0:00

Hey everyone , welcome back to the channel . Today

0:02

we are here with Allison Gibson . Allison

0:04

has a pretty vast health information

0:07

career over 15 years executive

0:09

leadership , value-based care and she's

0:12

very passionate about advancing healthcare systems

0:14

that align with incentives , improve

0:16

efficiency and optimize care delivery . So

0:18

thank you so much , allison , for coming down to the

0:20

studio today to record this podcast

0:22

. So first

0:25

I wanna know a little bit about your

0:27

journey and health information , because you are

0:29

more overall health information

0:31

based than you are just like medical billing and coding

0:33

based . So can you walk us through

0:35

like your health information management

0:38

journey and how you got to where you are today ?

0:40

Sure , 15 years or

0:42

so , so I feel like it kind of ends up being a bit of

0:44

a long story . But I actually started

0:46

by getting a temporary placement when I was

0:48

20 years old with a

0:51

third party company that did accounts receivable

0:53

for various medical groups . So

0:55

I started doing that , always was good at math

0:58

and analytical type stuff , so quickly got really

1:00

interested in the medical billing portion

1:03

, looking at those EOBs , understanding how the

1:05

contract rates are applied , how the write-offs

1:07

are happening , who's responsible

1:09

for what , understanding those deductibles and coinsurance

1:12

. So I did that for a little while

1:14

and I really liked it . But it was a temporary

1:16

position , so it was just a contract

1:18

for a couple of months . Whenever I was let go

1:21

from that they didn't ask for us to come in permanently

1:23

. So I was like , well , you know , I really like that , maybe I'll

1:25

go back to school , yeah , right

1:27

. So I got a part-time job

1:29

at a hospital , part-time with benefits

1:31

, because that was very important . I was a grown-up

1:34

, right , right .

1:34

I had a 20 year .

1:36

I have to come off my parents' insurance exactly

1:38

, and we didn't get to be there till 26 back

1:40

then . Yes , yeah , I

1:42

had to make sure I had benefits and

1:44

then I got pregnant with my daughter , so that kind of changed my

1:47

trajectory a little bit . I didn't continue

1:49

going back to school at that time , but

1:51

I really enjoyed that medical billing

1:53

and coding . So I thought , you know , I hope I can find

1:55

something similar , found something similar

1:58

, but not quite the same . I was working for

2:00

a company that actually did Medicare

2:02

Advantage billing , working with CMS

2:05

. So they actually were billing the beneficiaries

2:07

for their monthly premiums for the Medicare

2:09

Advantage plan and so they were subsidized by

2:11

CMS . So think you

2:13

have Medicaid , you're eligible for that , but you also have Medicare

2:16

. Now you're in a dual plan , so you were

2:18

billing or processing subsidies for these

2:20

Medicare recipients . I

2:22

wasn't really a fan of that job . It wasn't what I

2:24

thought it was when I heard it was a billing job . But

2:26

I did stay there for a year , worked

2:29

with quite a few people that I had worked with

2:31

in that temp space , so we were kind of

2:33

, you know , all together there . But

2:35

after that I got a job . I lived

2:38

in Northeast Pennsylvania , so now we live in Southeast , or

2:40

I live in Southeast Pennsylvania and

2:43

I was working at

2:45

a private practice group

2:47

there . I started in the counts

2:49

receivable and it was back to the same . I loved

2:52

it , I learned it , it was great . We

2:54

did not have a coding department , we only had an

2:56

accounts receivable department . So as

2:59

our group got bigger and we

3:01

gained more specialties , particularly

3:03

electrophysiology , we

3:05

started getting lots of denials that no one really

3:07

understood . Doctors coded for themselves

3:10

again no coding department whatsoever

3:12

. So we had complicated surgeries going

3:14

on and doctors just giving us codes and we'd

3:17

wait till the denials came because we didn't know

3:19

what was happening . They were just going up into

3:21

the ether and then coming back tonight .

3:23

Which was very telling

3:26

of the time . That's just how

3:28

things ran back and I've had practice days

3:30

we , the understanding

3:33

of the coding knowledge 15

3:35

plus years ago was not what it

3:37

was today .

3:37

Little to nothing is what I would say . You

3:40

know , we were lucky that we knew a CAT scan was a

3:42

7,000 code , you know so

3:45

. But I kind of started

3:47

learning the coding because I'd have to pull the records

3:49

to submit to insurance companies and we'd get the

3:51

denials and I'd read the record and I'd look at the description

3:54

of the code and I'd think , wait a minute

3:56

, this doesn't sound right , maybe

3:58

there's something better . So I kind of started

4:00

figuring out coding on my own

4:02

. They finally hired

4:04

one coder to be our compliance

4:07

department and she was wonderful and

4:09

I told her how I was interested in learning how to code

4:11

and she taught me how to

4:13

code E&Ms , because that was the majority of

4:15

what our private practice did , yeah

4:18

, so the first thing I even learned coding was E&M

4:20

. Yeah , and you

4:22

still stuck with it . After that I did

4:24

yep , I sure did . You know , it

4:26

was very interesting to me . It actually

4:28

felt like a whole different side of what I'd been looking at

4:31

, because I was thinking these complicated

4:33

surgeries that are always getting denied not

4:35

how do I know what level of visit

4:37

it . So that was really good

4:39

. And then I kind of approached

4:42

our management team and said

4:44

, you know , really interested in coding . I'd really

4:46

like to do a job coding

4:48

. Is there any way that that is gonna expand

4:51

? We literally have one person . So

4:53

they kind of gave me a deal right , like well , you can start

4:55

coding , and if you start

4:57

coding and you get a certification

4:59

, give you a raise and we'll let you work in the coding

5:02

department . Oh well , I thought so . It was actually

5:04

really good . I had a very supportive boss at the time

5:06

and that's exactly what I

5:08

did . I started training with the coder that was there . She

5:11

taught me how to do E&M . I remember printing

5:13

out a CPC practice test and

5:17

doing it by hand . So

5:20

I did that and I took the CPC test

5:22

and passed it on my first try and got my raise

5:24

and officially became a coder . Luckily

5:26

, I had already been working there for more than a year

5:28

, so I got my A removed immediately , which

5:31

was really cool . So I

5:33

worked there for a while and

5:35

then when I left there , it's because

5:37

I moved . So I moved about an hour and a half away , made

5:40

the commute for about two months , which was terrible

5:42

, if you know anything about In Pennsylvania

5:44

in our weather . It was dead of winter

5:46

that I made that commute from Southeast

5:49

to Northeast PA .

