The Compliance Guy

This was a great live show! Sean was joined by Terry, Christine, and Paul to discuss Medical Decision-Making for levels of EM service when Rx Management is involved. There was a lot to unpack in this episode so don't miss this one!

Terry and Sean take on the importance of words in the medical record. There is no slowing of the audit trend so providers better buckle up!

In this episode Terry and Sean take on what it means to flat-line with your coding and how to avoid unnecessary scrutiny!

This one is a head-scratcher for The Compliance Guy for so many reasons... Not going to give it away but this is a really good episode you are gonna want to catch!

We had a great program on Monday with Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM Christine Hall Stephanie Allard, CPC, CEMA, RHIT Scott Kraft and John Paul Spencer and their take on some hard-hitting issues: 1. Practices wanting to use RNs or MAs to do post of visits after 90-global surgery 2. Medical necessity for E/M services and the fact that a face-to-face visit has occu...

Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM and #TheComplianceGuy , addressed critical issues in the latest #TerryTuesday episode. In this episode, we delved into current events affecting our country, marking a significant departure from our usual content. Listeners can fast forward to the 15-minute mark for an insightful discussion on Untied Healthcare and Aetna's decisi...

Sean sat down with Dana McMahon, Chief Compliance Officer for Stryker to discuss all the great things she and her team are doing to ensure a culture of compliance and to lead Stryker into the future. Beyond that Dana is the Global President for Stryker Women's Network (see bio below)! This is one great discussion you do not want to miss! Bio Dana serves as Chief Compliance Officer for Stryker...

Terry and Sean sat down to discuss credentialing vs contracting. What are the main differences, how do you handle various aspects of each and the pitfalls to avoid.

The full panel was back this week taking on an array of topics impacting healthcare organizations across the country! Join Stephanie, Paul, Scott, Christine and Terry as they discuss and debate HCC Coding Issues, No Charging Physicians and others who refer to the practice and so much more...

This episode Terry and Sean take on adding services to your revenue mix and the costs for doing so if "Medical Necessity" is not met. There is a ton to unpack in the episode. Sean also blogged about this topic on LinkedIn Monday, July 1, 2024... take a look at that blog!

Terry and Sean are back at it once again taking on the big issues impacting healthcare providers! It's all about risk mitigation and creating a culture of compliance!

The Monday Roundtable is back with all new segments and compliance centered topics. Join Sean, Terry, Christine, Scott, Paul and Stephanie as they tackle the biggest issues in healthcare.

Don't let the title fool you... this is not just another incident-to podcast. This episode focuses on the employee/employment requirement(s) and how organizations continue to make significant mistakes.

Terry, Christine, Stephanie, Paul, and Scott were all back for this new episode of the Monday Roundtable. It was quite the discussion on various payor guidelines regarding G2211, The Anatomy of CPT Codes, Split/Shared Services, EMR as a Tool, and so much more...

Brian Lobley brings over 20 years of experience leading healthcare businesses, operations, and strategy. Prior to joining tango, he served as the executive vice president, chief operating officer, and president of Health Markets at Independence Health Group, the parent company of Independence Blue Cross, LLC. He was responsible for leading Commercial, Consumer, and Medicare lines of business and t...

In this episode Sean and Terry take on Addendums, Corrections, and Late Entries, and when you can make them, when you shouldn't, and when clinical summaries are a better options.

Sean and Terry are back with an all new #TerryTuesday episode that you are not going to want to miss!

 The full panel! Scott Kraft , John Paul Spencer , Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM , Stephanie Allard, CPC, CEMA, RHIT and Christine Hall CHC was back with all new topics! 1. Weight loss drugs and all the confusion on medical necessity 2. Physician disclaimers and the misnomers 3. Developing the next generation of coders, and the difficulties practices are having...

Bryan Meek of Brennan, Manna, and Diamond joins Sean to discuss last weeks final rule issued by the Federal Trade Commission and what it means at this point, where things are headed and how to navigate through all the noise. Don't miss this episode!

Sean and Terry are at it again, taking on the most perplexing and head-scratching auditing, coding and compliance topics and bringing a sense of sanity to insane situations!

Most of the all star team was back for this one and it was an outstanding discussion of the G2211, Medical Necessity vs. Correct Coding, SNF Visits and Medical Necessity, and so much more!

Sean and Terry are back at it with another great episode focusing on the most challenging issues facing healthcare providers and their organizations.

The all star panel is back together again with an all new episode. 1. Clean Claims 2. Misapplication of Diagnosis Codes 3. Change Healthcare Debacle

Terry and Sean take on Medicare's IPPE and AWV and all the misinformation and dos and don'ts! Hear directly from a Medicare Auditor on her thoughts and opinions on direct supervision / incident-to regarding these services.

The Panel takes on the most pressing issues facing healthcare providers today! 1. Medicare Physician Fee Schedule Update 2. G0136 - SD0H HCPCSII Code Dos and Don'ts 3. TPE Targeting Level II and IV EM Services