Compliance Conversations by Healthicity

What changes — and what stays the same — in healthcare revenue cycle over a 30-year career?  In this episode of Compliance Conversations, CJ Wolf speaks with Vanessa Moldovan , Head of RCM Strategy at Magical , about her career journey through physician revenue cycle operations, coding, auditing, education, consulting, and health technology leadership.  Vanessa shares firsthand perspective on the...

Healthcare organizations are navigating a rapidly changing privacy landscape, and many compliance teams are being asked to manage new risks faster than ever before.  Between evolving 42 CFR Part 2 requirements, increasing OCR enforcement expectations, and the rapid adoption of AI tools across healthcare operations, organizations are facing growing pressure to ensure privacy, compliance, and operat...

AI is moving fast in healthcare. But adoption, trust, and safety? Those are moving slower — for good reason.  Dr. Ashok Gupta has been on both sides of it. He spent years as a clinician, then built TheraNow , a virtual physical therapy platform that has supported over 70,000 patients across the US. These days he's also building AI-powered clinical documentation tools.  In this episode of Comp...

Each year, conferences like HCCA’s Compliance Institute and AAPC’s HEALTHCON offer more than education. They provide a window into where compliance is headed—what regulators are prioritizing, how risks are evolving, and what organizations need to prepare for next.  In this episode of Compliance Conversations , CJ Wolf and Brian Burton share their perspective on what to watch this conference season...

Vendors and business associates are critical to healthcare operations—but they also introduce significant compliance, privacy, and security risks.  In this episode of Compliance Conversations, CJ Wolf and Susan Walberg break down what organizations often miss when it comes to vendor oversight—and why those gaps matter more than ever.  What You’ll Learn:   Why compliance must be involved in vendor...

The CRUSH initiative (Comprehensive Regulations to Uncover Suspicious Healthcare) is more than just another acronym, it’s a signal of where healthcare regulation is headed next.   In this episode of Compliance Conversations, CJ Wolf is joined by Lisa Taylor , a seasoned Chief Compliance Officer, to break down what this request for information (RFI) means for organizations today—and what it could b...

Telehealth remains one of the most dynamic and closely watched areas in healthcare compliance.  In this episode of Compliance Conversations, CJ Wolf welcomes back telehealth compliance expert Keisha Wilson, founder of KW Advanced Consulting , for a timely discussion on the latest telehealth developments, including newly extended flexibilities, evolving documentation requirements, and the audit ris...

Medical decision making shouldn’t feel like a coding puzzle, and your documentation shouldn’t read like a template checklist.  In this episode, CJ Wolf is joined by Amanda Reikowsky , a coding quality audit & education supervisor at Hackensack Meridian Health and founder of CodeWise Solutions, LLC , to break down what MDM documentation should look like today—and why the best notes focus on the...

Mentorship can be the difference between feeling stuck and building a career with real direction. In this episode of Compliance Conversations, CJ Wolf is joined by Barbara Shaw , a seasoned healthcare coding, auditing, and risk adjustment professional who has made mentoring new coders a meaningful part of her work, especially through her involvement as an AAPC local chapter officer.  Barbara share...

Compliance risks don’t always start in obvious places—and that’s what makes them dangerous.  In this episode of Compliance Conversations , host CJ Wolf talks with Amy Bailey of HBE Advisors about the real-world compliance failures she sees most often across hospitals and physician groups nationwide. Drawing on decades of experience with investigations, self-disclosures, and Corporate Integrity Agr...

Refunds and overpayments sit at the intersection of compliance, finance, and legal risk. In this episode of Compliance Conversations, CJ Wolf speaks with David Glaser , healthcare attorney and in Fredrikson’s Health Law group, about how organizations can navigate refund decisions with greater confidence and clarity.  Drawing from years of advising providers nationwide, David explains:  The differe...

In this episode of Compliance Conversations , host CJ Wolf sits down with Jill Fallows Macaluso , Corporate Vice President and Chief Compliance Officer at Novo Nordisk , to explore how ethical culture, psychological safety, and empowered risk-taking can transform compliance from a regulatory obligation into a strategic asset.  Jill shares insights from more than two decades in a highly regulated i...

In this episode of Compliance Conversations , healthcare compliance expert Jessica Zeff, the Founder & CEO of Simply Compliance , shares real-world insight into why structured, electronic case management is essential for demonstrating compliance, managing risk, and responding efficiently to audits and investigations.  What You’ll Learn   What compliance case management actually looks like in p...