5:50

Yeah , and it doesn't take much for it to make an hour

5:52

commute like a two hour commute in the

5:54

winter . No , like a little bit of snowfall

5:56

and all of a sudden it's double the time and

5:59

mine was a complete turnpike commute .

6:00

So if anything shut down on the

6:02

turnpike I'm stuck . But

6:05

I did that for about two months before I got a job with

6:07

a very large local health system as

6:10

a physician auditor . Then when I say very

6:12

large local health system , it's huge , huge

6:14

, huge . Now . It was still huge then . But we had

6:16

one auditor which was ah

6:18

, ah , ah , ah , ah , ah , ah , ah , ah , ah , ah , ah

6:21

, ah , ah , ah , ah . One auditor for an entire

6:23

physician practice which probably at the time

6:25

had 500 plus physicians and I don't know

6:27

how many advanced practitioners . Probably

6:29

tripled that at this point , but still that

6:32

one auditor .

6:33

I totally feel you . I think my last auditing

6:35

role working for a large organization

6:37

we had probably a couple of thousand

6:40

physicians and four

6:43

auditors .

6:44

So I mean that's a similar ratio . Yep

6:47

, so I did that . But when

6:49

I started there I

6:52

worked for her to a manager who reported to our director

6:54

and I quickly kind of gained I

6:57

don't know side of the director . She saw what I was doing

6:59

and how I was doing it , got to know her

7:01

a little bit more . She was ready to retire

7:03

. So she decided she wanted to retire

7:06

and they said please don't retire . What we really

7:08

need from you is somebody to help work

7:10

on our EHR . And we'd really love them

7:12

to be certified in coding because we need to make templates

7:14

for doctors . We need to especially

7:17

make templates for specialty doctors

7:19

because we've gotten EHR and we've got

7:21

out the box templates . One

7:23

, they're not really what they need for what they do in practice

7:25

and two , how do we know their compliance ? So

7:29

she plucked me and about

7:31

four other people from the coding department and

7:33

made us into the EHR build team . Okay

7:35

, was this kind ?

7:36

of like Obama era , where everyone was kind of

7:38

pushing like it's now time .

