NatRevMD
Medical billing tips for healthcare professionals — by healthcare professionals. This podcast is here to help private practices get paid what they’ve earned. We share real-world strategies for accurate coding, smoother billing workflows, and fewer denials — all from a team that’s been in your shoes. Whether you’re just getting started or trying to tighten up your revenue cycle, you’ll get practical advice you can actually use.Join the conversation in our Facebook Group: NatRevMDLearn more at www.natrevmd.com
#136 Stop Undercoding: The Coding Mastery Tips Every Physician Needs (w/ Dr. Anne Hirsch)
Most practices think they need more—more patients, more visits, more volume. But what if the real revenue opportunity isn’t volume at all… it’s coding?
In this episode, Dr. Heather sits down with Dr. Anne Hirsch, an internal medicine physician turned coding expert and physician coach, to explore why most practices are coding far below what their clinical work justifies—often doing a level 5 visit, documenting a level 4, and billing a level 3.
You’ll learn:
• Why “fear-based coding” is silently draining your revenue
• The most common undercoding patterns physicians don’t realize they’re doin...
#135 Stop Overpaying Taxes: What Physicians Need to Know in 2025–2026 with CPA Riki Singh
If you’ve ever looked at your tax return and wondered, “Why am I paying this much?” — this episode will feel like a breath of fresh air.
Dr. Heather sits down with longtime CPA and trusted advisor Riki Singh, who manages over 250 small and mid-sized businesses, including many medical practices. Riki brings clarity to a topic most physicians secretly stress about: how to stop unintentionally overpaying in taxes.
In this episode, we break down:
Why so many physicians overpay without realizing itWhat actually matters when comparing W-2 vs. 1099 incomeSimple structural decision...#134 Is This Really the End of OB Global Billing? The 2027 Shift Every OBGYN Should Prepare For
For decades, OBGYNs have been forced to fit every prenatal visit, every complication, every late-night call, and every ounce of cognitive work into a single global maternity payment. But that model is ending — and the shift is massive.
In this episode, Dr. Heather Signorelli breaks down exactly what’s changing on January 1, 2027, why global billing is being eliminated, what we know so far, what’s still uncertain, and how practices can use this transition to finally get paid for the care they already provide.
If you’re an OBGYN, practice manager, or billing leader...
#129 From Physician to CEO: How Dr. Jonathan Block Built a Thriving Practice Through Leadership and Metrics
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification (https://natrevmd.com/eligibility-billing-verification/) to prevent costly claim denials before they happen.
In this episode of the NatRevMD Podcast, Dr. Heather Signorelli sits down with Dr. Jonathan Block — a board-certified urologist, obesity medicine specialist, certified physician executive, and former U.S. Air Force Major — to explore what it truly means to lead in medicine. With over 35 years in healthcare, Dr. Block has journeyed from the back of an ambulance to the h...
#133 Why Your Practice Is Invisible (And How SEO Finally Fixes It)
In this episode, Dr. Heather sits down with SEO expert Darcy Sullivan to unpack one of the biggest problems practices face today: visibility. You can be the best clinician in your community, but if patients can’t find you online, your practice stays invisible.
Darcy breaks SEO down in a simple, relatable way—from the “Oreo Method” to the real truth about Google profiles, backlinks, and why consistency matters more than complicated tactics. Whether you’re just opening your clinic or realizing it’s time to finally get intentional with your online presence, this conversation gives you practical st...
#132 When the Practice Thrives, Everyone Thrives: Inside a Rural Hospitalist Model
Free Resource:
Make sure eligibility isn’t causing preventable denials. Download the free Eligibility Checklist →https://natrevmd.com/eligibility-billing-verification/
In this episode, Heather Signorelli, DO, sits down with Dr. Dan Wandsneider—founder of a rural hospitalist group serving critical access hospitals across Wyoming and Colorado—to unpack what it truly takes to build a practice model that supports clinicians, strengthens communities, and elevates patient care.
Dr. Wandsneider shares his journey from residency to creating a sustainable, physician-led hospitalist model focused on protecting clinician well-being, reducing burnout, and keeping patients local. Together, they discuss the real...
#131 Modifier 59 Explained: Correct Uses, Wrong Uses, and How to Avoid Costly Denials
Free Resource:
Make sure eligibility isn’t causing preventable denials. Download the free Eligibility Checklist → https://natrevmd.com/eligibility-billing-verification/
Modifier 59 is one of the most overused—and misunderstood—modifiers in medical billing. In this episode, Dr. Heather Signorelli breaks down exactly when 59 is appropriate, when it isn’t, and why using it on labs (like a UA) is a major compliance mistake.
