Summary

In this episode, Sean M Weiss and Terry Fletcher discuss the complexities of compliance in healthcare, particularly as the year comes to a close. They explore the importance of understanding revenue cycle management, the disconnect between clinical and payer policies, and the necessity of reading contracts thoroughly. The conversation emphasizes the need for common sense in clinical practices and the critical role of compliance programs in healthcare settings.

Takeaways

• The importance of understanding revenue cycle management as the year ends.
• There is often a disconnect between clinical policies and payer policies.
• Providers must read and understand their contracts before signing.
• Medicare sets the standard for many insurance companies' policies.
• Insurance companies prioritize profit over patient care.
• Common sense is crucial in clinical practices and billing.
• Services should only be billed once completed, not prematurely.
• A written compliance plan is essential for healthcare practices.
• Compliance programs should be dynamic and regularly updated.
• Payer policies must align with clinical practices for effective compliance.