7:40

We have to get them Definitely Obama area . Yeah

7:42

, I mean we were already on an EHR

7:45

, but it was very much out

7:47

of the box and everything we did with that EHR

7:49

. We called the vendor and we had consultants come

7:51

in and do so . We didn't have anyone

7:54

on site that was actually actively working

7:56

on that EHR build type stuff and

7:59

we did more than just templates . We did a

8:01

lot of things that have expanded my knowledge and

8:03

got me where I am today . In

8:05

an EHR , people have to place orders , they

8:08

have to receive results , and that's when the quality

8:10

payment program was first starting with Medicare

8:12

. It was PQRS , then the position

8:15

for the reporting system and

8:17

I became the owner

8:19

of that , partially because a lot of our data

8:21

came from the EHR , but also because

8:23

I was building the EHR so I could look at quality

8:26

specifications and make sure all

8:28

of our orderables and resultables that

8:30

matched anything quality measure related had

8:32

the correct coding , not necessarily

8:34

CPT or ICD coding , but the correct

8:37

coding on the back end so that it would become structured

8:39

data and be able to be reported for

8:41

the quality payment program . So

8:43

while I was in that EHR team , that became my

8:46

job , part of my job , and three

8:48

months of every year is when we would report

8:50

for PQRS . So I had an entire team

8:52

of people helping me take away from

8:54

their side job , abstracting data from

8:56

charts , pulling things that came in free text

8:58

that were structured data , a three-month project

9:00

every year . So

9:03

we kept doing that , getting a bit more

9:05

involved in quality , starting contracting

9:07

with our local payers and enrolling in

9:09

quality programs that weren't quite

9:11

the same as Medicare but were kind of that

9:14

little book , the kind of like the glide path to where Medicare

9:16

was . So same kind

9:18

of measures but not exactly getting shared

9:21

savings , just kind of incentivizing

9:23

. We started doing things differently

9:25

. At the physician group we decided well , we're doing

9:27

all this and getting all this money from CMS

9:29

lead to incentivize our providers to

9:31

kind of change the way they practice . So

9:35

in doing that they actually created a brand

9:37

new team , the value-based care team , and

9:39

I became the value-based project supervisor because

9:41

I was already supervising the one very large

9:43

project that we had that was value-based

9:46

. So I did that

9:48

. I loved that job . When

9:50

I was doing that job I not

9:52

only worked with the physician groups and their

9:55

staff on how to meet these quality measures

9:57

, I helped create dashboards in the EHR

9:59

. So that point of care . When a physician

10:01

is seeing a patient , it will pop up and say

10:04

Victoria needs her colonoscopy

10:06

, victoria hasn't had a depression screening

10:08

Victoria's diabetic and needs her A1C

10:10

checked so that right at the point of care they

10:12

could see what quality metrics

10:14

this patient matches and what

10:16

they might be due for , so that they could be a bit

10:18

more proactive in getting

10:21

these things done for these patients . So a

10:23

lot of my work was working with the staff , teaching

10:25

them how to utilize these dashboards , but

10:28

also I had a team that worked at the business

10:30

office and continued to do that abstraction

10:32

and work with those insurance companies to submit

10:34

that data and also coordinate with the physician

10:37

practices and get policies

10:39

and procedures going . Everything was brand

10:41

new . So that was a really wonderful

10:43

job for me . I loved it , I was very happy

10:46

, but out of the blue , my colleague

10:48

from back at that physician group

10:50

in northeast Pennsylvania called me and

10:52

said hey , I'm working at Optum

10:54

and there's a job that we have opening

10:57

and I think you'd be great for it . And

10:59

I said nope , I love the job I have

11:01

Now . I'm a value based project supervisor

11:04

and it's wonderful and I love it

11:06

. And she said give it a chance . I

11:09

thought about it and I said tell me

11:11

more about the job . And

11:13

the job was working for Optum 360

11:16

on their natural language processing

11:18

innovation team on their computer

11:20

assisted coding product . And

11:22

I said tell me more . So

11:27

, a long story short , I spoke

11:29

with her boss . We got on

11:32

great obviously to

11:34

various kind of niche field and

11:37

you can talk the talk with somebody you get Right

11:39

. So I was talking about all my value

11:42

based work and all of that . And it turned out

11:44

that they wanted to start doing some proof of concept

11:46

work . They've had a computer assisted coding product

11:48

with Optum years and years and years

11:50

. It's still being

11:52

developed day to day , consistently

11:55

refining . But it's that product , it's going to code your

11:57

record and that's what it's going to do . We

11:59

started doing proof of concept work and , based on my

12:01

background , with value based , I did

12:03

a lot of that . It was at the time we

12:06

had all kinds of names for it . Now it's clinical

12:08

language intelligence and it's a true product from

12:10

Optum . But what

12:13

we did is took unstructured

12:15

data and , like I was kind of saying I was doing with the other

12:17

EHRs , we had the natural language

12:19

processing engine from the computer

12:21

assisted coding module , read all of

12:23

that text and then , instead of applying

12:25

an ICD or a PCS or

12:28

CPT code , it would pull

12:30

out SNOMED codes like codes and

12:32

RXNORM codes , so that we would be

12:34

able to see how those

12:36

match in specifications but more so clinical

12:39

indication . So , for an example

12:41

, the big project I worked on that is now called Optum

12:43

Case Advisor , but

12:46

in POC it was from a large executive

12:48

health resources group actually in Pennsylvania that

12:51

Optum had acquired they I

12:53

think their main business was overturning

12:55

appeals for inpatient claims that were

12:57

denied and said , no , they should have been observation . So

13:00

they're fighting them and saying , no , they really should have been inpatient

13:02

. And here's why they literally had a

13:04

binder this large of all the appeals they had ever

13:06

won . So if they said , oh , I've got

13:08

a patient that was in for a GI bleed and

13:10

it denied , they'll turn to GI bleed and

13:12

they'll find whatever appeal they want and

13:14

how they want it . And what levels of

13:16

whatever was there , what clinical indicators

13:19

they found that made that in the chart

13:21

and then they would pour through manually

13:23

a chart trying to find the

13:25

same clinical indicators so that they could win

13:28

their appeal basing it on a form or appeal

13:30

. That's the gist of it . Well , we turned that

13:32

electronic for them . We took that giant appeal

13:34

binder that they had . We OCRed

13:37

them , so we scanned all of them and turned them into

13:39

text that would be searchable . Search

13:41

that text , apply all those codes and now

13:43

you have structured data where , instead

13:45

of looking for certain blood pressures

13:48

, certain lab levels , certain test results

13:50

, pulling all of those out , telling you what they

13:52

are and applying structured coding to them , should

13:55

you need that for anything ? Wow , really

13:57

enhance their workflow . But

14:00

it became a new product as well that they

14:03

could now offer to anybody

14:05

who wants it for the same reason . And

14:07

obviously , continuous refinement right , the more

14:09

appeals you get , or the feedback

14:11

you get from a client and that is saying , hey

14:13

, we got this , this is a new indicator that we

14:15

know , we can find it , or just

14:17

add all the indicators and then you'll know Low

14:20

lab , high lab , pick out what you need . So

14:22

that was really cool and

14:24

I really really enjoyed that job

14:26

. But I did that for

14:28

about two years and I'm the type of person I

14:30

tend to work at the same place but I move around

14:32

.

14:33

Right or get bored . Or

14:35

someone finds out how talented you are .

14:37

Well , I'm not going to say that , but

14:40

I will touch on that as well because , as

14:42

you can see , you'll hear , I have maintained

14:44

relationships with all of these

14:46

people and my friend that called me . Most

14:49

of my career has been through

14:51

my networking and the relationships I've built . But

14:55

when I left there I thought you know , what

14:57

do I want to do now ? Like Optum

14:59

United Health Group , huge multinational

15:02

company , I could go anywhere I want . What do I

15:04

want to do , right ? So I just started

15:06

poking around to see and a job came up

15:08

for concept research and development . And

15:11

what that team was is

15:13

we developed what we ideated

15:16

. It was called so I thought of it . I got paid

15:18

to think , we ideated

15:20

and we developed concepts to

15:22

save money for the insurance company

15:24

. So essentially , you find up medical cost

15:26

savings , but utilizing my

15:28

medical coding and billing knowledge . So

15:31

I know the coding rule for this . I know oftentimes

15:33

it's miscoded as this . Well

15:36

, now I'm going to look at some data of all

15:38

the times of that miscode and

15:40

see if I can find some patterns that might just

15:42

look a little wrong or a diagnosis

15:44

code that maybe doesn't match altogether

15:46

. If we have coding for bill , this

15:48

code , sometimes for non-occlusive disease

15:50

or for occlusive disease and that

15:53

diagnosis code is for a non-occlusive

15:55

disease . On the occlusive code , I

15:58

have reason to think . Either you've built the wrong diagosis

16:00

code or you've built the wrong CPT code , something's

16:02

wrong . So that was what a lot of my stuff

16:04

was Finding claims where something was wrong and we should request

16:07

the medical record to determine what the

16:09

correct coding was . So this was on the insurance and

16:11

the guidelines yes , yes , so I was working for

16:13

Optum , but the client was UnitedHealthcare , so we

16:15

were looking at UnitedHealthcare claims . That

16:18

job encompassed a lot . It's obviously

16:21

not just medical coding , medical billing . When

16:23

I tell you I had to talk to everyone and their mother at UnitedHealth

16:26

group to get funds approved , I'm not lying

16:28

. That is where I learned

16:30

to adjust to my audience . I'm

16:32

so used to talking to other people who are medical

16:34

coders , who are doctors . Now

16:36

I'm talking to lawyers . I'm talking to people from

16:39

network who are writing contracts . I'm

16:41

talking to people who don't even know what a CPT code

16:43

is sometimes Right , but I'm having to translate

16:45

my maybe complex concept

16:47

even complex to us Right Into

16:50

layman's terms so that I can get it approved

16:52

by people within the company who

16:54

don't know what I'm saying If I say the

16:57

complicated words or if I start talking CPTs

16:59

. So I really

17:01

learned my presentation skills

17:03

and also being able to

17:05

adjust to my audience , which was infinitely

17:08

helpful as I kind of progress

17:10

. I

17:12

worked very closely with medical

17:14

directors there . One

17:17

is , if he's watching , hi , dr Falk , I'm

17:19

going to tell him . But I lean on him

17:22

a lot . He was my clinical guy

17:24

at Optum . So not a clinical person

17:26

, I like to think I know what I'm talking about , but I

17:28

oftentimes don't . But I know the coding

17:30

portion and I can understand the rules and regulations

17:33

. So with me or someone like

17:35

me and a medical director by my side

17:37

presenting these concepts to

17:40

people , it's weird to kind of go from the physician

17:42

side where I kind of feel like I'm sort of the bad

17:44

guy because I'm trying to tell you here's

17:46

what I need you to do and where's how I need you to do it To

17:49

. You're on my team and we're fighting for the same

17:51

point . So that was

17:53

a great relationship that I formed immediately

17:55

and carried me through almost four years in that position

17:58

. I worked very closely with lots of people

18:00

. My team there was wonderful

18:02

. I mean , I can't say enough about them . Most of

18:04

them are still there . But again

18:06

about four years on I thought what

18:09

am I ready for now ? And I thought

18:11

maybe I'll get back to value-based care

18:13

and see what's going on over there . I'm a little couple

18:16

years out , victoria . I were talking before

18:18

. You get a couple years out of something and you feel

18:20

like you know nothing about it anymore . So

18:23

I applied for and got a job as an associate

18:26

director of national value-based care operations

18:28

, which I'm not an operations person , had

18:30

never done operations before . So kind of

18:32

in that journey of just being in health

18:35

information management , I'm trying to kind of tick

18:37

off those boxes . What skill do I not have

18:39

yet Right , and operations was one

18:41

that I didn't have . So in operations

18:43

.

