Description

Behind every patient encounter lies a web of codes, regulations, and billing decisions that shape both care and cash flow. In this episode, healthcare attorneys Vincent Buttaci, John Leardi, and Paul Werner sit down with longtime collaborator and compliance powerhouse David Klein.

David is the Founder and President of DK Coding & Compliance, Inc., co-founder of PayDC.com, and one of the sharpest minds in medical coding, compliance, and reimbursement strategy. With over 25 years in the field – and more acronyms after his name than most lawyers can fit on a business card – David has built a career translating the messy language of clinical practice into the precise codes that drive reimbursement and compliance.

This conversation pulls no punches. The guys dive into everything from the absurdity of “impossible days,” to the risk of downcoding, to the darkly comic reality that scotch tape once helped fuel a multimillion-dollar billing scheme. For healthcare providers, investors, and anyone who thinks coding is just clerical busywork, this episode is a bracing reminder: coding is law, coding is money, and coding can make or break a deal.

Listeners will learn:

• Why medical coding is both compliance obligation and financial strategy
• How “downcoding” can be just as risky as overbilling
• What happens when modifiers get misused – and why payers love to exploit those mistakes
• The surprising role coding plays in private equity healthcare transactions and due diligence
• How AI and algorithms are changing both denials and defenses
• Why providers must take responsibility for their billing companies’ actions
• What “impossible days” reveal about audits, oversight, and defense strategy
• The common-sense test every provider and investor should apply before trusting a new device, service, or software

Join Almost Clinical hosts Vincent Buttaci, John Leardi, and Paul Werner as they challenge each other’s views on how to operate, invest, and succeed in healthcare’s rapidly shifting landscape, translate legalese into business sense for healthcare providers, executives, private equity professionals, and strategic stakeholders, and explore the issues shaping the business of medicine today and tomorrow.