The Compliance Guy

The team was back and took on when it does and does not make sense to employ remote workers as well as the do's and don'ts. The team also took on AI and the inherent risks associated with EHRs deploying this technology into their systems.

Before you say, "not again" keep in mind these are the problem child of providers and the government. The provisional services continue to create problems and until the ambiguous aspects of these services are more clearly defined we will have to continue threading the needle to keep you compliant.

The entire cast is back this week taking on the most complex and challenging issues tied to medical auditing, coding, and compliance...

In this episode Sean takes on effective leadership and what it takes to lead a team. While Sean is known as "The Compliance Guy" he started his professional career in practice management back in the mid-90s amid all the consolidation and acquisitions by the health systems "Physician Services" Groups. Take a listen... you just may be surprised at what a regulatory compliance professional knows abou...

The one and only Clint Pulver returns to The Compliance Guy to provide an update on his upcoming 2024 speaking tour, his new documentary (Finding Hill on YouTube), The Master Class Program, and so many more unbelievable amazing things Clint and his team are undertaking! Clint Pulver is a professional keynote speaker, author, musician, pilot, and workforce expert. Known as the leading authority on...

In the first Legal with Liles/Parker episode of 2024, Robert and Ashley sit down with Sean to discuss Compliance Risks in 2024! The list is long and distinguished...

Terry and Sean take on Cloning, Cut and Paste and Clinical Plagiarism... It is not as clear cut as you would think it is! Don't miss this one because the end-results could cost you dearly!

The All Star Panel was back taking on the latest in auditing, coding and compliance challenges for healthcare professionals.

Katie Deming, MD sits down with Sean to discuss engaging with those diagnosed with cancer. Dr. Deming, host of the Born to Heal Podcast and a #tedxspeaker , provides insightful and invaluable advice on communication. Don't miss this opportunity to change your outlook on how we engage with those diagnosed with cancer...

There is no doubt the machines are taking over! Terry and Sean explore how AI both helps and hurts providers of medical services and what they need to do to ensure they don't find themselves in a trap!

The All Star Panel is back for the first roundtable discussion of 2024 and what a great discussion it was. Topics Include: 1. G2211 - The New Add-on for Evaluation and Management Codes... The Dos and Don'ts 2. Medical Students - What they can and cannot provide as a services and the PATH Guidelines... 3. Laboratory Compliance - The world of lab services has been absolutely turned on its head o...

David sits down with Sean to discuss avoiding 2024 pitfalls with provider enrollment, credentialing, and contracting in addition to so much more. David is one of the most celebrated healthcare professionals and for good reason. Don't miss this one! Zetter Consulting Website: https://zetter.com/ NSCHBC Website: https://nschbc.org/

In this final episode of season 6 and the overall final episode of 2023 Terry joins sean to take on the critical nature of having a non-retaliation policy for your organization! You can't have a compliance program without one of these!

In this final roundtable discussion of 2023 the all star cast was back to address: 1. CPT Coding Changes for 2024 2. Impact of a transmittal change by CMS for chemo and Rheumatology Infusion Drugs 3. The impact of medical necessity 4. Documentation standards 5. The impact bad behavior has on a case at trial

CMS is at it once again with a new HCPCSII Code that will only lead to confusion and potential long-term audits and claw backs! Take a listen as Sean and Terry break down this one...

Terry, Scott, Paul, and Christine joined Sean for a great discussion... Topics include: 1. Holding on to overpayments when a refund, corrected claim, and/or self-disclosure should be made; 2. How to teach audit results... painting the wrong picture; 3. Wound care; 4. Critical mistakes providers make that lead to charges of healthcare fraud and/or false claims act violations... There is so much to...

Split/Shared Services is the theme of this episode and you do not want to miss this in-depth discussion!

The Allstar team was back together to discuss the latest changes to the AMA CPT Manual, Risk to Providers who Clone medical records, and so much more!

Terry and Sean take on 2024 changes from AMA/CMS regarding telehealth!

This episode is all about compliance... So much to unpack in so little time!

Terry, Christine, and Stephanie joined Sean to discuss a variety of pressing topics impacting compliance and operations. Topics for Discussion: - Billing for bundled or non-covered services “hoping” to get paid and then writing it off if you don’t. - trying to bill to insurance an injection code when it’s on the list of “likely self administered” because the patient doesn’t want to self Inject. -...

This is a very special episode of The Compliance Guy #TerryTuesday... There is some signing, and somethings that we refer to as "Don't Do That... It's Stupid!

Join Stephanie, Terry, Christine, Scott, and Paul as they sit down with Sean to discuss a variety of coding and compliance topics including: 1. Traveling overseas and needing medical attention... who is going to pay for it? 2. Modifier 25 CMS/AMA Joint Definitional Change...

In this episode, Sean and Terry take on Revenue Cycle Management and the role of compliance in operations.

You favorite dynamic duo is back and at it again! In this episode Sean and Terry take on the different types of audits... This episode is a must for every type of healthcare organization!