18:43

In that role , were you just overseeing

18:46

general operations , or did you have a team under you

18:48

as well ?

18:48

So they weren't directly

18:50

reporting to us , but we were responsible for the

18:52

value-based care team and it was

18:55

for UnitedHealthcare . So that particular

18:57

team at UnitedHealthcare was probably 500

18:59

plus clinical transformation consultant

19:02

, mostly nurses , some coders , some people that

19:04

had just been in the field or in health information

19:07

management and made their way to this . Maybe

19:09

whatever trajectory they got there

19:11

no specific , you

19:13

have to be this or you have to be that but

19:16

they worked directly with practices who had contracted

19:18

with UnitedHealthcare in value-based care arrangement

19:21

to help them meet their value-based care

19:23

metrics . Oh , okay , you know

19:25

, trying to achieve their goal of achieving their

19:27

shared savings or whatever incentives , whatever

19:29

their contract is for , but at the same time obviously

19:31

saving that same money for UnitedHealthcare or

19:33

achieving shared savings for them . So it was

19:35

a mutual partnership going for

19:37

the same goal but on both sides . But

19:40

we were responsible for that operation . So the

19:42

operation part I was responsible for was

19:44

two-fold strategic

19:46

operations . So we've got all these

19:48

value-based care initiatives . But what else

19:51

can we do ? We have certain ways that UnitedHealthcare

19:53

would contract with practices in a

19:55

value-based care arrangement . But what

19:57

else can we do ? We have lots of fee-for-service

19:59

. How can we maybe convert some of

20:02

this fee-for-service revenue to value-based

20:04

revenue . So it was strategizing on that

20:06

. So again , looking at lots of data , looking

20:08

at claims , looking at diagnoses , finding

20:10

those patterns , could this

20:12

be a bundled payment situation ? Is this a

20:14

surgical procedure ? What can

20:17

we maybe do with pregnancy and maternity ? It's already

20:19

paid as a bundle , but what else could we

20:21

do to kind of make

20:25

that an episode of care instead of just

20:27

claim-by-claim-by-claim type things ? So

20:30

that was one part of it , and then the other part was

20:32

the true operations part , which was defining

20:34

ratios for these clinical transformation

20:36

consultants . Because you could have five

20:38

practices and I could have five practices but

20:41

three of my practices might have been on EHR for years

20:43

and years and years and have their own quality department

20:45

and they don't even really need our help . And

20:48

we might have two practices that are brand

20:50

new and don't know what's going on and

20:52

don't even understand how to submit anything

20:54

for quality . So I had to figure out

20:56

workloads and ratios

20:58

and how can we assign these

21:00

practices certain levels and what level

21:03

? What does that actually mean ? What is a level

21:05

one ? What is a level two ? What characteristics

21:07

do they need to have ? What are the exceptions to those

21:09

characteristics , to make sure

21:11

that no one was being overworked , no

21:14

one was being underworked , but that every practice

21:16

was receiving exactly what they needed

21:18

, which was honestly a totally

21:21

new thing for me . I had never

21:23

done anything like that . So very

21:25

big learning experience , very big learning curve

21:28

, but still kind of under the umbrella

21:30

because as I move up and help

21:32

information management and more and more leadership roles

21:35

, you know those are kind of

21:37

things you have to deal with . So that was

21:39

really good for me .

21:40

If you don't mind me interjecting right here . So

21:42

one of the things I wanted to talk to you about was the value-based

21:45

care , and you mentioned about how kind of moving

21:47

away from the fee-for-service and the value-based

21:50

care and how we can enhance that a little

21:52

bit more . I feel like we've been

21:54

hearing so much for how many years now

21:56

. Oh yeah , value-based care , this is the future

21:58

. We're going to no more fee-for-service , we're not going

22:00

to have this fee-for-service . It's going to be gone

22:03

. And it's been so long that I've been hearing this now

22:05

and I'm just like , okay , when in the future

22:07

? Because it's been how many years now and

22:09

we're still so concentrated

22:11

on fee-for-service and the value-based care

22:14

. I don't feel like is progressing the

22:16

way everyone's been saying it's going to .

22:18

It's a slow walk , right . What you'll

22:20

notice is , year by year , fee-for-service

22:22

reimbursement is going down . Value-based

22:25

reimbursement is going up but , like you said , that's

22:27

been going on for at least the last decade

22:29

, if not longer . That's five

22:32

years or so . More and more prominent , as you see

22:34

, more and more value-based arrangements come in , but

22:36

fee-for-service is still the predominant revenue . I

22:39

don't think in my lifetime we're going to see value-based

22:41

care takeover . I mean , we're always going to have acute

22:44

illnesses and acute injuries , right ? Things

22:46

that you can't be helped . I got the flu last

22:48

week . I don't want my doctor to not

22:50

get paid for taking care of me because they couldn't

22:52

prevent me getting the flu . I fell down the stairs

22:54

and broke my ankle . Same thing

22:56

. I mean , there's some sort of bundles you can

22:58

do with surgical and post-care , but what about

23:01

me , who didn't need surgery , right ? So

23:03

you're always going to have acute illnesses that

23:05

you can still give quality fee-for-service

23:07

care for and that you need to give

23:09

quality fee-for-service care for . I

23:13

just don't see how . I mean , I'm not

23:15

going to say it can't happen , but I've seen a

23:17

lot of data and I've seen a lot of claims , and

23:19

to make a value-based care

23:21

arrangement that works all the time

23:23

for everyone isn't going to work

23:25

. Even in bundle payment episodes . You see

23:27

things like that because things happen

23:29

that are unrelated and people

23:32

need $1,000 , $10,000 injection

23:34

, or a patient has cancer

23:37

and after their knee replacement and that still

23:39

gets bundled in their bundle payment .

