Contempo Coding Podcast
Welcome to The Contempo Coding Podcast! 🎙️ Join us as we delve into the fascinating world of medical coding, sharing insightful stories and personal experiences of being a work-from-home mom. 🏠💪 Get ready to explore the industry, stay updated on changes, uncover hot tips, and gain valuable knowledge to empower your success in the dynamic field of medical coding. Tune in now and let's build your path to triumph together! 🌟💻
Contempo Coding Podcast
Building a Comprehensive Coding Career: An Interview with Stephanie Allard
I'm excited to introduce you to Stephanie Allard, a seasoned consultant and auditor with over 20 years of experience in medical coding, billing, reimbursement, and compliance. We dive deep into Stephanie's inspiring journey, from starting in a dental office to becoming a leading expert in the field. Stephanie also shares insights on the future of medical coding, the role of AI, and offers advice for those just starting out.
Hey everyone, welcome back to the channel. I am here today with Stephanie Allard. Stephanie Allard is a seasoned consultant, auditor and an author with over 20 years of experience in medical coding, in billing, reimbursement and compliance. She specializes in a lot of specialties 40 plus, I think, specialties and she's known for her work in external audits, forensics audits, revenue cycle reviews and payer investigations as well. Stephanie helps healthcare organizations improve their workflow and reduce risk, and she's also led large coding teams and is passionate about mentoring others and staying ahead of industry changes. So thank you so much, stephanie, for coming on the channel today and talking to my viewers. Yes, thanks for having me. So, stephanie, one of the first fascinating things that I like to ask about people is you know kind of how your origin story and how you started? So what kind of got you into the world of medical coding and compliance?
Speaker 2:My beginning. I always laugh because I ended up in a position in a dental office years ago and it was something where I just needed a job and I just was thinking, okay, that should be good. It said they could train you, you didn't need experience. So I get this job and show up in this office, does many other things outside of what my dentist did, like extractions and fun things like that, and I was there for four years. But I quickly realized that I did not want to be in the hands-on part of any area of medicine. So it did get me thinking about what I wanted to pursue. I didn't really have much direction after high school so I went back to school later in life I actually did it once when my oldest daughter was a baby and then decided again when my second daughter was born. So I went back and pursued medical coding and after getting certified under medical coding with a local like tech college, I went back to a community college to pursue the RHIT.
Speaker 1:Okay, was anything able to transfer over from the tech school to the community college?
Speaker 2:Or were they like.
Speaker 1:No, you kind of have to start all over.
Speaker 2:Yeah, no, that was a real big pain point and that was something I, you know, I I kind of decided on a whim what I wanted to pursue. And you know that first time with the tech school so I didn't even know what to look into, so I had no idea what transfer, so basically just started all over again. Yeah, so I had no idea it wouldn't transfer, so basically just started all over again.
Speaker 1:Yeah, when I went to school they didn't really have the like the associate's degrees in medical billing and coding. So I've had the like a certificate of completion program and since then they developed them and I'm like is it worth it to go back, cause I probably would only need to take like five classes, cause they will transfer some of them, or like the med term and stuff.
Speaker 1:Yeah, um, but I love those programs that people say, like the WGU, where they kind of give you almost like experience credits and stuff. Yeah, I see more and more people kind of leaning towards that. Now you've worked with an exorbitant amount of specialties tons and tons like probably almost every specialty out there, I would imagine.
Speaker 2:Close, I say everything. I do not do radiation oncology and I don't do cardiovascular.
Speaker 1:So how did you go about building such a broad base of knowledge and all these different specialties?
Speaker 2:So a lot of it actually started in my first position where I basically was filling in for people. So if someone was on vacation or you know whatever it may be medical leave on vacation, or you know whatever it may be medical leave, they wanted a long weekend, whatever. I had worked my way up into a position where I was basically filling in. So it pretty much by default was just a position where I was jumping around and learning a lot of specialties. I focused first on the E&M office side and eventually moved into surgical and even you know I moved into surgical, I would say, a little later in my coding career as well. I didn't start there. So that offered a lot of visibility into what the practices do. And you know, I in general in the industry had started in like a customer service type role in a hospital. So I had a lot of exposure there to just trying to help patients understand the bills or maybe work through denials, things like that.
