Home › 2025 › November

Monthly Archives: November 2025

AI for Work and Life

Posted on by

AI has been under development for decades.  Recently, AI has taken a hockey stick trajectory into the mainstream with the development of new and ever evolving AI tools.  At 67 years old, I have not been the most informed on technology over the years.  As I speak with others at our HLSA Networking events I KNOW there are useful and evolving benefits for AI.   But many have a self-imposed roadblock on learning new technology.

Whether you are just starting your career or if you are a seasoned executive there will be a place in your toolbox for AI which will enhance your career or just assist you in becoming more efficient and familiar with the technology and its tools.

As a result of my shortcomings in technology I decided to become more familiarized with AI and its current development.  I did so by enrolling in a free certificate course from the University of North Florida (UNF). The course is currently free for a limited time thanks to NLP Logix who has sponsored the program.

This program is designed to help professionals, students and lifelong learners understand and apply Artificial Intelligence in practical, everyday contexts – both in the workplace and beyond. The program is fully online and consisted of 8, self-paced modules with an approximate 10-hour duration total timeline.

I started Module 1 on October 23rd and completed Module 8 and received my certificate on November 16th.  The Course was facilitated by various experts and leaders in AI development in a number of various platforms.

The introduction to AI was the catalyst for starting the program and was interesting and thought provoking.  It fueled my ambition to learn more. The course then moved onto highlighting a number of AI Tools, how to use them and incorporated a demonstration on how these tools can be accessed and utilized for your work or life benefits.

In my opinion, the module on the Art and Science of Prompting was the most valuable as this is the key to getting your desired results from any AI tool.  The program then progressed into the rising ethical challenges that AI brings.  Narrow AI vs Large Language Models (LLMs) were discussed along with the pitfalls of each.  AI is not perfect so there are necessary guidelines you need to know about when engaging with AI tools.

The program then addressed AI in key industries such as Medicine, Law and everyday life and progressed into how AI has and may affect our world as it continuously develops and evolves.  The material covered make me think about the possibilities and cemented my decision to take this valuable beginner’s course.

I can enhance my newly gained knowledge further by engaging further with the utilization of AI tools and learning how to make AI enhance my work & everyday life.  Jumping in and utilizing various AI tools will ultimately determine the extent of knowledge I will gain.  I would suggest that any beginning student or seasoned executive with limited knowledge take a beginner’s course which may possibly inspire you by going into deeper context through the many programs that are developing on the Topic of Artificial Intelligence.

 

by Gary Meyn, LFACHE

 

 

Navigating the Complexities of Medical Billing: Coding Errors and Medicare Denials

Posted on by

Medical billing remains one of the most persistent administrative challenges for physicians. Coding errors and the high rate of Medicare claims denials are among the top perennial issues—and both can significantly impact practice revenue and operational efficiency.

Coding errors, whether due to outdated codes, misinterpretation of clinical documentation, or simple clerical mistakes, are a leading cause of claim rejections. Due in no small part to the complex and changing nature of the code sets. The ICD-10  updates for FY2025, for example, included 252 new codes, 36 code deletions, and 13 code revisions. These changes, along with the similarly evolving CPT codes, require ongoing education and rigorous attention to detail. Even minor discrepancies—such as mismatched procedure and diagnosis codes—can trigger denials, delay payments, or invite audits.

The need for vigilance in billing and coding is nowhere more apparent than with Medicare, the largest payer in the U.S. healthcare system. According to recent data, average Medicare denial rates for physicians can range from 5% to 10%, depending on specialty and region. Common reasons include insufficient documentation, incorrect modifiers, and lack of medical necessity. These denials not only reduce cash flow but also increase administrative burden, as practices must invest time and resources into appeals and resubmissions.

The financial implications are substantial. Rejected claims can lead to lost revenue, especially if not corrected promptly. Moreover, repeated errors may flag a provider for compliance reviews, adding legal and reputational risks.

To mitigate these challenges, many practices are turning to third-party revenue cycle management companies, certified medical coders, automated billing software, and regular audits. However, even with these tools, the human element remains critical—accurate documentation and clear communication between clinical and billing teams are essential.

In an era of value-based care and tightening reimbursement models effective medical billing skills and solutions are indispensable to sustaining your practice.

