I don’t know this with certainty, but I probably have more than one listener dreaming of starting their own business, in the mid-revenue or elsewhere. Others might be content in their current roles as CDI, coding, or mid-revenue cycle professionals, but are also looking forward to their big trip in August.

Today’s guest is living the best of both worlds.

Melanie Kiss started Chicas Abroad in 2021 with a small group of friends who shared a joint love for travel and adventure. Prior to that she had been a longtime HIM professional with stops ranging from the hospital setting to college classrooms to consulting, and even a long stint with AHIMA.

Today she’s leading worldwide curated travel. How does one go from HIM to Havanna, coding to Cebu? Listen to Off the Record as we discuss:

• Chicas Abroad: How it started and when Melanie realized it was time to go all in

• Melanie’s innovative marketing strategy (I learned a thing or two that I will adopt!)

• Entrepreneurship: Melanie’s words of wisdom and what learned about herself while taking risks and launching a business

• Following your bliss: When do you know it’s time to pursue something new?

• The coolest place she's ever been

• Off the beaten path experiences with difficult clients and other fun stuff. With a little HIM/coding talk, too, because this is a serious mid-revenue cycle podcast...

For this week’s episode I’m bringing you something a little different, but of such importance that I had to share it with my Off the Record audience: The massive audit expansion of Medicare Advantage announced by CMS.

In case you missed it, CMS in May rocked the mid-revenue cycle industry with the unveiling of a startling mandate. It will hire 2000 medical coders, beef up its audit technology, and expand its current limited auditing scope from 60 Medicare Advantage Plans to some 550 plans nationwide in an attempt to check widespread allegations of HCC upcoding.

My colleague Jason Jobes has been closely following the news and presented this topic in June—the most attended webinar Norwood has ever hosted. This is a replay of that very well-received show. It covers:

• The evolving risk adjustment landscape and the rise of Medicare Advantage

• CMS broad and bold audit scope and strategy

• Best practice techniques to survive in risk adjustment and avoid potential risks

Jason refers to several slides during the presentation, which you don’t necessarily need, but if you’d like to follow along or see the exact references and data we’ve posted them to the Norwood website with a link in the show notes.

Enjoy the show!

Show notes and resources

• View the webinar slides here (free; requires registration)

• Read the full CMS audit announcement.

In 1990 the heavy metal band Queensryche asked its listeners, “Is there anybody listening?”, a lament for not being heard in a world of overstimulation, noise and artificially.

In healthcare in 2025, the answer is yes: someone is listening. But the listener just might be a machine.

Ambient AI is one of the most promising applications of the recent AI wave, in my opinion anyway and possibly that of my guest, Dr. David Canes. Dr. Canes is a Boston-area urologist, owner of WellPrept, and a self-described tech enthusiast.

Recently David put out the YouTube video 11 Ways to Use AI In Your Practice Right Now, which I link to in the show notes. But he’s also the author of “Why AI scribes are changing medicine and the risks you must know.” I’d describe him as an early adopter and enthusiast but with his eyes open to potential shortcomings.

We cover the pros and cons of ambient AI and other forms of AI, and how it is impacting documentation, coding, and the revenue cycle, on this episode of Off the Record. We discuss:

• David’s path into medicine and ultimately urology

• Why he chose to adopt a positive mindset in the use of new technologies rather than fear or resistance

• Ambient AI: How it operates and what a patient encounter looks like using this tech, start to finish

• Positive impacts on provider burnout, charting, E/M professional billing, and CPT

• Cons of the new tech, including hallucinated answers and inaccurate summaries

• Use of generative AI large language models in patient diagnosis

Show notes

• Why AI scribes are changing medicine and the hidden risks you must know: https://kevinmd.com/2025/02/why-ai-scribes-are-changing-medicine-and-the-hidden-risks-you-must-know.html
• 11 Ways to Use AI in Your Practice Right Now: https://www.youtube.com/watch?v=OJLqIU2nbzc