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welcome to the hospital finance podcast your go-to source for information and insights that can help you protect and enhance revenue at your hospital and now the host of the hospital finance podcast Michael fastened ante hi Im my past nine and your host for the hospital finance podcast and Im joined today by Vinny Farina who is a senior manager on our revenue cycle team here at Bessler welcome Vinnie thank you so Vinnys gonna walk us through various aspects of IME shadow billing and how that entire process works within your hospital so if any let me open it up with the first question and its kind of a long one so bear with me were interested in what the two types of additional payments from Medicare through the Part A program the teaching hospitals received for Medicare Advantage ocation in patient discharges are can you walk us through those sure now the two types of payments are for indirect medical education IME and direct graduate medical education D GME IME payments are rece