 

Editor’s note: We discovered this Linkedin post by Anoop Silva, President of Wave Online, shortly after publishing article and wanted to add it as a postscript because it resonates so closely with the things we hear at our networking events, i.e. less than optimal documentation habits, poor modifier usage and workflow inconsistencies contribute greatly to revenue loss.

Made Lovely by Leslie- A Special Offer for HLSA Members!

Posted on by

We recently had the pleasure of meeting Leslie Reed at one of our monthly business mixers. Leslie is a licensed esthetician and owner of Made Lovely by Leslie Esthetics, a luxury skincare studio located at 18470 Blanco Rd, Suite 111 in Stone Oak. A focused and dynamic business woman herself, Leslie understands what motivates professionals and 0ver 80 percent of her clientele includes professionals like attorneys, executives, and entrepreneurs. As Leslie explains it “I know what it’s like to look in the mirror and want your skin to match how vibrant and successful you feel inside. That’s why I blend advanced skincare science with a relaxing, high-end spa experience — so you don’t have to choose between results and self-care.”

And about that special offer? Leslie is graciously offering our HLSA members a 25 percent discount on one of her treatments!

Who is a HLSA member? If you have ever come to one of our mixers or received our newsletter we consider you a member.

Just contact Leslie and tell her you saw the offer here or in our newsletter.

We know you will enjoy the experience!

 

 

Outside The Box Funding for Medical Practice and Healthcare Business

Posted on by

Whether you are a physician’s office or in some form of healthcare delivery  you accept or should be accepting credit cards. This opens the door for an excellent form of credit line funding known as a merchant advance (MCA).

A merchant cash advance (MCA) is a form of business funding designed for companies that generate consistent revenue and may need fast access to working capital. Unlike traditional bank loans, an MCA is not technically a loan. Instead, it is the purchase of a portion of a business’s future receivables in exchange for a lump-sum amount of funding, the business agrees to repay the advance using a percentage of daily or weekly sales or a fixed debit schedule drawn directly from its business bank account.

One of the main advantages of an MCA is the speed of funding. Many providers can approve applications and deposit funds within 24 to 72 hours. This makes MCAs appealing to businesses that need to cover urgent expenses, seize a time-sensitive opportunity, or handle temporary cash-flow gaps. Additionally, credit requirements tend to be much more flexible compared to traditional financing. Businesses with lower credit scores or limited collateral can still qualify as long as they show consistent revenue.

There are two primary methods of repayment. The first is called split funding, where a small percentage of each credit card transaction is automatically taken out and directed to the provider. The second method, now more common, is ACH daily or weekly repayment, in which a set amount is withdrawn directly from the business’s bank account. Because of this arrangement, a business does not generally need a specific merchant account provider to receive an MCA. Most existing payment systems work just fine. The main requirement is being able to provide bank statements and revenue history.

However, it is important to understand the cost structure. Instead of an interest rate, MCAs use a factor rate, which is a multiplier applied to the advance amount. For example, if a business receives $20,000 and the factor rate is 1.25, the total repayment amount becomes $25,000. The factor rate does not change based on how quickly or slowly the business repays because many MCAs are repaid over a short period (often a few months).

To qualify, most providers look at revenue stability, average monthly sales, the length of time the business has been operating, and the consistency of deposits. A history of frequent overdrafts or insufficient funds may reduce approval chances. Businesses that process consistent daily or weekly sales, especially through debit and credit card transactions, tend to receive more favorable offers.

Before accepting an MCA, businesses should review the repayment method and ensure it fits with their cash flow. It is advisable to seek a consultant who is well versed on MCA’s. A repayment schedule that is too aggressive can create financial strain. It is also valuable to compare multiple offers, review all fees, and understand whether the agreement renews or stacks additional advances. As a note, once paid you can immediately pull another MCA. Also in most cases you will qualify for a higher loan amount at a lower factor.

Merchant cash advances can be a useful financing tool when used strategically. They provide speed, flexibility, and accessibility, especially for businesses that may not qualify for traditional loans. The key is to approach them with clear understanding, careful evaluation, and thoughtful planning to ensure they support the business rather than overwhelm it.

AugustTrevino

Mr. August Trevino is a commercial strategist with over thirty years of experience with specialization in small business funding. To discuss your business funding needs he can be reached at email, au.ent9@gmail.com Ph, (210) 951-9268‬