MGMA Podcasts

In this episode of the MGMA Week in Review podcast, host Daniel Williams discusses the importance of financial accuracy in healthcare organizations through regular audits of payer payments. He also addresses the challenges faced by women physicians and highlights the role of the MGMA Women's Forum in advancing gender equity in medicine. In recognition of Valentine’s Day, Daniel shares key insights on heart health and practical steps for cardiovascular well-being.

Key Topics Covered:

The Importance of Regular Audits for Accurate Reimbursement
  • 47 percent of medical group practice leaders conduct monthly or quarterly audits of payer payments.
  • Auditing helps detect underpayments, claim denials, and inconsistencies in reimbursements.
  • Suggested actions for healthcare organizations:
    • Implement structured audit processes to compare payer remittances with contracted fee schedules.
    • Use automated auditing tools in revenue cycle management.
    • Conduct retrospective audits of claims to identify patterns of underpayment.
  • Read More Here
Advancing Women Physicians in Healthcare
Heart Health Awareness for Valentine’s Day
  • Cardiovascular disease remains the leading cause of death in the United States.
  • Simple heart-healthy choices for Valentine’s Day:
    • Choose nutritious meal options over heavy, processed foods.
    • Opt for dark chocolate, which offers cardiovascular benefits.
    • Engage in physical activity such as walking or exercise.
    • Learn CPR, a life-saving skill that can make a difference in emergencies.
  • Heart Health Tips
Stay Connected
  • Subscribe to the MGMA Week in Review podcast for future episodes.
  • Join the Conversation: Sign up for MGMA Stat to participate in weekly polls.
  • Follow MGMA for the latest insights in medical practice management.
For more information or to suggest a topic, visit MGMA.com.
Host: Daniel Williams
Podcast Website: MGMA Podcasts

This episode is brought to you by Greenway Health. 

Healthcare practices today need more than incremental improvements — they need a smarter, more connected way to work. That’s why Greenway created Novare — the first natively AI-enabled platform designed to reinvent the legacy EHR. 

Built with AI at its core, Novare helps unify clinical, financial, and patient engagement workflows — reducing administrative burden and helping providers focus more time on patient care. From ambient documentation to intelligent agents, Novare brings purposeful automation to the entire ambulatory workflow.  

To learn more about Greenway Health and Novare, visit greenwayhealth.com.

What is MGMA Podcasts?

Welcome to the MGMA Podcast Network, your gateway to insightful discussions and expert analysis on key topics in healthcare management. Dive into a diverse array of shows tailored to meet the interests and needs of healthcare professionals like you.

Explore the experiences and perspectives of trailblazing women in healthcare on "Women in Healthcare," or discover innovative strategies and solutions for your practice on "Business Solutions." Stay updated on the latest industry trends and news with "Week in Review," and gain valuable insights from industry leaders and MGMA members on "Member Spotlight." Don't miss our flagship show, "MGMA Insights," where we delve deep into the most pressing issues facing healthcare organizations today.

Whether you're seeking inspiration, practical advice, or in-depth analysis, the MGMA Podcast Network is your trusted companion on your journey towards excellence in healthcare management. Tune in and join the conversation today!

Daniel Williams:

Well, hi, everyone, and welcome to the MGMA Week in Review podcast. I'm Daniel Williams, and I'm flying solo today as my cohost, Colleen Luckett, had a scheduling conflict, but we wanna wish her a good weekend. Before we dive into this week's stories, I do wanna wish you all a very, very happy Valentine's Day. This is our Valentine's Day weekend edition, and I have some exciting personal news. I'm gonna be heading out later this afternoon for my very, very first weekend yoga retreat in the beautiful Colorado Mountains, and I am ecstatic about this.

Daniel Williams:

I am so excited to, just spend a lot of time relaxing, being mindful, and doing some yoga as well. And I'm looking forward to some very much needed r and r, and I'm excited to unplug, unwind, and just immerse myself in the experience. So I'm gonna be sure to share some reflections on that in a future episode. So with that said, let's jump into our first story. So our first story is this week's MGMA stat poll.

Daniel Williams:

Regular auditing of payer payments is crucial to ensure accurate reimbursement. Now if your practice isn't regularly auditing payer payments, you could be leaving money on the table. A recent MGMA stat poll found that 47% of medical group practice leaders conduct monthly or quarterly audits to ensure that they are being paid accurately according to their contracts. These audits are essential for identifying underpayments, claim denials, and inconsistencies in payer reimbursements. Now with the complexity of insurance contracts and the constant changes in reimbursement policies, it's easy for payment errors to slip through unnoticed.