Critical care coding isn’t just about time at the bedside. In this new episode of Compliance Conversations , CJ Wolf and Maya Turner discuss how recent CPT® guidance expands what’s billable, from telehealth consults to pre-arrival care coordination.  Key Takeaways:   When critical care starts (and where it doesn’t)  CPT® vs. CMS Guidance— and what happens when they differ  How to handle transport,...

As federal deadlines, a shutdown, and stalled legislation churn the rules, telehealth coverage looks different across Medicare, Medicaid, and commercial payers. In this episode, CJ Wolf , MD and Keisha Wilson (Founder/CEO of KW Advanced Consulting) breaks down what’s actually covered right now—and how to stay compliant without disrupting care.  You’ll learn:   Where Medicare telehealth reverted an...

Headlines change. Your mandate doesn’t.   In this Compliance Conversations episode, CJ Wolf, MD , and Brian Burton , Healthicity Chief Compliance & Privacy Officer, cut through the noise to show how to keep programs objective, patient-first, and audit-ready—even amid shutdowns, delayed rules, and shifting priorities.  What you’ll learn   Enforcement reality check: Why fraud, waste, and abuse a...

CJ Wolf sits down with Jacklyn DeMar (President and Chief Executive Officer of The Anti-Fraud Coalition) and Elin Kunz (testifying expert and former whistleblower) to explore the False Claims Act (FCA), the realities of retaliation, and how compliance programs move from “paper tiger” to practice.  What You’ll Learn   FCA in plain English: How cases start, why most settle, and the government’s role...

Artificial intelligence is no longer a future concept; it’s here, embedded in healthcare systems, vendor platforms, and even your day-to-day operations. But with innovation comes risk.  In this episode of Compliance Conversations, host CJ Wolf , MD, talks with Santosh Kaveti , Founder and CEO of ProArch , about:  Emerging AI Risks: From shadow AI to model drift  Governance & Education: Why AI...

Artificial intelligence is transforming healthcare, from ambient documentation to virtual assistants. But as opportunities grow, so do risks. How can compliance and security leaders enable innovation while ensuring patient safety and regulatory alignment?  In this episode of Compliance Conversations , CJ Wolf talks with Walter Haydock , former national security advisor and founder of StackAware ....

In this episode of Compliance Conversations, CJ Wolf sits down with Melinda Hawk, recognized as Healthicity’s Revenue Cycle Manager of the Year , to talk about her career journey, leadership lessons, and the power of collaboration between compliance and revenue cycle teams.  What You’ll Learn:   Insights from 35 years in home health and hospice  The importance of compliance-revenue cycle communica...

In this episode of Compliance Conversations , CJ Wolf speaks with Eddie Qureshi , CEO of Rainfall Health , to break down the new CMS TEAM Model —and what it means for your hospital’s future.  What You’ll Learn:   Which hospitals are impacted (and how to check the list)  Why CMS is shifting post-acute accountability to hospitals  What compliant documentation, coordination, and reporting looks like ...

In this episode of Compliance Conversations, CJ Wolf , MD, is joined by Rui Ribeiro , Co-Founder and CEO of Jscrambler , to dive into the client-side security threats healthcare organizations often overlook.   From patient portals to embedded video players, Rui explains how browser-based vulnerabilities are creating new risks that healthcare teams need to be aware of.  You’ll learn:  Why client-si...

In this powerful episode of Compliance Conversations, CJ Wolf interviews Dave Cardelle , RPh, Chief Strategy Officer at AMS , who shares practical insights on CMS’s shifting enforcement landscape and the real-world impact of hospital price transparency.  What You’ll Learn:  What makes a machine-readable file compliant (and what doesn’t)  Why average negotiated rates are the most challenging—and mo...

In this episode of Compliance Conversations , CJ Wolf welcomes back Maya Turner , a nationally recognized expert in medical coding and consulting. Together, they explore how value-based care and ancillary services are transforming provider reimbursement, especially in a telehealth-enabled world.  You'll learn:  What value-based care really means (and why it matters)  The billing codes you may...

Aaron Burnett , CEO of Wheelhouse Digital Marketing Group, joins CJ Wolf to decode the complex world of healthcare marketing, privacy laws, and risk mitigation.  What You’ll Learn:   The evolving legal landscape: OCR guidance , AHA lawsuits, FTC enforcement   Why third-party tracking is out—and what to use instead  How to collaborate across marketing, IT, and compliance  What “data destiny” really...