Speaker 1:I started out in E&M coding and then went over to surgery and it used to infuriate me For some reason they had just started out doing audits then of the surgical coders, but somehow all of my audits were on the enms that were done for the surgeons and I'm like okay, so we're ignoring the thousands of dollars of surgeries and we're focusing on the hundred dollar service instead.
Speaker 1:That's your focus during this audit. Yes, yeah, but yeah. So when you were trained working on all these different specialties, did you have someone that would kind of like tell you okay, this is how the specialty works and this is the coding regulations, the little nuances or did you kind of have to figure all that out yourself?
Speaker 2:a mix of both. So because it depended, you know, I I think it was a little unique because now I see a lot of facility systems choosing not to have coders in every specialty, or you know, every department or look at every charge, right, and I was a part of a department who was building and starting to go that route, with a coder looking at every service, right. So I would, you know, touch base with my coworker trying to, you know, go back. Then a lot of things were on paper, with my coworker trying to, you know, go back. Then a lot of things were on paper. So we would have a stack of, like super bills we'd work through each day and I would go and figure out the process and maybe ask some questions, but it was more so just kind of learning as you go and then, you know, maybe like saving some encounters for questions, things like that.
Speaker 1:Yeah, I think trying to find out the nuances of different specialties is tough for people, but it's a lot easier, I imagine, now than it used to be back before we had such the abundance of information on the internet. And now it's also the opposite. You might not be getting the best information, depending on where you're looking, because some people go oh yeah, you just slap a 59 modifier and they pay it for us every time.
Speaker 2:And someone online goes, oh yeah, that sounds good, we'll just do that, yeah, yeah, yeah, that works, that gets paid.
Speaker 1:So tell us you know you've had lots of great positions in the past. I've kind of came to know you from NamUs and now you're out on your own running your own company. What made you want to kind of take that transition.
Speaker 2:So, you know, it's funny because I never thought that I would actually. And it's one of those things in my career I always try to pause and see where I'm at, evaluate what I want to do, where I want to go, and, um, you know, it's just one of those things that I started to think about because, like I said, I never thought it would be me. So then you kind of start to question, you're like, well, what would that look like? And my dad owned his own business. Most of his working life, most of my life, he did a lot of dental work like crowns, bridges. He had a dental lab.
Speaker 2:So I grew up with my dad owning his business. My brother owns his own business. So I kind of, you know, started to see what it would look like. And for me there were a couple of things that were, I wouldn't say, scary, but were pauses for me that I didn't understand at the time that I was growing, considering. So I had to. You know, I always have to think ahead and look to the end point and all of those things. So after researching what concerned me, I I felt like I could, I could do it. So I I planned and took the leap.
Speaker 1:It's, it's exciting. I, when I leaped I don't think a lot of people realize I didn't have a big safety net it was scary. My husband wasn't working you know, it was during COVID and I had like maybe two weeks worth of expenses, maybe three, saved up. So I'm like, but the nice thing was and this is the advice I give other people when they're like you know, I don't know. I don't know if I should go out and branch out on my own. I'm like well, from my perspective, if I had gone out on my own and it didn't work out, I could always go back to being an auditor, I could always go back to find another coding job.
Speaker 1:So it was like, okay, well, I don't have this safety net, but I can always find something else. It's not like I'm no longer going to be able to be a coder.
Speaker 2:Or if it doesn't work out Exactly, exactly, you may just have to go back to something. That's not a preference. But you know, I will say too, I had a lot of really great friends in the industry and colleagues, and I mean you. You know the core group and they're amazing, strong, confident women. They're running successful businesses and it really helps to be able to talk through some of those things. And you know, I do tend I always say I tend to be a pessimist, even though I try to be positive In my mind when I'm working through big decisions, I always think of worst case scenario, things like that. So it's nice to have people to bounce that off of, because that really helped give me not that I didn't have confidence, but it helped me understand that, yes, you're going into the unknown, but it's going to work out.
Speaker 1:Yeah, a little bit more of an informed decision.
Speaker 2:Yes, a little bit more support.
Speaker 1:Yeah, now in our industry we have a lot of regulatory changes things going on with CMS and the private payers. Now administration changes and there's a lot of regulatory changes, things going on with CMS and the private payers. Now administration changes and there's a lot of things that seem to be shifting at very rapid pace. How do you stay on top of all of that, especially working in so many different specialties?
