Contempo Coding Podcast

Navigating the Medical Coding Career Landscape with Crystal May

• Victoria Moll

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In this podcast, I sit down with Crystal May, a seasoned professional in the field of medical coding and auditing, to discuss her extensive experience and insights. Crystal shares her journey from starting in medical transcription to becoming a recognized expert and educator in healthcare information management. We delve into the significant changes in the industry, such as the transition to ICD-10, and discuss the impact of AI on medical coding. Crystal also talks about her passion for mentoring the next generation of coding professionals and the importance of continuous learning in this ever-evolving field. Join us for an enlightening conversation on the future of healthcare and the vital role of medical coders.

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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, victoria. Thanks everyone for coming back to the channel I have with me here today, crystal May. So Crystal has over a decade of experience. She provides practice management and consultant services for Norwood Solutions and Managed Services Department. She is responsible for auditing and quality assurance, data aggregation and analysis, reporting of audit findings, creation of educational content and is an auditor coaching as needed and does provider education as well.

Speaker 1:

Yeah, so Crystal serves as both a subject matter expert and teaching assistant in her roles with the AAPC. As a subject matter expert, she contributes to projects such as exam committees, curriculum and published material updates and the creation of various AAPC content. In her role as a TA, she supports the VILT, which is the virtual instructor-led training program. So she supports the VILT students through training courses and provides SME support for the instructors. Crystal currently serves as the president for her local chapter and does other positions in the past which most of us have. I will do anything but treasurer. That's the one thing. I'm not watching her money. I'm not touching the money. She is currently working on her undergrad degree in HIM and has been accepted into the AAPC's Emerging Leaders Program for 2024, the very first crew, hopefully, of many, right? Yeah, yeah, I hope that's the plan. So, crystal, with a really extensive background in medical coding and medical auditing, what has sparked your interest in getting into this field and how did you kind of embark on your career path? So?

Speaker 2:

I actually started because a friend of the family was doing medical transcription and I was a mom of two young kids and looking for something that I could do part time in order to make sure I could take care of them during the daytime, you know, after school, be able to work a little bit here and there, got into transcription, fell in love with medical language, terminology, the disease process, like the whole, the whole of it, right, right. And that industry slowly started dying out, yeah, and it became more of an editing type role and I started looking for other work. Saw the writing on the wall for what it was and I'm like you know what. It's time to kind of switch gears a little bit. So I actually went back to school for coding, okay, and did that in 2016 is when I finished school. I got certified in 2017 and that was all she wrote, oh, wow.

Speaker 1:

So, having been through what happened with medical transcription, does that put some fear in you now, with everything going on AI? Because let me tell you, I was told by someone, oh my God, probably a year ago now. They're like, ha ha, your job's going to be done in six months. And I'm like ha ha, we're still using fax machines in healthcare. We are not fast at adopting technology and I don't doubt that there's going to be some changes, but it's not going to be a complete elimination of our job, the way people think it is. It's not the one-to-one translation that a lot of people like to just, on the surface level, think that we have.

Speaker 2:

Yeah, they tend to think computer replaces coder and that's not going to be the case. It's going to be computer assists coder.

Speaker 1:

Yeah, so you've achieved significant recognition in your field multiple excellence awards for being a senior risk adjustment coding consultant at Norwood, and Norwood is actually a top 105,000 fastest growing private company, which is like crazy, and I'm hearing more and more about the company as well. Yeah, can you share what these accomplishments mean to you and how they have influenced your professional journey?

Speaker 2:

They mean everything. I mean I don't really see myself as being particularly special or excellent in a way that other people seem to Like I'm showing up, I'm doing my job and I'm honestly doing what I love. So it doesn't really feel like I'm working hard to accomplish something because the accomplishment is great and it's great to have somebody recognize that, but I truly love what I do. So if I can help somebody in the middle of that, then I'm all for it. That's, that's the best part to me.

Speaker 1:

OK, so Like what is your role at Norwood kind of entail? Like what does your days mostly look?

Speaker 2:

like team leading I'm responsible for auditing quality, helping with hiring, even kind of across the board, not just risk adjustment but also valuation and management auditing, pro fee, auditing all the things all at once.

Speaker 1:

I see a lot of posts now that you and others are posting about Norwood and how Norwood's hiring. What kind of positions are they like hiring for? Do they do full-time, part-time?

