Michael Warner, an Osteopathic physician, board certified in family medicine, turned patients’ rights advocate has a lot say about a patient’s rights to access. Warner is passionate about empowering patients to co-author their medical record. Through his research, Warner has found that giving patients the opportunity to take control of their information greatly increases accuracy, efficiency, and patient satisfaction. In a post-study follow-up survey, most patients reported that they “appreciated being given the chance to co-author” their medical records. For any healthcare organization, this is music. Listen to this episode, Patients Empowered: Improving Accuracy Through Co-Authorship, to learn how to: Collect patient data before their visit to maximize efficiency. Share history, exam, and Medical Decision Making with patients for accuracy. How HIPAA’s privacy rule allows patients to amend their records.

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Everything You Never Knew You Needed to Know About ACO Compliance by CJ Wolf

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In this episode of Compliance Conversations, I sat down with Stephani Scott, VP of Audit Services for Healthicity, to chat about her twenty years of experience and pick her brain on important auditing issues. As all of you know, auditing is a crucial component of an effective compliance program. Stephani explains how she approaches post-audit education with difficult providers, “I always tell them to be prepared first and foremost.” Then she adds, “make sure you’ve reviewed the audit and you know where they did well. Sometimes the effectiveness depends on your approach.” Scott provides rules for post-audit education, like how to deal with a physician who inherently distrusts auditors or bad apples who code incorrectly on purpose. Tune in to learn the auditing ropes with expert Stephani Scott and learn how to: • Build Trust with Providers• Effectively Change Behaviors• Approach Post Audit Educations Like a Pro• Deal with Bad Apples

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In this episode of Compliance Conversations: I asked compliance and healthcare law expert Marcie Swenson, “What do you think the hot topics will be for 2018.” And she gave us two answers: “Benchmarking and data breaches and cyber security.” Organizations will be utilizing OIG guidance to create their own benchmarks and rate their own compliance program. I also asked Marci what she hoped to see differently in 2018 and she passionately responded, “more risk assessments. To be proactive in compliance you have to perform a risk assessment.” Tune in to this episode of Compliance Conversations: Benchmarking Your Way to Compliance, for hot topic predictions and tips for 2018 including how to: Use the OIG Guide to Benchmark Your ProgramPrepare for Cyber Threats and Data BreachesUtilize Risk Assessments

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Find out how Culture can Solve Compliance Issues“Compliance professionals were people before they were in compliance,” said Rudy Green in our most recent episode of Compliance Conversations. Green told me about his long and interesting path to compliance from an undergraduate degree in organizational behavior, to being drafted into the NFL, then to law school. He did all of this before taking a position as the compliance officer at the University of Texas in Austin. He added, “life experience is what makes a great compliance officer,” he said. Compliance professionals are critical to a company’s success (especially in healthcare). So, it only makes sense that company culture counts. Could company culture be the answer to solving compliance issues? The data suggests yes but — big surprise — it’s not always that easy.Tune in to this episode of Compliance Conversations to learn how to: Effectively Deal with Complex Issues as They AriseTackle Risk Assessment the Right WayUse Patience as a Compliance Tool

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In this episode, compliance expert CJ Wolf sits down with product development expert Jeff Young to discuss tools that can simplify compliance and make you so much more effective as a compliance officer. Young explains how tools are changing healthcare organizations, “with the tools that are out there today you can gather data consistently in one location, identify risks based on data trends and decide what to do. Maybe you need to put a new policy in place, or you need to introduce training to your organization. The idea is that it gives you the power to get away from some of this manual work by utilizing technology to help automate and optimize what you’re doing as a compliance officer.” Regarding random audits, Young asks, “if you’re looking at just ten random records, how do you know those are representative of what the physicians doing, and how does it really help you to understand where you need to focus for that physician?” Listen to this episode to learn how to utilize technology to decrease manual labor, improve training, easily identify risks, and much, much more!

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For this episode of Compliance Conversations, I sat down with Chad Peterson, a senior consultant at a large hospital, in their professional coding and reimbursement group. He educates physicians, mid-level providers/ advanced practice providers and even ancillary staff about E/M coding. Peterson explained some of the most common E/M coding mistakes. For example, in 2013 they came out with the status of 3 chronic conditions in addition to the already set guidelines. There’s often confusion around when to use regular HPI elements or when to use the status of 3 chronic conditions. “This is something really useful for your physicians,” Peterson added. Tune in to this episode of Compliance Conversations, “E/M Coding Tips and Risks,” to learn: How to navigate the gray areas of medical necessity When to use the chronic conditions statusWhy the risks of EMR upcoding and auto-populating are so grave

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I recently talked with Christopher Chandler, a senior consultant at a large medical group in the professional coding and reimbursements department. Christopher explained a whole slew of common misunderstandings of surgical coding. We soon realized that at the end of the day, many people just don’t understand the coding system. There’s so much confusion about how the coding system works, how ICD coding works with CPT coding, and even more confusion when multiple procedures overlap. It’s cause for a lot of mistakes–and a ton of stress. But, when you really understand the system, you can navigate surgical coding in a way that will accurately reflect what the physician’s doing, regardless of complexity. Rid your life of added stress by becoming a surgical coding expert by listening to our newest podcast, Common Misunderstandings of Surgical Coding, where you’ll learn how to:Ensure reimbursement through accurate codingCode separate procedures Avoid over-coding, coding post-op work, and more!

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In this episode of Compliance Conversations, I sat down with Senior Consultant, Brenden O’Neil, who works in Intermountain’s professional coding and reimbursement department. O’Neil and I had a fascinating discussion on CPT codes and the complicated gray area of coding a laminectomy. The code has changed, physicians are in limbo, and revenue is being lost. And, there are a number of compliance issues that might arise. If you’re a compliance officer in an organization with neurosurgeons, you should perform an audit and run some data analytics for the code 22633 or that range of codes that represent fusions anytime a 63047 or laminectomy is reported. Otherwise, there could be trouble on the horizon. If you’re in healthcare, you won’t want to miss this. Listen to our newest podcast, Complex Coding, Complicated Compliance, to brush up on: Laminectomy and Potential Compliance IssuesSpecific Updates to Code 63047Payers, Medicaid, and more!

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In this episode, Sean McKenna, Shareholder at Greenberg Traurig, and I discussed the ins-and-outs DOJ and OIG investigations, and how the federal government is determining who–and how–they prosecute. While we all know the importance of having a robust, effective compliance plan, Sean also stresses the importance of having an independent and empowered compliance committee. One which refuses to bury it’s head in the sand when compliance issues surface. In his experience, organizations that operate routine, transparent compliance programs will be equipped with the best line of defense. Tune in to our Compliance Conversations podcast, Proactive Compliance is Your Best Defense, to listen to Sean and CJ dive into: Why incident reporting and documentation needs to be taken seriously What the OIG constitutes as an illegal kickbackHow to protect your organization from false claims investigations

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