23:41

Right , right and even , I think , to some degree

23:43

. You know the AMA has a very strong hold

23:45

on their CPT code set and it's been

23:47

even interesting . There's a lady

23:50

, sherry Poe Bernard , who recently was

23:53

asked if she was going to be making the third edition

23:55

of her risk adjustment coding book , which was published

23:57

by the AMA , and the AMA had said , oh

24:00

, we're not really interested in continuing producing

24:02

this risk adjustment book because they

24:04

get paid for CPT . So

24:07

I thought it was very telling that they're

24:09

not really wanting to push

24:11

the value-based care , their risk adjustment , coding

24:14

care models

24:16

, as much as they want to push their fee for

24:18

service , which they have the licensing

24:20

fees for for CPT , which makes sense

24:22

from a business view right . Right , it's

24:24

like I get it , but .

24:25

Yeah , the one thing I actually

24:27

and I always forget to mention that is I did finally

24:30

go back to school while I worked

24:32

through United Health Group . So , oh wow

24:34

, when I was in the NLP team

24:36

, I started going back to school for my bachelor's in

24:38

health information management . I

24:40

attended Western Governors University , which is completely

24:43

online and it's an at-your-own-pace university

24:45

. Oh wow , and having been in the field for about 15

24:47

years , I got a bachelor's degree in eight months .

24:49

Okay , you have your master's though now

24:52

, don't you ? I do .

24:53

So after I got my bachelor's degree in eight months

24:55

, I thought maybe I should try for that

24:58

master's . And the good thing is , you know , tuition

25:00

reimbursement through work is what I use for

25:02

that and the university that I went to

25:04

being a kind of at-your-own-pace , competency-based

25:07

university , I was able to

25:09

kind of have my employer pay

25:11

for almost all of my schooling because I finished

25:13

it so quickly . Oh , wow , so it was great

25:15

. You know , hi , no student loans . I would

25:18

have never had that thought . I went back to school when I was

25:20

20 , right , right , exactly . So you know , sometimes

25:22

you don't get there right away , but then you get there . But

25:25

yeah , I went back again to WGU for

25:27

my master's in health leadership has

25:29

since become a master's in health administration , which

25:31

everyone obviously knows what that is . I'm

25:33

trying to get my diploma reissued just via MHJ

25:35

so that no one asks me when an MHL is . We want an MHL is anymore

25:37

, but for now it's a master's

25:39

in health leadership . But that's also

25:42

been something that helped me almost kind of check

25:44

that box for those other associate director

25:46

jobs , because while I had been in

25:48

the coding field and the health information management

25:50

field for that long I didn't have that

25:52

associates or bachelors degree , I had a box

25:55

sometimes . Right , I had all the certifications

25:57

, but not those check boxes . So as soon

25:59

as I was able to check the box , it was easy

26:01

for me to make those transitions . Wow

26:03

. So that was really good too . And

26:06

again , I was able to get my employer to pay for those things . So

26:08

I will always say take advantage of those

26:10

two if you

26:12

want to , because it will definitely help you

26:15

in your career . Yeah .

26:16

So last week you were saying that you were working

26:18

in the value-based care with UHC . So then

26:20

what happened after that ?

26:22

I was laid off from UHG . So

26:24

there was a bit of a mass layoff at UHG

26:27

back in August of this year and I was part

26:29

of that layoff . So we were a brand new department

26:31

and then they were looking to cut costs

26:33

and , you know , pretty easy to get the brand new

26:35

people out of there , right . So

26:37

we got laid off and I went on vacation

26:40

the week after and I

26:42

thought you know , okay , what am I going to do ? We were already scheduled

26:44

to go on vacation . So I said I'm not going to do anything , I'll

26:46

go on vacation . When I get back I'll start

26:48

doing things . So I updated my resume

26:51

and I started looking around at what sites to upload

26:53

it on , what jobs to apply for , and kind

26:55

of just got started . And I immediately

26:57

got a call but it wasn't from a job that I applied for

26:59

. It was from a job that had

27:01

found my resume on one of the sites I had uploaded

27:03

it to . Okay Happened to actually be a

27:06

local company who

27:08

reached out to me and asked me if I would be willing

27:10

to interview for a position . So

27:12

I did some pre-negotiating before I agreed

27:14

to do the interview and then

27:17

I interviewed and I got

27:19

the job within a week . I went in and met everyone

27:22

on my 40th birthday . They

27:24

told everyone that I came in on my birthday

27:26

just in case they didn't hire me . I wanted

27:29

them to feel a little bad about it . Make

27:32

it good if they're doing something else , that's right , but

27:35

I do have a funny thing about that too . So on my birthday

27:37

I met everyone and then about three days later

27:39

they called and offered me the position . So

27:41

I've just recently started , as of October 16th

27:44

, as the coding compliance manager at Medical

27:46

Imaging of the Lehigh Valley . I know , and now

27:48

you're- working .

27:49

You've gone from working remotely , right

27:51

? Yes , working in person .

27:53

How's that been going for you ? Interesting

27:55

, it's going to be hybrid . It is hybrid . I

27:58

am actually lucky enough that I'm replacing someone that's retiring

28:01

and she will be there through the end of the year . So I'm

28:03

in person with her for the next

28:05

two months or so , hoping

28:07

to download her brain into mine , and

28:10

then I will be hybrid from then . I actually already

28:12

worked from home in my two and a half weeks

28:14

, so it'll probably be , you

28:17

know , not so much in the office , but

28:19

it is a big change . I haven't commuted in

28:21

almost seven years . Again

28:23

, beyond lucky that this is only 10 minutes

28:26

from where I live , so I can't complain . I don't

28:28

even have to get on the highway . And

28:30

I said , you know , if I had to take another job

28:32

in an office , I couldn't

28:34

have asked for a better commute . Honestly

28:36

, right , right .

28:38

So pretty happy about that I'm

28:40

a little surprised that you or maybe you

28:43

have been , and we just haven't discussed

28:45

it been tapped by a lot of these AI companies

28:47

, because a lot of your skill sets seem

28:49

to be something that I feel would be of

28:51

interest to a lot of these companies developing the AI

28:54

coding modules and programs

28:56

.

28:56

I have been approached . A lot

28:58

of them want a 1099 employee and

29:01

I don't want to be a 1099 employee . I

29:04

have a family that I'm supporting . Benefits

29:07

, as we've said before , are very important

29:09

, so I've kind of

29:11

wished away at all the 1099 type

29:13

stuff . But I have had some people reach out

29:15

to me through LinkedIn , especially

29:17

actually recently

29:19

, as last week I've had some reach out to me for a part-time 1099

29:22

position developing AI logic

29:24

for claims for CMS . So it

29:27

is something . And again , linkedin

29:29

, make sure that you're putting yourself out there , because

29:31

even if you're working full-time , I mean

29:33

some of that stuff . I'm thinking like now

29:35

that I'm back in physician's side , like

29:37

maybe I do want to know what claims AI logic

29:40

is being developed .