Speaker 2:

So we do have full-time and part-time. It's employee positions. There's a variety of different roles we have. We do consulting services, obviously, as well as staffing services Pretty much anything in the mid-rev cycle space Norwood's able to handle.

Speaker 1:

Oh wow, so you have certification through aapc and I see mom, I do so. Being dual certified and having so much experience, what are some of the most impactful changes you've seen within the health care and information industry as far as standards and practices during your career?

Speaker 2:

oh, hands down, change over to icd-10 that was.

Speaker 1:

That was a doozy. That was something, especially with all the delays. So when ICD-10, I mean it was delayed so many times, I think it was the very last delay that they had. We had already been so knee deep in training, right Like it was a little bit of a shock, that one. It's like oh no, it was so close, wait just a couple more years. My chapter had boot camps and we had scheduled boot camps and we put very clearly on the forms like this is the training, it's for icd-10, because it's going to happen eventually, no refunds. And um, then it got delayed like a week later. I could imagine the ghost. We had two chapter members that put a stop payment on their checks. So that was a fun issue as a chapter officer to have to deal with, I'm glad. So I'm glad to not have quite those issues with the chapter officer stuff. I'm glad that wasn't me.

Speaker 2:

I'm glad that was hopefully just a one time thing.

Speaker 1:

Yeah, right, but yeah, so that was a fun one. But yeah, icd-10, I remember I was at the elbows with providers, like embedded in the practices, like do you have any questions? What's going on? Anything I can help you with. Where were you during, like the ICD-10 transition? I was learning it.

Speaker 2:

I was not yet ready to teach it to somebody.

Speaker 1:

Okay, that's for sure have you thought about icd-11? Have you thought about, like, do I want to kind of get ahead of that? I?

Speaker 2:

have. Actually, I've been doing a little bit of research into it and I want to find more. I am very curious as to how the whole stem and leaf works. Um, I and I love the way pcs codes build. Yeah, and it seems very reminiscent of that to me and I'm really eager to dig into it. I want to find more info.

Speaker 1:

I know this much PCS. Every year I go to learn PCS and I still get through this. Just a ripple. Just a ripple. One of these years I'm going to do it, but not not this year, that's. That's for sure. You contributed to a lot of publications. You offer lots of insight on complex coding issues and health care topics. How did you get started writing?

Speaker 2:

january of uh 20 was 24, now 23, so january 2023, um, and as soon as I was in the door, somebody said hey, we've got an article that we need for one of our newsletters. We wanted to know if you wanted to write one. I'm like, okay, sure, why not? Yeah, so put together an article, sent it and they were like this is fantastic, we're gonna go ahead and run it. And I'm like, uh, do you want to do some editing on that? You want to maybe proof it a little bit? Some they're like no, it's good okay, that's better than me.

Speaker 1:

I I don't know if I still do it, but I remember the first couple of times I tried writing something like professionally, I changed tenses apparently, and I got a lot of things corrected because I was changing tense and I'm like, oh, okay, um, but yeah, so now do you write for, like AAPC, the magazine, and you write for? I have not yet okay.

Speaker 2:

I have not yet. I've actually um written quite a few um articles for Norwood, um for our our monthly newsletter, um that we send out for our consultants, and then I recently actually had one for NamUs. Yeah, namus reached out and they were like, hey, we have kind of a tight turnaround. We need something in the next like five days. Do you think you could put something together? And I'm like, oh, that's awesome.

Speaker 1:

Okay, sure, oh, they're going to love you for that. Yeah, it was awesome. I loved it. I love NamUs. I've been actually doing some more stuff for them. We have some things planned coming, hopefully by the end of the year, so I'm excited. They're a fantastic organization to work for. Yes, they are.

Speaker 1:

Yeah, I like how they give you lots of different opportunities, like they're like, can you write an article, hey, how about this, hey, how about that? And they kind of like build you up, yeah, throughout the organization. Yeah, and they're so phenomenal I really do think NEMUS is the future. If're going going into any kind of auditing, absolutely yeah, I agree, they have amazing resources and they're just such a fantastic organization. I don't know how Shannon does it all. She probably doesn't know how she does it all.

Speaker 2:

I get that comment all the time and I'm like, honestly, couldn't tell you.