You’ll learn:
The real CPT and Medicare definition of modifier 59When to use 59 vs the X-modifiersWhy adding 59 rarely changes payment but can flip denialsThe most common misuse patternsClinical examples from urgent care...#130 Meet Sarah: The AI Assistant Reducing Admin Work and Boosting Patient Engagement
Discover how AI is transforming urgent care and primary care. In this episode, Dr. Heather sits down with Geoffrey, CEO of Preface Health, to explore how AI intake, ambient scribing, and full-journey patient support are revolutionizing the way clinics operate.
Learn how Preface Health’s intelligent assistant, “Sarah,” helps reduce administrative workload, improve documentation accuracy, boost coding precision, and enhance patient retention by supporting follow-up care and engagement.
👉 See how AI can streamline your workflow: Book a demo with Preface Health (https://www.prefacehealth.com/)
#128 From Zero Patients to a Thriving Practice — The Grit Behind Private Practice Success
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification (https://natrevmd.com/eligibility-billing-verification/) to prevent costly claim denials before they happen.
This week on the NatRevMD Podcast, Dr. Heather Signorelli sits down with orthopedic surgeon Dr. Eli Ahdoot, who built a successful private practice from scratch — in the middle of a pandemic. From knocking on hospital doors to managing payroll and balancing family life, Dr. Ahdoot shares what it really takes to grow a profit...
#127 Build a Life You Love — and Still Be an Exceptional Physician
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification (https://natrevmd.com/eligibility-billing-verification/) to prevent costly claim denials before they happen.
What if your medical career could take you beyond the walls of your clinic — to new places, passions, and possibilities?
In this inspiring episode, Dr. Heather Signorelli talks with Dr. Andrew Willner, a board-certified neurologist, author of The Locum Life, and host of The Art of Medicine podcast. Together, they explore how physicians can emb...
#126 Can Your Physicians Actually Pay for Themselves?
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification (https://natrevmd.com/eligibility-billing-verification/) to prevent costly claim denials before they happen.
Ever wonder how many patients your practice really needs to see each day to be profitable? In this episode, Dr. Heather Signorelli breaks down the profitability math every private practice owner should know — from understanding overhead and compensation structures to knowing exactly how much profit each patient brings in.
You’ll learn how to:
✅ Calculate...
#125 How Many Patients Do You Need Just to Keep the Lights On?
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification (https://natrevmd.com/eligibility-billing-verification/) to prevent costly claim denials before they happen.
In this episode, Dr. Heather Signorelli breaks down how to calculate your cost to carry the seat—the number of patients each provider must see to break even. You’ll learn how to separate fixed and variable costs, understand your true overhead, and use these insights to make smarter hiring and compensation decisions. Perfect...
#124 Why ICD-10s Don’t Set Your Pay Rate — But Decide If You Get Paid at All
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification to prevent costly claim denials before they happen.
Most practices think ICD-10 codes determine how much they get paid, but the truth is, they decide if you get paid at all. In this episode, Dr. Heather Signorelli breaks down how vague or incorrect ICD-10 coding can sabotage your revenue, trigger denials, and signal “low value” to payers. You’ll learn how to code with precision, prove medical necessity, and finally ge...
#123 How to Keep More of What You Earn: Asset Protection for Physicians
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification to prevent costly claim denials before they happen.
In this episode of NatRevMD, Dr. Heather Signorelli chats with Omar Morillo, Certified Financial Planner and founder of Imperio Wealth Advisors, about how physicians can protect their assets, save on taxes, and plan for the future.
They dive into smart business structures, asset protection, pension plans, and es...
#122 5 Numbers That Tell You If Your Practice Is Healthy (or Bleeding Revenue)
Before you dive in—make sure your team isn’t missing a critical first step in protecting your revenue. Check out our free guide on Eligibility & Billing Verification to prevent costly claim denials before they happen.
In this episode of the NatRevMD Podcast, Dr. Heather Signorelli reveals how just five key metrics can tell you whether your practice is thriving or quietly losing up to 15–25% of its revenue every month. Many practices don’t realize they’re leaking revenue simply because they’re not tracking (or understanding) the right numbers.
You’ll learn:
✅ How to know if your...