29:41

It's like the gold rush right now because everyone's

29:44

trying to quick get in there and develop the ultimate

29:47

program that's going to interface with

29:49

Epic and Alina and everything

29:51

, and

29:53

it's fascinating to see them all kind of

29:55

rushed together and trying to Everyone's converging

29:58

upon it . Yes , People

30:00

were telling me six months ago they're like your job's going

30:02

to be gone in two months and I'm like never

30:04

, the fax machines that we're

30:06

still using , I don't know . I mean , I'm not

30:08

saying there's going to be some changes , there's definitely

30:10

going to be .

30:13

I don't think it's ever going to take over for coders

30:16

or health information management professionals , and

30:19

now that I'm on the physician's side and I'm seeing the

30:21

AI advancements on the physician's side

30:23

, I'm totally blowing my mind . It's

30:27

a whole different AI world that I'm used to and

30:30

I love it . I think it's amazing

30:32

because , again , like you said , I'm very passionate about

30:34

the patient care aspect . I

30:36

don't think I could be a doctor or a nurse . I can help the

30:38

people who help people is how I kind of put it which

30:41

is what I feel like I've been doing for the last 20 years

30:43

in one way or another . But yeah

30:46

, that's my career .

30:48

So you have a lot of different certifications , in addition

30:50

to your ones that you have for

30:52

your degrees from Western Governors

30:55

University . So you have

30:57

your CPMA , your certified

31:00

auditor , your accredited healthcare

31:02

fraud investigator , which is very interesting . So

31:04

which one of your certifications has been

31:07

the most challenging one ?

31:09

Well , I would go twofold , right . So I

31:11

have an RHIA , which is registered health

31:13

information administrator , through AHIMA . That

31:16

one is hard to attain because you need a bachelor's

31:18

in health information management yes

31:20

, it has to be through the right exaggeration or an accredited

31:23

university , exactly . So

31:25

that in itself I couldn't just say like I know

31:27

all of this , let me go take the test , as I could for

31:29

a lot of the AAPC certifications , where I'd

31:32

just been in the field and I'd been reading

31:34

medical records and I thought , yeah , I am pretty much

31:36

your auditor , let me see about this test and that thing

31:38

. So that

31:40

in itself was kind of a big

31:42

goal of mine to get my RHIA , but I had

31:44

a big hump to get her in order

31:46

to get that . And then the

31:49

one that you just mentioned , accredited healthcare fraud

31:51

investigator . So that's through the National

31:53

Healthcare Antifraud Association , the NHCAA

31:55

. That one was very hard

31:57

to get because , unlike a lot of

32:00

the certifications that we would hold in this

32:02

industry , you need continuing

32:04

education units before you can even apply . Oh , wow

32:06

, and so many of them have

32:08

to be direct from NHCAA . Oh , okay

32:11

, yes , so it took me about two

32:13

and a half years to get the relevant

32:15

CEUs to even sit for that test because

32:18

they also have to be directly towards fraud . Now , I've

32:20

never worked directly in a fraud department

32:22

. I didn't work in an SIU Special Investigation

32:24

Unit which is really people

32:26

who have that certification often work in an SIU

32:29

. But when I was doing concept research and

32:31

development , we found a letter . What ?

32:33

Yeah .

32:35

And that was very interesting to me when

32:37

I started finding the fraud and when I was doing all that

32:39

data analysis . I wanted to learn how

32:42

do I actually analyze this data and determine

32:44

patterns that might indicate fraudulent

32:46

activity ? And that's a big part

32:49

of that . Ahfi certification

32:51

AFI .

32:52

It's kind of what we would call it . So

32:55

was that expensive then to have to get all

32:57

of those CEUs ? Like , how did they break that down ? Do

32:59

they think you pay for each CEU and then pay for the certificate

33:01

that you was in and the exam and membership ?

33:03

and all that . Yes is the short answer , but

33:05

in my case I was lucky enough that at the time I was employed

33:07

by UHC . I was employed by UHG , who has a corporate

33:09

membership with the NHCAA and

33:12

offers monthly webinars that

33:14

NHCAA offers . So I was able

33:16

to get their direct CEUs in that way without

33:18

having to purchase them myself . And then the

33:20

other CEUs could have either been direct from NHCAA

33:23

or at least pertinent to the fraud investigation

33:25

. So when I took Excel classes or SAS

33:28

classes or anything data related

33:30

, I could kind of use that towards it , but not

33:32

when I took , like , cardiology coding .

33:33

Yeah right , so like the AAPC

33:36

and the AHIMA ones will kind of cross the curve

33:38

, because the AAPC will take a HIMA CEUs

33:40

For the most part Right .

33:41

Vice versa right , yeah , but not

33:43

necessarily those , yeah . So it was

33:45

pretty hard to accumulate

33:48

them time-wise , but I was very

33:50

lucky that the employer that I worked for

33:52

at the time provided for that . I

33:54

also had professional development opportunity

33:57

in a year at Optinman UHG . So

33:59

I was able to say at the beginning here here's

34:01

what I would like to accomplish for my professional

34:03

development this year and , if it was approved

34:05

, Optin paid for that or

34:07

UHG paid for that . So one year

34:10

getting that certification was my professional

34:12

development goal . Therefore , I got them

34:14

to pay for it . So I kind of

34:16

did that . I got my CPMA , my CRC no , not my

34:18

CPMA , no .

34:19

Cpma , CRC and AFI

34:21

that way , oh , wow , it's always

34:24

nice when they're clear with you about

34:26

hey , we have a budget for you .

34:28

And ask . Ask the question

34:30

because sometimes they've never

34:32

even thought about it , Right ?

34:34

And yeah , because I've been in situations where

34:36

we I

34:39

was managing a team and they're like , oh , I want to go to this

34:41

conference and I'm like , okay , well , our budget

34:43

this year can't afford it , right

34:45

, but when we're scheduling the budget for next

34:47

year , remind me , because we

34:49

can put that in for next year

34:51

to have that additional information . We

34:54

can't guarantee that we'll get it , but we can

34:56

put in the request to get an additional budget for

34:58

continuing ed or for a conference you need , because

35:00

maybe we're bringing on a practice that has

35:02

a certain specialty and we don't know anyone that

35:04

has the training in that specialty .

