now they're struggling to find that opportunity.

Speaker 2:

Yeah, there's just that gap, and I say that's always the one thing. If I could fix it, I would that gap between okay, I know you're a certified coder, you wanna get a coding job, and here's all of these jobs, but they want two years experience. We have to do something to bridge this gap. And, uh, to your point, yeah, a lot of it is the employers. They don't want to train it's and it admittedly is a lot and they do take on a risk that we could spend two, three months training someone and then they leave and we have to restart the process Absolutely. So there's got to be some kind of solution. And whoever, I'm sure, figures that out is going to be a millionaire, absolutely no doubt about that, no doubt about that.

Speaker 2:

Yeah, it's. You know the solution. I think part of it has always been like well, you have to create entry-level positions. If there's some sort of maybe claim edit position that you could put your apprentice coder in to start getting them familiar. But the trick is now, with AI, I think some of that is going to complicate things. It is, yeah.

Speaker 1:

Well, okay, so I have a few thoughts on this. So years ago, when I had the billing company, our local state college did have an in-person externship that was part of their health information management program. They've done away with that now and they've got a virtual platform that they put their students through, and I noticed that a lot of the colleges have a virtual platform for externship and it's not in the office anymore. There's a lot to be said about those externs that come in and we do use them for payment posting or we use them for denial follow-up or we use them for some of those tasks that maybe have built up. That and that's where they learn is on the job. And those externships are going away. I don't see those as much as they used to be. That would be helpful in the industry if we brought some of those back.

Speaker 2:

Yeah, and I think it is a hurdle to figure out how to make that work, even with the virtual ones. Some of them, I don't think, are even true virtual externships. They're like modules, right exactly. They're not really like you're signing on and meeting on a Zoom with Jen and a count counting and telling you what she does and screen sharing. If you could go back in time, what advice would you give yourself just starting out in medical coding?

Speaker 1:

Ask for more. Yeah, ask for more. Don't be afraid to ask. Do you have anything else I can do? Can I grab your denials? Can I grab your? Yes, yes, can I take a look at that and see? Sometimes it's better to put the fire out permanently. What is the root of this? What is the problem with this? You can prevent that, moving forward. I think that would be my advice to my young self is ask for more.

Speaker 2:

I love ask for more. That was how I kind of built myself up a lot in the time when I was just starting out. They wanted volunteers who can go and get CPC certified. Sure, I'll do it. Then it was hey, we're doing a transition to the practice management systems. We're going to move all of these practices that we just acquired to our system. Can you go out to the practice and back load all of their schedules into the new system? Yeah, okay, sure, I'll go out and do it. It led on to different things. It was the things that the projects that no one else wanted to take you learned so much, I'm sure.

Speaker 1:

Yes, right, the scheduling process of the. There's a formula to schedule it. Yes, right, what gets booked in the mornings? What's in the afternoons? How do you keep the flow going? You wouldn't know that if you hadn't worked on those types of projects. Then I got to put on my resume.

Speaker 2:

I have worked on an implementation team for installing a new medical record practice management system. Yeah, it was. No one else wants to raise their hand and volunteer to do it, because in the long run it'll really serve you. That's right. So now, as the president and senior consultant of Sterling Global Solutions, what is your vision for the company and for its future? Any new product services coming out that you're excited about?

Speaker 1:

Well, I'm very excited to. My company focuses a lot on compliance in that big picture. So compliance from the billing side of it, the coding side of it, implementing periodic audits internally and not just doing it for the practices but teaching the practices, having that working compliance program in place, so it includes education, education, education. I think that if I could see the vision, it would be to bring more solutions to practices so that they could be successful. And that's going to take bringing in new coders, new billers those of that are curious of compliance.

Speaker 1:

Sometimes you say the word compliance and I get the impression that a lot of people think, right, oh, my gosh, no, no, we have a department for that. Yeah, wait a minute, let's change the word to how do you know? So you think you're doing a good job, but how do you know that's compliant, isn't it's that, that fact-based Assurance, not right in my heart? I do a good job, but how do I know I'm really doing a good job? And I think that's something too that people should realize goes great on a resume. Mm-hmm, I had a 95% collection rate in the outstanding AR. That was 1.5 million outstanding when I got it. Technically, that's compliance. You were able to go in and find the facts and fix it, put some new processes in place. You bring in that, that extra revenue, and you don't even realize that is compliance. Yeah.

Speaker 2:

Yeah, everything kind of ties back to compliance. I Think I used to have a boss that would say everything comes back to coding, because they would get a denial and it would be oh, there's codes on the denial, so it's a coding problem. Yeah, all roads lead back to the revenue cycle.

Speaker 1:

Well, you know that we have to have revenue cycle. Business is a medicine is a business, yeah, you know, and We've got to remember that, yes, we're here to care for those people, but, at the same time, in order to do that, there's a cost involved and we we've got to find that, find balance there that Keeps the lights on keeps the roof over our head and it's unfortunate because sometimes we're like do we wish when you would be getting billed for this?

Speaker 2:

No, I don't like getting medical bills no one likes getting medical bill but we're just working in the confines of the system.

Speaker 1:

that we have right and then we're always trying to preserve fairness right.

Speaker 2:

So, and we can still advocate, and we can still promote right right, but is it, is it fair to charge the insurance?

Speaker 1:

Is it fair to charge the patient without their knowledge? Is it, is it fair to get more than what you agreed for? Yes, I think that a lot of the industry. We need to keep that word in mind. It's, it's fairness and and if we are fair, then we are compliant and we are good stewards of our contracts and and able to continue this great business of medicine.

Speaker 2:

Yeah, I love it. Well, thank you so much, christine, for taking the time to meet with me today. I will link below everyone all of Christine socials. You can connect with her on LinkedIn. You can go and check out coding with Christine Hall and Thank you again. Come with us, thank you.

Speaker 1:

It's a pleasure, victoria. Thank you.