Speaker 1:

Lots of coffee, little treat so you mentioned that you have a passion for career development and helping the next generation of coding professionals. Can you elaborate on kind of what you've been involved with and with mentoring and educating the new and up and coming coders?

Speaker 2:

Sure. So I'm a teaching assistant in the VILT program and that's a lot of one on one connection with students helping with coding issues, helping explain why we do what we do Right, helping with study skills, time management, some of those soft skills you know that are we do what we do right, helping with study skills, time management, some of those soft skills you know that are involved with what we do, as well as just overall, just general support, advice how to you know get over those nerves, how to get over that that little bit of a. Sometimes you have that road bump where you just feel like you just can't do it. Yeah, that's a counter that cardiology and E&M feel like you just can't do it.

Speaker 2:

Yeah, that's a counter that cardiology and E&M. For me it was cardiology and ophthalmology, so I get it. Yeah, at least ophthalmology is like a tiny section. It is. But then when you can't remember the difference between the OS and the OU, it becomes a much bigger issue. No, but it's. It's. It's fulfilling. I love it and my whole thing for the longest time. My husband always said if you could find a career where you could just get paid for learning, it would be perfect. It's like researching, exactly, and it's exactly what coding and auditing is. There's not a day that goes by that you don't learn something, so being able to pass that on to somebody else makes it even better. And one of the other things with Norwood is we have core values, one of which is learning is our journey. Knowledge is our legacy, so it's about we're lifelong learners. We never stop learning. There's always something new, something that we need to adapt to, pivot for, and then being able to pass that along so that the next generation coming through can benefit from it, it's all the better.

Speaker 1:

Yeah, I love that. Yeah, so you really enjoy doing the virtual instructor, the teaching TA stuff.

Speaker 2:

How many classes do you do in a month, so TAs typically carry somewhere between four to five classes. Okay, how long do I learn a class? Then it can vary. Sometimes it can be 15, 20. Sometimes it can be 25, 30. It really just depends on the class load. Oh OK, wow yeah.

Speaker 1:

Are they?

Speaker 2:

all at different times. Do you have to? They're at different stages of the program. They can be different types of programs, so we could have a CPC and a CDO, or a CPC and a CRC, or it's a lot.

Speaker 1:

It is a lot. It is Because it's one thing when it's like a structured program and you're like we're all learning cardiology and at the same time. But now it's like this one's doing cardiology, this one's doing urology, this one's got an ICD-10 introductory question Exactly this one's trying to find their job.

Speaker 2:

It's all over the place. Yeah, gosh, that's got to be a lot, but it keeps you on your toes. Yeah, and I can imagine it does, and I don't really like the repetitive. Yeah, if you've ever been in one of those roles where you're coding or auditing and it's the same thing 25 times in a row, your eyes kind of start going cross-eyed, you start getting a little bit lazy about it and then you're losing focus. Yeah, brain fog starts setting in. It keeps you busy, it keeps you engaged and that's perfect.

Speaker 1:

Do you find that you get emails a lot at uh friday at eight o'clock when everyone's studying, or?

Speaker 2:

sunday afternoon at 2 pm. Yeah, all the time all the time?

Speaker 1:

do they have a like a turnaround, like you have to get them done in 48 hours, or do you yeah, yeah, it's what's in generally within our hours kind of like accommodating with that? Are they like? I'm having the struggle, now I need you?

Speaker 2:

to. It varies. Ok, most, most are very understanding and since the TA role is typically a secondary role for most of us, we do work full time during the day. We have families, we have other responsibilities, so we have that flexibility in the timing to do it when we are able to. Yeah, the instructors, however, have dedicated class times.

Speaker 1:

Do you not have to be on there for the dedicated class time? You just kind of do the you do for the first one.

Speaker 2:

it's the orientation session, but after that you don't have to attend the classes, unless there's a reason the instructor needs to pull you in for something.

Speaker 1:

Okay, well, that's awesome. Yeah, maybe something for people to look into. They hire a lot of teacher assistants. Now there was a small crew and it's just built and built and built and built. And I'm assuming they have them for all the different certifications. So if you're someone who only has your CRC, you could just only do CRC. Yeah, I like that. Your role as the senior risk adjustment consultant involves optimizing mid-revenue cycle efficiency. Can you explain exactly what the mid-revenue cycle is and what you look for in opportunities to improve it?