35:06

So we have to send you to a conference , yes , and

35:08

I asked the question because with

35:11

the job that I have now , I would be managing

35:13

people and I haven't managed people directly

35:15

actually ever in my career I've managed

35:18

without the authority of them directly reporting

35:20

to me , but I've never had people who

35:22

are my direct report . So again , kind of each thing

35:24

I do , I'm kind of gaining one thing

35:27

, even if I'm going back to something I've done before

35:29

. And that was one of the questions I asked in

35:31

my initial interview was what's my education

35:33

budget ? What's my education budget for my employees

35:36

? What type of training do they already have

35:38

? What type of certifications do they already have ? What are you

35:40

willing to support for them

35:42

to get ? Yeah , as again

35:44

, if we're talking about my career , all

35:47

of the leaders in my life have helped

35:49

me move on to the next thing and I

35:51

want to be the same type of leader that I've had

35:53

in my life , because I want these people to be able to do

35:55

whatever they wanna do Right and you wanna

35:57

be the right leader for them , and if you

35:59

don't have the situations

36:02

by the rest supporting you that they're saying , hey

36:04

, we are also invested in their continuing

36:07

education , then you don't get to be the good leader

36:09

, absolutely .

36:10

It's so frustrating when you're like , yes , I know this

36:12

is important and if it was up to me

36:14

I would absolutely give it to you , but

36:16

I can't .

36:17

And I honestly feel genuinely very

36:19

excited about my new position because they

36:22

seem to be very , very

36:24

willing to let me do what I think needs

36:26

to be done , and I really just

36:28

wanna grow my team and whatever

36:30

they need to do for professional development at work and

36:33

outside of work . I wanna be able to

36:35

give them that opportunity and I really think that , based

36:37

on the chats that I had before and while being

36:40

employed at my new job , I think I'm gonna be able to do

36:42

that . And again , I wanna follow in the footsteps

36:44

of these great leaders who have gotten me where I am .

36:46

That's so amazing . So we

36:48

have a lot of people on my channel that

36:51

are like newbie coders and they ask

36:53

me a lot about getting into health information management

36:55

. Should I get my RHI T ? Should I get my RHI

36:57

based off

36:59

of the broad knowledge you've had of the health

37:01

information landscape ? What

37:03

advice would you give to someone who's just wanting

37:05

to get into health information management

37:07

?

37:08

I would say put yourself out there . It's a vast

37:10

, vast industry . It's not

37:13

just medical coding , it's not just medical billing

37:15

, it's not just EHR . If you think

37:17

about a hospital , how many

37:19

people have to work at a hospital and how many

37:21

people have to do something to make one procedure

37:23

go through right ? What actually interests you in health

37:26

information management ? Are you an analytical

37:28

person , like I am , and you wanna look

37:30

at this math and figure out this billing and coding

37:32

rules and all of that stuff ? Because that's

37:35

what really tied me in is learning

37:37

. I've always been analytical

37:39

, but now actually learning how to analyze

37:41

and then from there kind of that data aspect

37:44

as well . So you could do all kinds of

37:46

things . You could be a production coder , you could

37:48

be an auditor , but you can also be a data analyst

37:50

, you can be a system administrator

37:53

and there's still health information management . Like , health

37:55

information management is such

37:57

a huge thing , so just think about where

38:00

you wanna be and then that probably fits in

38:02

somewhere in health information management , have

38:04

you ?

38:05

in your experience , done any kind of more programming

38:07

, end of coding like SQL and stuff like that

38:09

or Visual Basic ? What of C++

38:12

, all that ?

38:13

C++ , I don't know , Like that's a plus plus

38:15

when I was 15 years old . No

38:19

, I have done a little bit with SAS

38:21

. So when I was at Optum End

38:23

doing the concept research , we would look at huge

38:25

, huge data sets . We did have data analysts but

38:28

a lot of times I wanted to run if I

38:30

have a little idea . I didn't wanna ask a data

38:32

analyst to run the data . I wanted to test my

38:34

hypothesis before I started getting years

38:37

and years worth of data . So I did learn some basic

38:39

SAS so that I could run my own queries

38:41

when I had a random thought or hypothesis

38:43

, or so that I could whittle my hypothesis down

38:45

so that I'm not being so broad

38:48

and I can kind of see oh , now I

38:50

see , looks like let me apply some more criteria

38:52

to this because I'm a little too broad

38:54

, I'm picking up a little too much of this universe . So

38:56

a little bit self-taught on that

38:58

. But got the opportunity to

39:00

learn . I was given the opportunity

39:02

, given the programming license , given the access

39:05

through , again , my employer and again

39:07

I can't say enough ask the questions

39:09

. You can probably

39:12

get more than you realize by explaining

39:14

why you think you need something because , again

39:17

, such a big

39:19

, vast industry , so many things going

39:21

on and so many different ways to get to your information

39:24

.

39:25

I wanna dial it back here for a second because I just remembered you

39:27

said something about AI on the

39:29

physician's side . So what have you seen so far

39:32

with AI ?

39:33

So I'm working with a group of diagnostic and interventional

39:35

radiologists and I've

39:37

seen two forms of AI that's being used

39:40

in practice right now , which are both

39:42

amazing to me . One

39:44

is , I believe it's called AI Doc and

39:46

it's for actual images on radiology and

39:48

what it does is it produces a heat

39:50

map of the image . So , kind of think , if you're looking at

39:52

the computer and you do a reversal of your

39:54

colors , it produces a heat map

39:56

of the image that points out

39:58

an anomaly in the image . Now it

40:00

might , it's gonna guess and it's gonna try to know

40:03

this is a pulmonary embolism or this is whatever , but

40:05

it's always an anomaly . And

40:08

I spoke with a physician who showed this to me live

40:10

and actually showed me a pulmonary embolism

40:12

. So he pushed it , it did the heat

40:15

map and you could see a very large

40:17

anomaly space . Now it was a very large

40:19

PE . He would not have missed it , clearly . But

40:22

he was saying , you know , but it will

40:24

also catch ones that are very small that

40:26

I honestly might have missed

40:28

. And if I can get this AI like

40:30

it's not always right and I have to correct it , but

40:33

if it can find one thing that I

40:35

would have missed myself and it's

40:37

more than paid for itself , and I 100% agree

40:39

. It was amazing to see that and

40:42

he showed me a few where it was right about what it found and

40:44

a few where it was wrong about what it found . But also

40:46

there's machine learning algorithms on the back and you

40:48

provide feedback whenever you change it

40:50

. So from having working on the

40:52

other side developing these types of things

40:55

, I know that that feedback's

40:57

going back to whoever's producing that and

40:59

they're gonna use that to refine that

41:01

product and make it so that

41:03

it's working better and identifying more

41:05

properly .