Speaker 2:So the biggest thing is first, you can't stay on top of all of it all of the time. So for me, it's important to understand that when you're working on something here and now, you have to go back. Even if I think I know a lot of information about laboratories or a lot about E&M or Incident 2 or all these subjects we deal with a lot, you still have to go back because resources can change, especially now, you know, when we have different changes, even in administration CMS documents change, hhs, websites change, so those types of things. You know. Sometimes something may be taken away. That was a core source for me and I don't have it in writing, right, or there's a new definition and that's really going to help with either my audits or defense if I'm doing the legal work, things like that. So it's one of those things where you, more so, have to have an ability to research, because it's impossible for people to know everything.
Speaker 1:What are some of the shifts that you kind of keep at the top of your list, like these, are the things that I definitely need to make sure that I'm keeping an eye on.
Speaker 2:So right now for me I have a large focus in behavioral health and a lot of it surrounding some of the newer services, so the behavioral health integration services with CMS. You know, especially now with changes in reimbursement and things like that, I will get asked a lot of questions about. You know, what can we implement because we're feeling a hit in our revenue and they want to expand and grow, but practices don't always know what that includes. So behavioral health has just been something I do work a lot in that space and I get a lot of questions there. But this whole integration is coming up a lot more.
Speaker 1:And I'm sure a lot of people see your success and how professional you are and all the great work that you've done working with all these different organizations and might come to you and go. You know, I thought about getting into kind of medical coding or I'm just getting started out. What advice do you have for people that are starting to get into this field and they might want to be the next? Stephanie Allard.
Speaker 2:So you know and it's funny you asked this because my oldest daughter currently is pursuing she's going to a tech school in Knoxville where we live for coding and billing. And you know, I've told her you're going to work from the bottom up, like I there's, it doesn't matter what I know I can told her you're going to work from the bottom up, like I, there's, it doesn't matter what I know I can't transfer information over. So the biggest advice that I have is, first of all, you know, don't go in with expectations related to work from home, for example. That is the number one question I'm asked is if I do this, can I work from home? But I have a viewpoint that that can actually be a little crippling, depending on the organization you're working with, because it is more work to mentor and train and work with someone if you're not there in person.
Speaker 2:And you know, a lot of times, for example, if you're with a company who will hire remotely, they're expecting to some degree you to already have certain abilities, so they're not there with resources to bring you up to a level necessarily, or they'll just kind of leave you where you exist and you don't have as much opportunity.
Speaker 2:So I think it's really important to make sure that you are looking at all your options and I like to advise people if you're going to pursue it, look at what is locally in your area. So look at your hospitals, see what their job listings look like, their requirements, you know, just get your foot in the door, because any part of the health system that you can be exposed to you're going to take something away from it, and that is the only way that I can describe my own experience is just constantly adding. You know, you look back to the jobs that were always awful, right, and you're like, oh, why do I have to do this? This is painful. Or you know, getting stuck at month end helping get all the charges out, but all of those things compound and that's what's. That's what builds your experience, yeah.
Speaker 1:And I like that you mentioned. Look at what your local area is looking for, the different certifications, the different training, because people will sometimes ask me about certifications and I know they're less preferable ones and I don't want to just bad mouth that organization, but I'm like I know there are maybe pockets of areas where they do accept this certification. Yeah, so check your area and see if they take that and if not, you should probably get like a CPC or a CCS or something like that, whatever it is that they're looking for.
Speaker 2:Yeah Well, and that's a big thing. And actually I had a project I was working on recently and the organization was questioning because the person didn't have like an AAPC base credential. So I do think that that's important. You know, I also think it's important to branch out into other entities. Obviously, I've done that. I've worked a lot with Shannon and NamUs and those programs are amazing. So it's important to get that insight from different areas if you want to diversify.
Speaker 1:Speaking of diversifying, you know, one of the things people are very concerned about right now is AI and all of the things that are happening with AI, and you know I get a lot of highly concerned people that are like, hey, I want to get into medical coding but I'm concerned that the jobs can be obsolete in a few years because of AI, you know with coding and with auditing and compliance. Where do you kind of see AI coming in there?
Speaker 2:So I have a couple different viewpoints. Actually, I can think of three different ways I've been looking at it, and one of them actually just recently. Last night I went out to dinner with Dr Singh Kush and Ed Baker. I presented with him at at health con and we were having a discussion about ai from the perspective of providers using it and you know there's a lot of organizations out there pushing it to code right. They wanted to select the codes, they wanted to do all of that and I.