#121 Cigna’s New Downcoding Policy (R49): How Denial Code C150 Could Cut Your Revenue
**Free Guide for Listeners:** Boost your practice’s cash flow and reduce denials with our step-by-step **Eligibility & Billing Verification Training Guide.**
Download it here → https://natrevmd.com/eligibility-billing-verification/
Starting October 1st, Cigna is rolling out a controversial “R49” policy that automatically down-codes higher-level E/M visits—cutting physician reimbursement even when documentation fully supports the billed level. In this episode of the NatRevMD Podcast, Dr. Heather Signorelli, DO, breaks down what this means for your practice, how ICD-10 codes and E/M guidelines intersect, and why the California Medical Association is fighting back. You’l...
#120 Don’t Let Hiring Kill Your Profits: A Framework for Physicians with Dr. Una
Checkout the EntreMD Business School: https://entremd.com/
Hiring the wrong way can drain your practice’s profits—but it doesn’t have to. In this episode, Dr. Una shares her proven framework for hiring profitably in private practice. You’ll learn how to avoid cashflow crunches, recognize the right time to bring on new team members, and build a thriving, sustainable team that supports your long-term growth.
👉 Visit us at www.natrevmd.com to learn more resources for your practice.
📌 Don’t forget to subscribe to the podcast and leave a review—your...
#119 Stop Losing 6 Figures to Credentialing Mistakes: 5 Fixes Every Practice Needs Now
Credentialing may not be glamorous—but it’s one of the most important parts of keeping your practice’s revenue flowing. In this episode of Nat Rev MD, Dr. Heather Signorelli breaks down the Top 5 Credentialing Mistakes that cost practices time, money, and peace of mind. From missing contracts to failing to renegotiate payer rates, delaying new provider credentialing, and overlooking expirations, she shares practical steps to prevent costly errors.
By the end of this episode, you’ll know exactly how to spot risks, plug leaks, and create systems that protect your revenue...
#118 From 30 Hours of After-Hours Charting… to Zero
Most physicians don’t burn out from patients—they burn out from endless charts, inboxes, and denied claims. After 15 years in “charting chaos,” Dr. Sarah Smith discovered a system to close every chart before leaving work—and now she teaches other physicians how to do the same.
In this episode of the NatRevMD Podcast, you’ll learn how to:
Eliminate 5–30 hours of unpaid work each weekClose charts the same dayStop eligibility denials that drain revenue👉 Tune in now—and visit NatRevMD.com to learn more.
👉 Explore our Eligibility & Billing Verification Guide
for practical tip...
#117 The Power of Saying Watch Me: Dr. Rachel Rubin on Building, Scaling, and Leading in Medicine
When Dr. Rachel Rubin was told her work was “too weird” to succeed, she proved everyone wrong. Now a leading sexual medicine specialist and founder of a thriving practice, she’s reshaping how medicine approaches women’s health.
In this episode of the NatrevMD Podcast, Dr. Rubin shares how rejection fueled her success, the role of networking, why marketing is service—not sales—and her course helping clinicians prescribe evidence-based hormone therapy.
👉 Don’t forget to subscribe, leave a review, and share this episode with other professionals.
For more resources, visit NatrevMD.com.
#116 Stop Losing Thousands in Patient AR: 5 Strategies That Work
Is your practice losing revenue to unpaid patient balances?
In this episode of NatRevMD, Dr. Heather Signorelli uncovers why patients aren’t paying, the mistakes that cost practices thousands, and the simple strategies you can implement—from credit card on file policies to front desk scripting—to cut patient AR, protect your revenue, and maintain strong patient relationships.
For more resources, visit NatRevMD.com—and don’t forget to share this episode with other healthcare professionals who need it.
#115 The Lessons Owners Shouldn't Overlook
Building and running a medical practice is never simple. Many healthcare leaders struggle with staffing challenges, revenue cycle headaches, or simply trying to balance patient care with the demands of business ownership. But here’s the truth—success is possible with the right systems, leadership, and team culture in place.
In this episode, Dr. Heather Signorelli sits down with Krysta, a nurse-turned-CEO, who shares her journey from the ER to running multiple urgent care centers. Together, they tackle big questions like:
✅ What does it really take to transition from clinician to CEO?
✅ How can practices overcome...
#114 The #1 Front Desk Mistake That Causes 30% of Denials
Stop Losing Revenue to Eligibility Errors
Did you know that up to 30% of denials in private practices come from eligibility mistakes? In this episode of the NatRevMD Podcast, Dr. Heather Signorelli unpacks the seven most common eligibility errors—from skipped checks and inactive coverage to coordination of benefits and payer ID mix-ups. She also shares practical fixes you can implement right away to cut denials, protect revenue, and keep cash flow steady.
