The Compliance Guy

Episode 347 - Monday Auditing, Coding and Compliance Roundtable


Listen Later

Summary

This round table discussion focuses on critical aspects of healthcare compliance, particularly around deductibles, copays, telehealth, and billing practices. The panelists emphasize the importance of understanding patient financial responsibilities, the need for modernized billing processes, and the legal implications of waiving deductibles. They also discuss the nuances of telehealth services and the risks associated with blanket orders in laboratory testing. In this conversation, the speakers discuss critical aspects of healthcare compliance, focusing on medical necessity, standing orders, genetic testing, and telehealth codes. They emphasize the importance of ensuring that medical services are justified and appropriately billed to avoid legal repercussions. The discussion also highlights the evolving landscape of telehealth and the need for healthcare providers to stay informed about regulations and best practices.

Takeaways

  • Patients are increasingly burdened by high deductibles and copays.
  • Practices must ensure they collect patient financial responsibilities upfront.
  • Consultants can provide valuable insights into managing patient costs effectively.
  • Telehealth services must adhere to strict compliance guidelines.
  • Routine waiving of deductibles can lead to legal issues for providers.
  • Modernizing billing processes is essential for patient satisfaction.
  • Preventive services should be prioritized to maximize reimbursement.
  • Blanket orders for lab tests are not compliant with regulations.
  • Providers must clearly communicate costs to patients before services are rendered.
  • Maintaining compliance is crucial for the sustainability of healthcare practices. Medical necessity is crucial for appropriate patient care.
  • Standing orders can lead to unnecessary tests and costs.
  • Patients may face increased financial responsibilities due to blanket orders.
  • Genetic testing must be medically indicated, not patient-requested.
  • Healthcare providers should be aware of the legal implications of their orders.
  • Telehealth codes are still in flux and require careful navigation.
  • Consultants can help practices optimize their billing and compliance processes.
  • Regular audits can uncover missed opportunities for reimbursement.
  • Laboratory services must be treated as medical services with proper documentation.
  • Staying informed about changes in healthcare regulations is essential.
  • ...more
    View all episodesView all episodes
    Download on the App Store

    The Compliance GuyBy Sean M. Weiss

    • 4.9
    • 4.9
    • 4.9
    • 4.9
    • 4.9

    4.9

    36 ratings


    More shows like The Compliance Guy

    View all
    My Favorite Murder with Karen Kilgariff and Georgia Hardstark by Exactly Right and iHeartPodcasts

    My Favorite Murder with Karen Kilgariff and Georgia Hardstark

    172,017 Listeners

    Compliance Conversations by Healthicity by CJ Wolf

    Compliance Conversations by Healthicity

    18 Listeners

    The Daily by The New York Times

    The Daily

    112,277 Listeners

    Up First from NPR by NPR

    Up First from NPR

    56,530 Listeners

    CodeCast | Medical Billing and Coding Insights by Terry Fletcher

    CodeCast | Medical Billing and Coding Insights

    203 Listeners

    Crime Junkie by Audiochuck

    Crime Junkie

    368,960 Listeners

    Talk Ten Tuesdays by ICD10monitor

    Talk Ten Tuesdays

    40 Listeners

    Morbid by Ash Kelley & Alaina Urquhart

    Morbid

    99,364 Listeners

    Monitor Mondays by RACmonitor

    Monitor Mondays

    25 Listeners

    Paint The Medical Picture Podcast by Sonal Patel

    Paint The Medical Picture Podcast

    25 Listeners

    The Ezra Klein Show by New York Times Opinion

    The Ezra Klein Show

    15,918 Listeners

    The Deck by Audiochuck

    The Deck

    11,686 Listeners

    For The Love of Revenue Cycle by Vanessa Moldovan

    For The Love of Revenue Cycle

    23 Listeners

    Auditing Antics: Navigating Medical Coding and Auditing by Stephanie Allard Consulting, LLC

    Auditing Antics: Navigating Medical Coding and Auditing

    10 Listeners

    False Claims Act Insights by Jonathan Porter

    False Claims Act Insights

    4 Listeners