The Compliance Guy

In this Episode the entire All-Star Panel is back together to discuss the latest most pressing coding and compliance issues healthcare organizations are facing! The panel takes on Computer Assisted Coding (CAC) and the problems that come with this technology as well as the significant differences between office, inpatient and facility coding when it comes to EM Guidelines.  Such a great episo...

Shay Eskew joins #thecomplianceguy tomorrow at 11am right here on #linkedinlive for an insightful discussion on life, surviving, healthcare and so much more. PLEASE DO NOT MISS THIS ONE!!! Shay is the CSO of CirclesX – a technology company & the Chief People Officer of Shay Eskew – Motivational Speaking and Consulting. He is an All-American & top 1% All World ranked #ironman triathlete, bu...

The all star cast of characters is back as they join Sean to discuss 2023 em services and the impact changes have and will have on your coding and compliance! Christine Hall CHC CPC , CPB, CPMA, CRC, CEMC, CPC-I / Scott Kraft Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM / Stephanie Allard, CPC, CEMA, RHIT / John Paul Spencer will join me to discuss how the AMA has added so muc...

Terry joins Sean to discuss a variety of coding and compliance related topics including the critical importance of following instructions and complying with published guidance. The conversation also addresses the Clean Claims Payment (42 CFR 447.45), Christmas Trees and being a farmer... Enjoy!  For more information on Terry and her service offerings visit her at www.terryfletcher.net 

In this episode Collin Callahan of Flannery Georgalis joins Sean to discuss what a prosecutor / defense counsel looks for in an expert, why expert reports are so critical, the dos and don’ts of SMEs and their reports, Daubert Motions vs Motion in Limine, and more... There are even some tributes to Runaway Jury and a Few Good Men! Don't miss this outstanding episode with one of Sean's favorite gues...

In this episode Sean hits on a Daubert Motion, which is a type of motion which seeks to exclude the presentation of an expert's testimony to a jury. Daubert motions are named for the Supreme Court case, Daubert v. Merrell Dow Pharm., Inc. (509 U.S. 579 (1993)). Rules 702 and 703 of the Federal Rules of Evidence govern the admission of scientific evidence in federal court. The rules allow expert wi...

Terry joins Sean to discuss Compliance Programs and Obligations for participating with all insurance companies... The difference between compliance plans and compliance programs, why compliance fails in smaller practices and how things like the No Surprise Act impact your efforts!  There's also a discussion about a pink comfy, Tom doing laundry and making coffee, and so many other things to k...

On this Monday roundtable discussion Sean is joined by Terry Fletcher, Christine Hall, Paul Spencer and Scott Kraft to discuss coding and compliance issues plaguing hospitals and physician practices. The panel addresses providers creating and signing notes prior to ever seeing the patient, cloning, clinical plagiarism, impact of not having a compliance plan, and so much more.   

Dawn Carter, Director of Product Strategy of Centauri Health Solutions joined Sean to discuss Risk Adjustment Audits and the ins and outs of these often times annoying administrative requirements if you participate with an MA Plan... This was such an interesting discussion and we believe you will think so too!  Links to articles from the show: Article 1:  Medicare Advantage, Direct Contr...

Terry joins Sean to discuss the ins and outs of Medicare Advantage (MA) and what you really need to know about these plans. Why is the OIG investigating MA plans and what are they finding. Don't miss this one!

Sean was joined by an all star panel of guests including Christine Hall, Paul Spencer, Terry Fletcher and Scott Kraft to discuss "Scary Scenarios" they've each dealt with over the past week and what you need to know to avoid the same costly mistakes as others... Don't miss this one as it's an absolute fright! 

In this episode I am joined by Stephen Soloway MD FACP FACR to discuss his new book "Medical Politics" This dynamic book shows you through a Non-Fictional lens health care's landscape and all that is wrong with it! You can find the book on Amazon ( https://lnkd.in/gP4UrfWh ), at Target or at Barns & Nobel Book Store or wherever books are sold!

In this episode of the Daily Dose Sean discusses and reads the Foreword of Dr. Stephen Soloway's new book "Medical Politics" This dynamic book takes you through a Non-Fictional lens of health care's landscape and all that is wrong with it! 

Terry Fletcher joins Sean on this #TerryTuesday Episode of The Compliance Guy to discuss Time Based Coding, Las Vegas, The Steelers and other fun facts! Don't miss this one as Sean and Terry hit their stride! 

Terry Fletcher joins Sean to discuss the PHE and its impact on the healthcare industry! No matter what side of the isle you sit on this should not be a political issue but rather a business and compliance issue and that is what Sean and Terry focus on!  Don't miss this one! 

On this roundtable Sean is joined by Terry Fletcher, Karen George, Stephanie Allard, Christine Hall, and Paul spencer for a discussion on the following:  1. Information Blocking Rule 2. No Surprises Act / Independent Dispute Resolution 3. Preparing for a Payor and/or Contractor Audit  4. MDD Audits and their impact on HCCs

This is part 2 of the series on using the Gap Analysis to develop and implement an effective compliance program in your organization... Do not miss this episode because Sean delivers the punchline! 

In this episode Sean takes on the critical aspects tied to GAP analysis and what they are, how to perform one and how it impacts your ability to build an effective compliance program, which leads to demonstrating a "Culture of Compliance"!  Don't miss this one! 

This is an awesome episode with my very good friend Terry Fletcher. Take a listen as our answer(s) may shock you! 

After a week of being off for Conferences Sean is back with an all new episode... Today's focus is delivering audit results to providers in the most effective and efficient way! 

Terry joins Sean to discuss a variety of topics including ablations, bilateral services and other nuanced issues impacting health care organizations. Don't miss this one!  

Terry Fletcher, Christine Hall, Scott Kraft and Paul Spencer joined the Coding and Compliance Roundtable to discuss a host of critical topics including:  1. Evaluation and Management Services - What does it mean to take a clinically relevant history and examination 2. Telehealth Services - The Challenge Continues  3. Incident-to Services - Can a Physician bill Incident to another physici...

Sean was joined by Scott Kraft, Christine Hall, Paul Spencer, Stephanie Allard and Terry Fletcher to discuss all of the latest in the world of coding and compliance. 

In this episode Sean and Terry tackle "Split Visits" not to be confused with "Split-shared Visits"... E/M Services on the same date as a preventive service have and continue to cause a lot of confusion for coders and billers. Hangout with us for a bit and let us clear up the confusion.

In this episode Sean takes on Templated Compliance Plans and the Do's and Don'ts! Taking the time to understand how compliance templates work for and against you is critical to establishing an effective program. The key takeaway from this podcast should be, “Don’t Be Lazy” if using a template… spend the time and effort on the front end to save you money, and your sanity on the back end.