Whether you’re managing a small office or multiple providers, these tips will help your front...
#113 How to protect your revenue during a transition
Making the decision to switch billing teams can feel overwhelming. Many practices worry about revenue dips, workflow confusion, or the burden of transition. But here’s the truth—when done right, switching can actually protect your revenue and even increase collections by up to 35% in the first 90 days.
In this episode, Dr. Heather Signorelli breaks down the top myths about changing billing teams:
✅ Will your revenue drop?
✅ Can a new team really learn your quirks?
✅ Is it too much work to switch?
✅ What happens to patient balances and old AR?
You’ll walk away with cl...
#112 Your Backup Plan for Overflow Dermatology Patients
Join us in this episode of the NatrevMD podcast as we explore the journey of Dr. Jamie Hale, a pioneering dermatologist who has successfully navigated the challenges of managing a private practice.
Discover how Dr. Hale and her business partner built their practice from the ground up, addressing patient care demands and administrative hurdles. Learn about their innovative solution, the SkinRelief Hub, a telehealth platform designed to provide timely care for dermatological conditions. This episode offers valuable insights for practitioners and patients alike, highlighting the importance of problem-solving and innovation in healthcare. Tune in to be inspired b...
#111 Dropping Medicare: Smart Strategy or Risky Move?
Is dropping Medicare a bold business move—or a dangerous gamble? In this episode of the NatRevMD Podcast, Dr. Heather Signorelli dives deep into the pros, cons, and realities of opting out of Medicare. From understanding the difference between being “non-par” vs. fully opting out, to the financial and operational risks practices face, this episode gives you the insights you need before making a decision.
Tune in to learn what the data says, what specialties are most likely to opt out, and how to evaluate the impact on your practice’s revenue, patients, and long-term strategy.
📢 Subscr...
#110 - Why Your Medical Practice Culture Determines Your Success
In this episode of the Nat Rev MD Podcast, Dr. Heather Signorelli chats with Marissa Vasquez, office manager at Emerald Coast, about the realities of running a medical practice. From building a positive culture and managing staff challenges to streamlining eligibility and financial processes, Marissa shares practical lessons every practice can use to thrive.
📢 Subscribe, leave a review, and share with a colleague who needs this.
Want more resources to grow your leadership and revenue skills?
Head over to natrevmd.com — where physician leaders go to sharpen their business...
#109 - How Physicians Become Strong Leaders: Insights from Dr. Matt Astin
Most doctors think leadership is just “being in charge.” It’s not.
It’s the ability to inspire people to follow your vision—even on their toughest days. It’s knowing when to speak up, when to listen, and when to repeat yourself until the message sticks. It’s realizing you can’t lead everyone the same way—and that your leadership style can make or break your team.
In this week’s NatRevMD Podcast, Dr. Heather Signorelli talks with Dr. Matt Astin about what makes a true physician leader without sacrificing patient care or burning yourself out...
#108 - Increase Your Practice Visibility: Top Marketing Tips with Emily Steele
Is your practice getting lost in the noise?
In this powerful episode, marketing strategist Emily Steele joins Dr. Heather Signorelli to share the exact steps practices can take to improve visibility and attract more patients—without a massive budget.
You’ll learn:
#107 - Should You Drop Insurance? A Step-by-Step Guide to Cash-Pay Success
Is it time to ditch insurance?
In this episode of the NatRevMD podcast, Dr. Heather Signorelli walks you through how to decide if going cash-pay—or dropping a specific payer—is right for your private practice.
We’ll cover:
Whether you're fed up with denial...
#106- Are You Really Getting Paid What You Deserve? How to Understand Your Practice’s Financial Data
You’re seeing patients. Billing regularly. But are you actually getting paid what you should be?
In this episode, Dr. Heather Signorelli breaks down the real way to read your practice’s financial data so you stop guessing and start knowing. From spotting CPT reimbursement shifts to trending by date of service, this is your blueprint for data-driven decisions that actually grow revenue.
No more flying blind. Get clarity. Get paid.
🎧 Listen now and take the lead with facts, not feelings.
📢 Subscribe, leave a review, and share with a colleague who needs this.
🔗...