Daniel Williams:

Many medical practices assume that payers are always paying them correctly, but let's face the facts here. The reality is the discrepancies are more common than you might think. Even small payment variances can add up over time, significantly impacting revenue. One of the most effective strategies for catching these discrepancies is implementing a structured auditing process. This means regularly comparing payer remittances to contracted fee schedules and flagging any mismatches.

Daniel Williams:

Technology can also help. Many revenue cycle management systems offer automated auditing tools that make it easier to track payment accuracy. If you're not sure where to start, a good first step is to conduct a retrospective audit of recent claims to identify any patterns of underpayment. From there, practices can develop a proactive auditing strategy to ensure they're receiving the revenue they rightfully earned. Accurate reimbursement is the backbone of financial sustainability, and auditing payer payments should be a priority for every health care organization.

Daniel Williams:

This is a section that Colleen usually handles, the MGMA stat, but I will add here your contributions are vital to MGMA's ongoing work to provide great resources, education, and advocacy for medical group leaders. So please sign up for MGMA stat to make your voice heard in our weekly polls. Simply text stat, s t a t, to 33550 or visit mgma.com/mgma-stat, and then polls will be sent to your phone via text message. I received my, MGMA text yesterday and got my this actually got this stat poll, and that's why I included it here. So let's go to our next story, building support and allyship for women physicians.

Daniel Williams:

We need your help. Now this next story, I really do wish that Colleen were here for it. She's been actively involved with the MGMA women's forum, and I know she'd have some great insights on this topic. So let's get right to it. Women physicians face unique challenges in the workplace, and a recent piece from Medical Economics highlights the importance of sponsorship and allyship in advancing gender equity in healthcare.

Daniel Williams:

Women physicians experience higher rates of burnout, depression, and even suicide compared to their male counterparts. This isn't just due to workload. It's also about bias, workplace culture, and a lack of leadership opportunities. Despite making up nearly 40% of the physician workforce, women are still underrepresented in executive roles and decision making positions. One way to address this disparity is through sponsorship, not just mentorship.

Daniel Williams:

While mentorship is valuable, sponsorship goes a step further. It means actively advocating for women physicians by recommending them for leadership roles, speaking opportunities, and professional recognition. Research shows that when men use their influence to support women in medicine, it helps break down structural barriers in ways that mentorship alone cannot. If you're wondering how to get involved, the MGMA Women's Forum is a great place to start. It provides networking opportunities, resources, and support for women leaders in healthcare.

Daniel Williams:

Whether you're a physician, administrator, or an ally looking to make a difference, supporting initiatives like these is essential. Let's continue the conversation and ensure that women in medicine get the recognition, leadership opportunities, and support they deserve. What I'm gonna do is I'm gonna drop a direct link to that, women's forum in our episode show notes, so look for that there. And then finally, this is Valentine's Day, and it's Valentine's Day weekend. So I'm just gonna say, please celebrate Valentine's Day with actual hearts in mind.

Daniel Williams:

It is Valentine's Day, and we could not end this show without talking about heart health. While today is about chocolates, flowers, and romantic dinners, it's also a great time to think about your physical heart and how to keep it healthy. According to the American Heart Association, cardiovascular disease remains the leading cause of death in The US, and small lifestyle changes can make a big impact in reducing risk. We all love indulgent Valentine's treats, but there are plenty of ways to celebrate while keeping heart health in mind. Consider swapping out heavy processed meals for a heart healthy dinner.

Daniel Williams:

Think grilled salmon, roasted vegetables, or a fresh salad with avocado and nuts. Instead of a box of chocolates, try dark chocolates with high cocoa content, which has antioxidants that support heart health. Physical activity is another great way to celebrate love while taking care of your heart. Dancing, a long walk, or even a couple's yoga session can boost endorphins, strengthen your cardiovascular system, and bring you closer to your loved ones. And if you really wanna make an impact this Valentine's Day, learning CPR could be the best gift you ever give.

Daniel Williams:

Every year, thousands of people experience sudden cardiac arrest, and a bystander CPR can double or even triple survival rates. The bottom line, love your heart as much as you love your loved ones. This Valentine's Day, consider making small, intentional choices that support heart health because the best way to show love is to ensure you're around for many more Valentine's Days to come. This wraps up our show for today. As always, you can find links to all the articles we discuss here in the episode show notes.

Daniel Williams:

If you enjoyed today's episode, be sure to subscribe to the MGMA Week in Review podcast so you never miss an update. As I mentioned at the beginning, I'm gonna be off at a yoga retreat this weekend, but I hope you all have a wonderful Valentine's Day filled with love, health, and maybe a little heart healthy movement. Take care, and we'll see you next time.