Speaker 2:

Yeah, so mid-rev cycle is that place where all of the things that we do kind of converges together. You're looking at coding, auditing, documentation, improvement and then revenue and all of that. That is part of it all congealing into one to make sure we're reporting the best patient's history or make sure we've got the best care for the patient, make sure all of the things that are there are actually necessary and compliant, and then being able to evaluate those processes and make sure that, if necessary, they are adjusted in order to be compliant or whatever we need to do to actually make it more efficient, and make sure that, if necessary, they are adjusted in order to be compliant or whatever we need to do to actually make it more efficient and make sure that we are being as accurate as we can.

Speaker 2:

Okay, so everything except for like scheduling and then like follow up of the claim, or Well, I wouldn't say the follow up is necessarily outside of it, because denials and appeals you know that could be part of it as well. Well, because it's still in the middle of that revenue cycle. You haven't actually gotten paid yet.

Speaker 1:

So okay, you're involved in a range of professional activities, from serving on the crc exam committee to being an improved instructor. How do you balance all of those commitments? Oh, with work. And what drives you to keep wanting to do so many goddamn?

Speaker 2:

things first, things first. I have a not have hobbies, crystal night. I actually get that a lot. They're like you go go somebody else like go go do something for you. I'm like, but I am because I enjoy this. Yeah, it's kind of like a hobby, do I mean? I wouldn't work as many hours as I do if I didn't enjoy it. Right, most people they go to work, they work their eight hours, they go do if I didn't enjoy it? Right, right, most people they go to work, they work their eight hours. They go home, they're done for the day and I'm like looking around, going, ok, what else can I? How else can I get something done?

Speaker 2:

But as far as the balance number one, I have an excellent support system. I have a husband that absolutely loves me and he supports me a thousand percent Almost, and I absolutely love it. We've actually been married for almost 25 years now, so he's been up with me for quite a while, oh wow. And he knows, as soon as I get done with one thing, move it off my plate shortly before something else is going to be coming right along. But it helps also to have an amazing employer who not only supports you in those extra endeavors, but actively encourages it and pushes you to do more. Not in a way of like, hey, we need you to do more, but in a go, grow, expand, learn more, you know, and then bring that back and help us. You know, figure that out as well, and it's kind of amazing to have that difference, because I have experienced employers that that's not the case. Yeah, it's always. What more can you do for us?

Speaker 1:

Yeah, and that's probably very helpful too with, like, managing your burnout, because you don't feel like you're being pushed in. Exactly, they're willing to help you out and accommodate and cheer you on, absolutely, so that sounds awesome. Well, norwood sounds like a great place If you're looking for a medical, coding, auditing, consulting job. Check Norwood.

Speaker 2:

Norwood staffing Norwoodcom.

Speaker 1:

So then you've got all of these things that you're doing professionally.

Speaker 2:

Like do you have issues?

Speaker 1:

Do you still have issues where you're like my battery is just about to run out, this repeating cycle of energy going because it actually energizes me when I'm doing what I'm doing. I've started taking certain different dance classes because it's so fascinating to me to, instead of thinking about Medicare policies and code update Right, I'm like thinking about what, where am I putting my leg and my arm and where am I moving next? It's like it's a whole different part of my brain that I have to work that I'm so not used to, and it's like refreshing to tune into that and not have to think about medical coding. It's like, oh, ok, well, now I feel better and I can go back to the things that I need to focus on.

Speaker 2:

See for me that's just another specialty or a different certification. That's I go dive into something new and learn something new. Oh, that's plus. Nobody wants to have me dancing. I'm clumsy as I'll get out.

Speaker 1:

Well, and I'm sure that that no one has any shortage of projects that they're willing to handle, right, yeah, so start getting involved in the APC. Yeah, come by and they're just like tap, tap, tap, tap. Hey, we have a committee that you would like Would you like to be, and that's exactly what happened.

Speaker 2:

Seriously, committee.

Speaker 1:

Yeah Well, that's awesome and I love that. I was talking with some of the others about how I have certain people that will comment on my channel and they'll kind of want like the exam questions, and I've seen a couple of people now and then they'll be like oh yeah, I have you know, here's the questions that I remember from the exam. I wrote them down, I'm going to set one up here and and it's like I don't know what the first off. No, how would that even be beneficial? Because the databases that they have now of all of the questions changes. There's like a one in a thousand chance that you're gonna even get those. Why are you, why are you wasting your time trying to even memorize? But memorize the concepts?

