5 Minutes with... Brad Justus

Senior Account Executive @ himagine solutions inc.

BC Advantage Magazine (BCA): Can you tell us a little bit about yourself and how you got started in the healthcare industry?
Brad Justus (BJ): I was born in Michigan, grew up in Oklahoma, and moved to Florida my senior year of high school.  I graduated from The University of Florida and accepted my first post - college job at a company that specialized in paper forms and labels for all industries.  They said they needed someone to handle the healthcare accounts and my healthcare career began.  I later moved into nurse staffing and ran a large pediatric home health agency with responsibilities of over 100 catastrophically ill babies, infants, and children.  I then moved into the healthcare finance and technology space with a focus on Health Information Management for the last 12 ½ years at himagine solutions inc.

BCA: You currently work for himagine solutions, inc; tell us what your role is and a little about your company.
himagine solutions inc. is a leading healthcare outsourcing solutions provider with the largest team of inpatient and outpatient coders in the U.S.  Our professional HIM outsourcing services include basic staff augmentation as well as more strategic managed coding solutions including full department outsourcing through our Enterprise HIM offering to support more than 250 healthcare providers across the U.S.  In my role as a Strategic Account Executive (SAE), I consult with some of the largest hospitals, physician groups, and health systems and help provide them solutions to improve their quality, productivity, and costs.

BCA: What does your job consist of on a daily basis?
I speak with CFO's, Revenue Cycle Directors, and Health Information Management leaders at many of the largest hospitals, physician groups, and health systems.  I split my time between building new strategic relationships and driving quality, productivity, and cost savings with my existing customer base.  My large Enterprise HIM clients receive an army of assistance from my team including HIM Subject Matter Experts, Operational oversight, and back office support.  I work with my team to communicate effectively and deliver results daily on the custom solutions I have designed for my important client base.

BCA: What is the first thing you look at to help improve a practice's profits on your initial consultation with a new practice?
My primary focus is on the Medical Coding piece of the Revenue Cycle.  There was a major shortage of experienced, credentialed coders prior to ICD-10 and this has been compounded with the productivity decreases up to 40% post ICD-10.  The first place to look is usually the quality, productivity, and work flow of their existing coding team.

BCA: When helping clients increase their revenue cycle, what are a few steps you encourage the practice to take on, to make sure they end up increasing their revenue?
Quality coding starts with Quality documentation.  Proper physician education and complete, accurate documentation is a Must.  A coder can only code what is in the chart.  This and ICD-10 have driven the demand for Clinical Documentation Improvement programs and professionals.  With the rise of the EHR, most coding can be done remotely from the coder's home.  This puts all providers in competition for staff across the nation.  Hospital HR departments focus on a myriad of positions and will always be fighting an uphill battle for good permanent hires.  Many hospitals and physician groups turn to multiple companies for contract coding staff but often with frustrating results.  We developed our Enterprise HIM program to offer a managed coding solution that combats these hurdles and offers a much better quality, productivity, and cost effective solution.  It has been very well received by the industry.

BCA: You are also known as the "ICD-10 Whisperer." I love it! Tell us more about your knowledge and experience with ICD-10.
For years, ICD-10 was looming and my clients were always frightful of when it would actually happen and the impact it might have on them and the industry.  I knew the more I understood ICD-10, including its potential impact and best ways to prepare, the more valuable I would be to my clients and to the industry.  I became a huge advocate of the benefits of ICD-10 and a proponent of ending the delays and supporting its adoption.  I helped many providers with assessments and remediation including Health IT upgrades, training, and education for coders and physicians and coordination of dual coding efforts.  I shared what I learned and championed ICD-10 throughout social media and someone called me the "ICD-10 Whisperer" and it stuck.

BCA: Do you have a tip you would like to share with our readers when it comes to ICD-10?
Now that ICD-10 is live, it is more important than ever to audit your coders and their charts coded in ICD-10.  Education never stops and this will show you the weak areas and coders who need additional help before it becomes a huge issue of improper reimbursement and denials.  We have developed an Enterprise Audit program to support these efforts as ICD-10 auditors are scarce and auditing is also slower in ICD-10.

BCA: Now that ICD-10 has gone into effect, have you been faced with many of the same issues from clients that perhaps were not prepared for the new code set?
Post ICD-10 Go Live, we have seen many of our clients have initial success.  Those who secured resources and provided proper training have experienced very successful implementations.  Although, even the most prepared have seen productivity decreases of 10 to 40 percent. 

BCA: In your opinion, do you feel most people were prepared and took the proper steps to get their office staff ready for the ICD-10 implementation?  If not, what are the most common issues you are seeing?
Unfortunately, some of the smaller hospitals and physician groups not tied to a health system have struggled more due to lack of preparation or resources.  The full impact has yet to be felt as we don't know how bad denials will become.  Many did not secure the proper resources and are now struggling to augment their teams with a dried up talent pool.  Many of these organizations will need to look to alternative models like Enterprise HIM or face possible acquisition or even bankruptcy.

BCA: If a practice is seeing a lot of denials, what advice would you give to our readers?
Assume denials will occur and put procedures in place now.  Denials are a Key Performance Indicator (KPI) to follow.  Set up a tracking system to log denial rate by number and/or percentage of denials, denials by payer type and reasons.  Visit these trends on a set basis with your teams to prioritize and manage quickly.  Determine if you need more staff or consultative expertise to remedy.  Don't forget to also track your A/R Cycle and your physician productivity.

BCA: Do you feel that it is easy or hard to do your job on a day-to-day basis, since you cover so many aspects of the healthcare industry?
My job is challenging, but rewarding.  I enjoy using my experience and expertise to identify client problems and offer innovative, custom solutions.  I am reminded every day of the impact these solutions ultimately have on patient care, which is why healthcare change management is critical.

BCA: To our readers that may want to make a step up in their career and do what you do, what kind of advice would you give them?
Things changed for me when I jumped all in to social media.  It is the greatest communication tool in the history of man.  No matter what stage of your career you can learn, meet great new people, and show thoughtful leadership.  If you listen, add to the conversation and promote others, you will be given opportunities you could never dream of.  This adds to your passion and makes you a better person and a better employee.  If you have not embraced it yet, jump in.  There is an amazing conversation taking place that needs you.

BCA: Is there anything else you would like to add?
I would love to keep the conversation going online.  Please connect with me on LinkedIn www.linkedin.com/in/bradmjustus or follow me on Twitter @Brad_Justus or just email me at bjustus@himaginesolutions.com and don't forget to check out the himagine solutions website at www.himaginesolutions.com