41:06

Yeah , and I think it definitely makes the work that we're

41:08

doing in healthcare so much more meaningful , because

41:11

we're able to concentrate on the more

41:13

detailed information instead of being constantly

41:15

overwhelmed . Now , of course , that doesn't come without

41:18

some risks . Of

41:20

course , we have a lot of issues

41:22

that we're seeing right now with and

41:24

kind of new versions , I guess , of some issues . We've

41:26

already seen providers using the same macro

41:29

or copy paste , and now it's just okay . Now we're

41:31

automatically having some sort of AI

41:33

tech fill in a note , but it's not necessarily

41:35

correct or they all look the same , so

41:38

it's the similar risk

41:40

. But I think there's ways that we'll be able

41:42

to utilize this

41:44

more tactfully in the future so that

41:46

we can produce things

41:48

that are more concentrated on what

41:50

we need to focus on in healthcare .

41:52

Yes , I agree . I agree . The

41:55

second thing that I've seen has to do with their

41:57

dictation of their reports and also

42:00

with quality metrics , which this is part

42:02

of the reason I'm very excited about it , because the

42:04

radiology side , I'm learning , doesn't have

42:06

that many quality metrics that

42:08

they can really utilize in their practice , because

42:10

diagnostic radiologists are just reading diagnostic

42:13

tests , interventional radiologists are performing

42:15

complex interventional procedures , right . So

42:17

both of those scales kind of don't really fit

42:19

on what we talked about before , the existing quality

42:22

paths . But there are some

42:24

, and most of them are around incidental findings

42:26

in radiology . So if I go for a scan

42:28

my abdomen and pelvis but the field

42:30

of view shows my lungs and there's a nodule on my

42:32

lung Right , then they would find an incidental nodule

42:35

. They weren't looking for any brain in my lungs . So

42:38

we have a program that we are testing

42:40

right now with some of our docs and I watched

42:43

it in action . It takes

42:45

their dictation . They're still dictating the

42:47

entire body of

42:49

that report themselves , but it takes

42:51

their whole dictation and it formulates the impression

42:54

from the findings that they have in the

42:56

body of their note . Oh , and it does it in

42:58

their own voice , so they teach it as

43:00

they start it . They just dictate everything , including

43:02

the impression , for however many studies

43:04

, and then it's saying it in their voice . However

43:07

, they tend to phrase things whatever they say and of

43:09

course they could make those edits . But it's also

43:11

alerting them that , hey , that incidental

43:13

nodule you saw fits this

43:15

Fleischer criteria . And if you place

43:17

that Fleischer criteria in there , that's a quality

43:20

measure that you identified that . So it

43:22

can automatically know , based on the fact that you've dictated

43:24

a certain size nodule that you saw , that

43:27

that then meets the criteria for an incidental

43:29

finding for the Fleischer criteria

43:31

, and it'll put in your criteria automatically . So

43:33

you're not trying to , you know , figure

43:35

out the right way to say you use the Fleischer criteria

43:38

for that incidental finding , right , which

43:40

is really cool from my perspective , because now

43:42

my doctors don't have to work so hard , right

43:44

, they're already like same thing . We've seen it for

43:46

years . I identified the nodule

43:49

, you did . But I need just to know about the Fleischer

43:51

criteria . I need to know about this

43:53

and that . So it kind of prompts them

43:55

and allows them to either choose that

43:57

they want to use that criteria or no

43:59

. There's an exception this patient's actually younger than 35

44:02

years old . I wouldn't apply that criteria . Well

44:04

, then they can say younger than 35 , and it'll give

44:06

them the criteria for that . Yeah , so kind

44:08

of like a decision support tool , but

44:11

it's actually generating that from their findings

44:13

, which was very cool to see and very

44:15

powerful in the right hands because

44:17

it's just so much great

44:20

help to those physicians that know how to use it appropriately

44:22

.

44:22

But then of course you know we have those outliers

44:24

. But for the intent that

44:26

it should be utilized just amazing that sounds

44:29

fantastic and , honestly , the productivity

44:31

benefit for those physicians .

44:32

Right , they're dictating their studies , they're

44:35

not having to type out or dictate all

44:37

this special criteria that they know in their

44:39

brain and that they are using but

44:41

that they have to verbalize or state

44:44

in the exact right way for it to count

44:46

for them , which I think is immensely

44:48

helpful . Because you know , we've seen it for years with

44:50

patients over paperwork and

44:52

things like that , right , so it's the same kind

44:54

of idea on that

44:56

sense . But anything to me

44:59

that makes life better for a doctor , that

45:01

can enhance patient care , is great .

45:03

Yeah , especially when we're seeing so much in

45:05

physician shortages and just in burnout

45:07

. Where you know nowadays

45:09

you get sick or you need to talk to your doctor

45:12

, it's like okay , well , you either can go

45:14

to urgent care right now or , if

45:16

you want to see your PCP , they can see you in three

45:18

months . Or you know you go

45:20

for a problem and you're supposed to follow

45:23

up and , oops , that follow up is that never got scheduled

45:25

. And then it's like what do you do in

45:27

here ? Well , like why do you need to see your physician ?

45:30

Yeah , and I can talk about that on a whole nother

45:32

podcast and invite my husband , who comes

45:34

from a place with universal health care . Yeah

45:39

, yeah it's a common

45:41

conversation in my house .

45:44

So , alison , this has been great . I'm so excited

45:46

that you came down to talk to me today

45:48

about all these things with health information management , about

45:50

with AI . What

45:53

is next for you ?

45:54

What is next ? Well , now that I am back

45:57

working in my local community , I

45:59

have applied to be the president of our

46:01

APC chapter to follow in my friend

46:03

Victoria's Footstep , and

46:05

I'm pretty sure that I'm going to get it , considering

46:08

I was the only nominee . But

46:11

when the nominees came out , I also happened to know

46:13

several of the other people who applied for positions

46:15

that I used to work with at previous institutions

46:18

, so I'm very happy to see who

46:20

I think my team is going to be . So

46:22

I think that's what's next for me is kind of getting myself

46:24

more back into the local health information management

46:27

community , since I've kind of stepped away from

46:29

that for the last seven years . Meeting

46:32

the people in my community that are doing these types

46:34

of jobs and really just embracing

46:36

my new position , building the team that I

46:38

have , growing them professionally and being

46:40

the best leader I can yeah Well .

46:41

I think the Allentown chapter is so lucky to have

46:44

you . Thank you , and it's going to be great

46:46

to see what you're going to be developing . Feel

46:48

free to tap into me because I

46:50

like you and you came to talk

46:53

to me today so I can certainly present for the Allentown chapter

46:55

. You need a speaker for the 2024

46:57

year . Thank you so much again

46:59

, allison , for meeting with me and my viewers

47:02

today . Thank you ,