Speaker 2:

that's what you need to. And here's the thing even if could, even if you could technically somehow figure out how what's exactly going to be on that quiz or on that exam, you're doing yourself a disservice. When you get done taking that exam, what do you have to do? You have to be able to go into a job and perform the actual noting. If you are shortchanging yourself during your education portion, only going to become more evident on your employer tests on your first couple weeks on the job, first month on the job, and you might not even make it past the first few months on the job, it really is beneficial for students to really truly take that education for what it is and put the time and effort into it, because I promise you it will give back to you.

Speaker 1:

Yeah, absolutely. Just know terms, know your guidelines, know how to navigate through your book. You don't have to memorize everything, you just need to know how to utilize everything.

Speaker 2:

I tell students all the time they're like I don't know what to look up. Okay, so pick one. Yeah, yeah, pick something. Look it up see if it works. Yeah, if it doesn't work, pick something else.

Speaker 1:

Well, I'll have people sometimes say like, oh well, you looked up such and such and I looked up this, and why is it wrong? I'm like it's not wrong if you got to to look up the same thing.

Speaker 2:

sometimes it's very circular in nature. It really can be.

Speaker 1:

So you were recently accepted to the AAPC's brand new first cohort of the AAPC Emerging Leaders Program, which is a huge honor because they got hundreds of applications and picked like 40. Oh, did they? Yes, hundreds.

Speaker 2:

Oh, wow, I did not know that. Yeah, okay, I knew they picked 40.

Speaker 1:

I just didn't know how many they had gotten. Oh yeah, wow yeah, it was hundreds. What are you hoping to gain from this experience, and what are your hopes for how you can use this to better?

Speaker 2:

shape the industry Oof, what am I hoping to gain? Well, first, I don't really have a whole lot of details yet.

Speaker 1:

Yeah, I've heard there is. I was expecting that they would be like, yeah, month one, we're going to cover this.

Speaker 2:

Well, eventually, yeah, eventually we will. But it's so new Like we don't even have our meeting until, I believe it's next week. Ok, so we don't have any information except that there are 40 of us and we're going to be going through this program together. I mean, that's really all we know.

Speaker 1:

And they make you take a are here at HealthCon oh, that's awesome. Yeah, yeah. Have you ever, since you've been involved in your local chapters, thought about serving on like the chapter association or the board of directors in any way?

Speaker 2:

Not really, and now that this is happening, I'm guessing that odds are that's probably where this is headed and that's why they're creating the program. But this is actually my fourth year being a chapter officer, so this year I have to step back, as the rules state, and one of my officers was actually like you can't leave us at the end of this year. I'm like I'm sorry, it's not my choice. Four years, you got to take a step down. So I'm going to take at least a year off, I think, to make sure I'm good and solid.

Speaker 2:

And this program is a 10 month program. It's not, you know, it's not two weeks and you're done. It's a commitment. So I'm hoping to get as far as what I get out of it. I'm hoping that leadership skills obviously I have some already that are there, but I'm hoping to develop those in a way that can let me be a better leader for not just my team at work but also incoming generations of coders. Like there's a there's a large gap that is coming and I don't think a lot of people are aware of just how big it's going to be. We have a population in our industry that are getting ready to hit retirement, and then we have a population of new coders coming in that can't get their foot in the door yeah, yeah and it and it's yeah.

Speaker 1:

What are we going to do? And not to mention, you know, with AI evolving, a lot of the changes that we're going to see, with some of the entry level work that we're going to need to have a higher level of understanding, just coming in Absolutely Almost to the degree of like a documentation expert.

Speaker 2:

Like you're auditing from the first time you're in the door.

Speaker 1:

Yeah, yeah, absolutely so thank you so much, Crystal. This was a really great conversation. Where can my viewers connect with you if they want to find out more about you?

Speaker 2:

I am on LinkedIn. My username, I believe, is CrystalMayCode. I think that's what it is. If not, search CrystalMay on LinkedIn and you'll find me All right. Well, thank you so much for hanging out with us today. Thanks for inviting me. I had a blast. It was fun Great.