September 01, 2008
5 Minutes With
BC Advantage (BCA): Tell us about your background and how you got started in the industry. Sharon Williamson (SW): I left a mortgage company for a part time job in a private physician's office working the aged A/R with the hope that the position would become full time within a few months. The job did become full time within six months. I worked in billing in an internal medicine practice for six years before moving on to an OB-GYN practice where I did coding, billing and pre-certifications/surgery scheduling for four years. The doctors that I worked with in the practice were very confident in my abilities and gave me a lot of encouragement to expand my horizons.
BCA: What do you enjoy most about what you do? SW: There is so much need for regulatory knowledge in the industry that most facilities cannot keep up with everything. I enjoy working with the clients to identify both financial and educational opportunities as well as issues that put them at risk from a compliance perspective. There is a lot of satisfaction in being able to help a facility or practice develop better or more efficient ways to perform tasks.
BCA: What do you enjoy the least? SW: The travel conditions have declined significantly in recent months. That makes it more difficult to get to client sites in a timely manner. I enjoy travel for the most part, but the delays and cancelled flights are difficult to deal with.
BCA: Describe a typical day at one of your sites. SW: Typical is not a description I would use for most client sites. If I'm performing a documentation review, I sit and review records and compare source documents to claims or patient accounting data. I compare the documentation to coding guidelines and other regulatory information published by Medicare and other third party payers. This helps to identify areas of risk and opportunity.
I also perform operational assessments. That involves looking at processes in place that begins with patient registration and follows the patient encounter through remittance advice and guarantor billing. I interview appropriate staff and review policies and procedures to try to identify more efficient or compliant ways to perform daily tasks.
BCA: In you opinion what has made the biggest impact on our industry and where is the focus of providers heading? SW: There are so many changes for just this year alone that it's hard to pinpoint just one area. With the implementation of Present On Admission (POA) indicators and MS-DRGs, facilities are dealing with multiple changes. We now have to deal with RAC reviews, Medicare replacement plan reviews, and multiple other reviews that we have not dealt with in the past. There is a lot of administration burden associated with these reviews with little or no support staff to perform many of the related tasks. This is putting a greater strain on facilities. Many facilities are working to develop and implement Clinical Documentation Improvement departments or projects to try to help providers and other staff members keep up with the changes. Of course there are always code changes and other things that update quarterly that facilities and providers have to keep up with as well. At MedLearn, we work with our clients to try to help improve both documentation and processes.
BCA: What do you think that billers and coders should be focusing on right now? SW: Again, there are so many new developments on the horizon that focusing on one particular area would be difficult.
BCA: What resources do you regularly refer to stay on top of things whilst you are on the road? SW: I'm very fortunate to work with a company that provides so many resources to the consultants. MedLearn publishes many coding and regulatory publications that help me with my work. I also utilize the 3M coding system, AMA's CodeManager, CPT Assistant, the AHA Coding Clinic for ICD-9-CM, the CMS website and multiple carrier websites as well as other resources and publications as appropriate.
BCA: You have 2 certifications through 2 different associations what do you feel that they give you? Would you consider adding to them and if so which one(s) do you think would be relevant for you? SW: I received my coding certification through the American Academy of Professional Coders in 1997. This gave me the confidence that I needed to begin establishing myself as an educator. It also adds credibility to my recommendations in many cases. The compliance certification was obtained through HealthCare Compliance Resources in 2001. The class that I attended for the training included many topics that I was not as familiar with including OSHA, CLIA and personnel issues. I learned so much in those three days. My association with both establishments has given me network opportunities beyond measure.
BCA: What do you do to maintain your certifications whilst you are on the road? SW: I write education material, work as a technical editor for some of our MedLearn publications, subscribe to and read many newsletters as well as multiple other publications. I also try to attend at least one coding and/or billing related conference each year as my schedule allows.
BCA: You have many roles (wife, mother, grandmother, consultant and medical billing business owner) how do you stay motivated and on top of everything? SW: My family helps to motivate me. I want so much for them. I also have a great respect for the profession that I'm in and a desire to learn and help to teach as much as I can.
BCA: In an ideal world what would you like to be doing right now? SW: That's a tough question. There are times that I really miss the staff that I worked with at the facility I worked in before joining the MedLearn team. I managed a coding and billing department for hospital based providers in a large hospital setting. The job was frustrating but rewarding. It was difficult to leave the staff behind. I also enjoy my work now.
I really love to plant things and watch them grow. I'd like to spend my days enjoying my family and working in my garden in what is my idea of an ideal world. I'd like to volunteer with various organizations and spend as much time with my granddaughter, Adelyn, as possible.