A payer says no—but does that mean you should appeal?

In this episode of Practice Perfect, Jennifer McNamara and Maya Turner break down when to fight the payer, fix the claim, or fix the process.

From medical necessity and prior authorization to credentialing, patient responsibility, modifier 59, and payer policies, they discuss why understanding the reason behind a denial matters before taking action.

They also touch on Independent Dispute Resolution (IDR) and why denial data can reveal much bigger problems in your revenue cycle.

Key takeaway: Getting a claim paid isn't always the same as getting it right.

🎙️ Practice Perfect
Jennifer McNamara & Maya Turner

🎧 https://www.practiceperfectpod.com/

Change at work is inevitable. New leadership, new processes, new technology, new expectations—and sometimes an entirely new organization. But how we respond to that change can say a lot about us as professionals.

In this episode of Practice Perfect, Jennifer McNamara and Maya Turner get into the soft skills that can make or break your professional growth.

They discuss why organizational change can feel uncomfortable, why discomfort does not automatically mean a decision is wrong, and how employees and leaders can navigate change without allowing emotion to drive their decisions.

Jennifer and Maya also break down an important distinction: project management vs. micromanagement. Accountability, deadlines, checkpoints, and expectations are not necessarily micromanagement. The difference often comes down to trust.

The conversation also turns to professional communication and social media. You can disagree. You can raise concerns. You can challenge a decision. And when there are legitimate concerns involving compliance, fraud, harassment, safety, or unethical conduct, those concerns should be reported through the appropriate channels.

But disagreement does not require destroying someone else's dignity.

In this episode, Jennifer and Maya discuss:

• Adapting to organizational change without reacting emotionally
• Why soft skills matter at every level of your career
• Maintaining professional relationships even when you disagree
• Project management vs. micromanagement
• Trust, accountability, and expectations in the workplace
• Communicating concerns professionally
• Knowing the difference between a personality conflict and a legitimate compliance concern
• The AAPC Code of Ethics and professional conduct
• Why your social media presence matters professionally
• How online comments can follow you into future employment, leadership, and even expert witness work
• The importance of mentors when navigating difficult professional situations

One of the biggest takeaways from this conversation:

You can disagree with someone without attacking who they are.

Instead of, “This person clearly doesn't know how to code,” consider, “I disagree with this coding interpretation.”

Instead of, “They're a terrible leader,” consider, “I have concerns about this leadership decision.”

Professionalism doesn't mean never disagreeing. It means knowing how to disagree without losing your integrity in the process.

🎙️ Practice Perfect Podcast
Hosted by Jennifer McNamara with co-host Maya Turner

Practice Perfect brings real conversations about medical coding, compliance, leadership, revenue cycle, professional development, and the realities of working in healthcare.

Resources Mentioned:
AAPC Code of Ethics — Review AAPC's ethical principles, including integrity, respect, commitment, competence, fairness, and responsibility.

Learn more about Healthcare Inspired and our education programs at HealthcareInspiredLLC.com.

The elephant in the room is here — and waiting until January is not a strategy. 🐘

In this episode of the Practice Perfect Podcast, hosts Jennifer McNamara (Healthcare Inspired) and Maya Turner (Turner Expert Solutions) break down the CMS 2027 Proposed Rule and what it means for physicians, ASCs, and multi-specialty practices — right now, not next year.

🔑 What we cover:

• The projected ~45% Medicare revenue decrease when the conversion factor cut and expiring temporary increase stack together

• Why CMS is treating every non-E&M service as a "secondary procedure" — and what that does to bundled reimbursement

• How to run your 12-month revenue baseline and identify your high-dollar procedure exposure

• The 60-day comment period: how to make your voice count with CMS

• Where AI helps (and where it absolutely does NOT replace certified coders and compliance experts)

• The OBGYN global package overhaul — new prenatal risk coding and Medicaid trimester considerations

• Payer contract renewals and December-to-January care overlap

🎬 Plus — Lights, Camera, Healthcare! We're breaking down The Devil Wears Prada 2 and the leadership lessons hiding in plain sight.

✅ Action items: Pull your Medicare baseline. Audit your OBGYN workflows. Submit comments during the CMS window. And whatever you do — protect your coding, compliance, and education budgets.

🎤 Coming up: Maya Turner presents on Independent Dispute Resolution (IDR) at the AMBA Association conference.

👥 About your hosts:

Jennifer McNamara — Founder of Healthcare Inspired, specializing in revenue cycle optimization, compliance, and provider education.

Maya Turner — Founder of Turner Expert Solutions, coding, billing, and IDR subject-matter expert.

Subscribe for more practical, no-fluff healthcare operations education from Healthcare Inspired and Turner Expert Solutions.