Speaker 2:I even have a client that I work with. That is amazing and all the technology they've been implementing and they've been working on their EMR system coding and it's one of those things where we go back and forth, like I work with the AI developers. They run things, then I go in and audit it, see what it looks like, see where differences are. But one of the things I'm noticing through that project is that there's still ways for the providers to get around things. So if they know the system's looking for something, then they're going to try something else. Or, you know, if there's a certain tool they were using in the EMR to beef up their documentation like copy and paste is a constant problem they just find a way to get around it. So you know I have concerns there around compliance and what the parameters are for the providers, but I do see it being used as a tool, absolutely. You know there's different areas of coding where, especially on the facility side, you have to read through hundreds of documents and that's really going to speed up that process, identify what we need to be picking out and then validating.
Speaker 2:I don't, I don't see it taking over the process. Especially it's hard with E&M because there's so much subjectivity and as much as I work with my client and their system, that's where things hang up, because we always have the if this, then that, then that, so that's yeah. That's interesting. One other thing that I've found I've been approached by some companies who are implementing AI for research that I'm interested to see what that turns into, because they have great programs but they're very expensive and there's a lot of costs attached to AI. And you know, frankly, a lot of the organizations I work with sometimes they don't even want to invest in an encoder for their coding staff and that's like what? $30 a month. So I think that the companies, if they're not partnering with EMRs and things like that, I'm just interested to see, because there's a technology of equipment, but not so much the computer administrative ends of things.
Speaker 1:Yeah, and we'll certainly, I'm sure, see a lot more compliance activity, because we are, I'm sure, going to see providers that are like, oh, we'll just turn this switch on for the AI and send everything out the door, and I don't doubt that there are also going to be organizations that are going to attempt to replace their coders with AI because that's, that's been something that they've done before, with even things like offshoring and then wind up going.
Speaker 1:Oh, that didn't work and now we have to pay out a lot of money to fix this again yes, yeah, exactly, I think so for sure.
Speaker 2:And that's the thing too. It's like compliance needs to be aware of what is being implemented. You know me being an external party with all of my clients. I'm kind of surprised to see, like, how much is being integrated. If I don't work with a particular system for a little bit of time, and then I always ask my clients you know, like, what's what's integrated into the system? Are you using anything separate? And it's it's becoming a lot more prevalent inside of the EMRs.
Speaker 1:Yeah, I get a lot of very fly by night companies that'll contact me and I was talking to someone else about this recently where they're like oh, hey, I, I make AI projects and I didn't. I just noticed that you guys are still using books.
Speaker 1:And I don't know if you know this, but we can make programs that do what you do so we could collaborate with you. Blah, blah, blah and I'm like I don't. I'm sorry, I hope I don't hurt your feelings with this, but 3M and Epic are way ahead of anything you're thinking of developing right. Yeah. So I don't want to discourage you, but you've got some stiff competition if this is what you're planning on doing?
Speaker 2:Yes, yeah, I've actually had people say you know, do you want to come and be a director for us? Even after opening my own firm and saying you know we have AI, it's going to do the work and there's not going to be a need for auditors.
Speaker 1:Well, that was supposed to be in March. So, outside of the scope of compliance and auditing and stuff, what are some of the things that you enjoy personally to kind of recharge in your off time?
Speaker 2:Yes, so one of the biggest personal hobbies I have is reading. So I always joke that purchasing books and researching books is a different hobby than reading, right? But yeah, that's what I like to do to decompress. And you know, outside of that, I really like to get out when the weather's nice to you know, go hiking and biking and things like that. We live in a beautiful area near the Smoky Mountains so we have access to a lot of you know nice places like that. Oh, that's so lovely yeah.
Speaker 1:So, stephanie, thank you so much for coming with me today and doing this interview. If my viewers want to connect with you online, where should they go?
Speaker 2:Yes, so you can go to stephanieallardconsultingcom. Also find me on LinkedIn because I have been trying to put a lot of content out there just to help with. You know just different areas of all of the specialties and I have the podcast now auditing antics. So again, just trying to put content out there to start conversations. I find a lot of times people just don't even know what questions to ask or what to be aware of. So trying to tackle that more through the social media side and I'd love to have you join me there and the podcast is also on Apple Podcasts, linkedin, youtube, spotify, a lot of the main ones.
Speaker 1:Well, thank you again. So much, stephanie, this has been great. Yes, thank you.