#105 Get Paid What You’ve Earned: 7 Tactics That Boost Practice Revenue by 30%
Stop Revenue Leaks, Fix Your AR, and Build Financial Momentum
You're doing the work, but is your revenue telling the same story? In this no-BS episode, Dr. Heather Signorelli pulls back the curtain on the silent killers draining your practice income. Discover 7 tactical moves that stop revenue leaks, revive your aging AR, and flip the switch on predictable, growing revenue. Real talk. Real results. This is how thriving practices stay ahead.
Don’t settle for “just enough.” Listen now and start building financial momentum.
Subscribe, leave a review, and share to help more practices...
#104 Don't miss out on extra payments - Part 2
In this follow-up to our last episode on MIPS (Merit-Based Incentive Payment System), Dr. Heather Signorelli takes a deeper dive into what physicians need to know to maximize Medicare reimbursements and avoid penalties. We unpack the four MIPS categories—Quality, Promoting Interoperability, Improvement Activities, and Cost—and how they impact your final score. You’ll also hear real-world examples of specialty-specific metrics, tips for leveraging your EMR for MIPS success, and how group vs. individual reporting works. Whether you're new to MIPS or just looking to improve your performance, this episode is packed with actionable insights to help you stay c...
#103 Don't miss out on extra payments
Are you leaving Medicare money on the table? In this episode of the NatrevMD Podcast, Dr. Heather Signorelli unpacks the Merit-Based Incentive Payment System (MIPS) and how your practice can benefit. From eligibility thresholds to performance categories, learn how to avoid penalties and earn bonus payments by staying compliant and proactive.
✅ Practical tips
✅ Who needs to report
✅ How to check your eligibility
Subscribe, leave a review, and share to help more practices plug revenue leaks—without the extra stress.
🔗 Visit www.natrevmd.com for resources like our book, billing course, and se
#102 5 Most Common Claim Denials (and How to Fix Them)
In this episode of the NatRevMD Podcast, we uncover the 5 most common claim denials—and exactly how to fix them. From the #1 denial that starts at the front desk to documentation tweaks that save thousands, we’re diving deep into the silent killers of your revenue.
Discover real-world strategies to avoid modifier mistakes, stay on top of timely filing limits, and even use a simple 30-second script to stop COB issues before they start.
Subscribe, leave a review, and share to help more practices plug revenue leaks—without the extra stress.
🔗 Visit www.natrevmd.com...
#101 TCM Billing Made Easy: 99495 & 99496 Explained
In this episode of the NatRevMD Podcast, we break down TCM billing and the key differences between CPT codes 99495 and 99496. Learn how to bill correctly, avoid denials, and maximize reimbursements with real-world scenarios and expert insights.
Subscribe, leave a review, and share to help more practices optimize their billing!
🔗 Visit www.natrevmd.com for resources like our book, billing course, and services.
#100 Should You Hire a Nurse Practitioner
In this episode of the NatRevMD podcast, we explore the ins and outs of building a business case for hiring a Nurse Practitioner. Learn how to assess your practice's needs, calculate financial implications, and craft a compensation plan that aligns with your goals. Whether you're considering an NP, PA, or another physician, this episode is packed with actionable insights to help you make an informed decision.
Subscribe, leave a review, and share this episode to help more practices thrive!
Visit www.natrevmd.com for resources like our book, billing course, and services.
#99 Yearly Audit
2025 is around the corner. In this episode, we walk private practice physicians through 7 key questions to reflect on the past year, identify opportunities, and plan for growth. Let’s set your practice up for success.
Subscribe, leave a review, and share this episode to help more practices thrive!
Visit www.natrevmd.com for resources like our book, billing course, and services.
#98 Membership Fees in Healthcare: Balancing Costs and Compliance
Rising costs and declining reimbursements are pushing many practices to explore membership and administrative fees. In this episode, Dr. Heather Signorelli explains how to implement these fees while staying compliant. Learn about tiered membership models, compliance tips, pros and cons, and the steps to get started.
Subscribe, leave a review, and share this episode to help more practices thrive! Visit www.natrevmd.com for resources like our book, billing course, and services.
#97 Top Priority: Patient Payments & Qmb Compliance
In this week's episode, we dive into the critical topics of patient payments and Qualified Medicare Beneficiary (QMB) compliance with expert insights from Dr. Heather Signorelli. This podcast breaks down complex billing processes, compliance essentials, and actionable strategies to streamline patient collections while staying within regulatory guidelines. It's perfect for healthcare practitioners, billing professionals, and practice managers committed to optimizing revenue and maintaining compliance.
Join the conversation with other healthcare professionals in the NatRevMD Facebook Group.
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