Guess What? Compliance Can Be Simple!

Everyone followed the rule. The patient still could not explain their own treatment plan afterward.

In this episode of Guess What? Compliance Can Be Simple!, Dr. Natasha Guess examines a 2024 Department of Justice case involving a major healthcare system and the exclusion of support persons for patients with disabilities. She walks through why offering an accommodation is not the same thing as confirming it worked, what effective communication actually requires under the law, and the specific operational process every practice needs before, during, and after a patient encounter to catch this gap before a regulator does.

If your practice has ever relied on a policy to answer a question that only a person in the room could actually answer, this episode is for you.

Guess What? Compliance Can Be Simple! is hosted by Dr. Natasha Guess, founder of Guess Compliance Consulting LLC.

Spotify: https://open.spotify.com/show/0PiHkaXMXOJk2NfWm5UfUm?si=jjDtTOaZQ9SfDtn7-trA7Q
Apple Podcasts: https://podcasts.apple.com/us/podcast/guess-what-compliance-can-be-simple/id1853309920YouTube: https://www.youtube.com/playlist?list=PLsdYEfN6ziUxSXY0sefq0e1XMXUdJaF7P

Resources mentioned in this episode:

Request a Compliance Diagnostic:
https://guesscomplianceconsultingllc.com/compliance-diagnostic

What happens when a growing healthcare practice needs someone to start immediately—but the required checks have not been completed?

In Episode 47, Dr. Natasha Guess examines how an ordinary hiring decision can become a serious compliance risk when onboarding moves faster than screening, credentialing, and operational oversight.

You will learn:

• Why hiring an employee and clearing them to perform healthcare services are not the same decision
• How rapid growth can expose weaknesses in onboarding and workforce screening
• Why assigning a screening task is not enough without documented verification
• One practical question leaders can use to test their pre-start process

Your practice may have screening requirements on paper. But would your actual workflow stop an employee from working if one of those checks had not been completed?

Take the free Practice Risk Assessment to identify potential operational gaps inside your practice:

https://guesscomplianceconsultingllc.com/compliance-diagnostic-

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.com
LinkedIn: Dr. Natasha Guess

Your practice launches a new service. The technology works, patients are being enrolled, and claims are ready to go.

Then someone asks: “Has compliance reviewed this?”

In this episode, Dr. Natasha Guess examines what can happen when growth moves faster than a practice’s compliance systems. Using a federal remote patient monitoring case, she explores why a service can appear ready for launch while important operational requirements remain unresolved.

You will learn:

• Why a vendor’s assurance may not be enough
• The compliance questions that can get missed during a fast launch
• How technology, workflow, documentation, and billing can fall out of alignment
• Why compliance should be involved before the launch date is set

If your practice has recently added a new service, technology, location, or provider type, this episode will help you consider whether your compliance operation has kept pace with that growth.

Resources mentioned in this episode:

Compliance Diagnostic: https://guesscomplianceconsultingllc.com/compliance-diagnostic-

Listen now:

Spotify: https://open.spotify.com/show/0PiHkaXMXOJk2NfWm5UfUm

Apple Podcasts: https://podcasts.apple.com/us/podcast/guess-what-compliance-can-be-simple/id1853309920

Connect with Dr. Natasha Guess:

Website: https://guesscomplianceconsultingllc.com

LinkedIn: Dr. Natasha Guess

If you asked five employees right now what AI tools they actually use to do their jobs, and then asked leadership what AI tools have actually been approved, would those two lists match?

In this episode, Dr. Natasha Guess breaks down why that gap, not the absence of an AI policy, is often the real compliance risk hiding inside growing practices. She connects it to a recent federal development in AI oversight, and walks through exactly how to find out where your own practice stands before the gap finds you first.

You will learn:

• Why "they are only using it to save time" is not actually a governance answer
• The real difference between an approved AI tool and one an employee just started using on their own
• Why approving a tool once is not the end of the governance process
• A simple, five-person exercise you can run this week to find your own AI visibility gap

If you are not confident you could name every AI tool currently being used inside your practice, this episode is worth twenty minutes of your time.

Resources mentioned in this episode:Compliance Confidence Assessment: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Listen now:Spotify: https://open.spotify.com/show/0PiHkaXMXOJk2NfWm5UfUmApple Podcasts: https://podcasts.apple.com/us/podcast/guess-what-compliance-can-be-simple/id1853309920

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.comLinkedIn: Dr. Natasha Guess

There is a compliance question that does not get nearly enough attention. What happens when your patient cannot effectively communicate with your staff? Not because they are not trying, but because your practice has not built a reliable process to meet their communication needs.

In this episode, Dr. Natasha Guess breaks down a real resolution involving a repeated communication failure, and a strikingly similar case resolved by federal regulators at a completely different kind of facility around the same time. Together, they show this is not a niche accessibility issue that only applies to certain specialties.

You will learn:

• Why effective communication is a meaningfully higher bar than most practices assume they are operating under
• Why relying on a family member to interpret informally does not meet the standard, and what actually does
• How to reverse engineer a real communication access system before you ever need one
• The exact question to ask your front desk this week to find out whether you have a functioning process or just good intentions

If your practice has ever assumed "we will figure it out when the patient arrives," this episode is worth twenty minutes of your time.

Resources mentioned in this episode:Compliance Confidence Assessment: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Listen now:Spotify: https://open.spotify.com/show/0PiHkaXMXOJk2NfWm5UfUmApple Podcasts: https://podcasts.apple.com/us/podcast/guess-what-compliance-can-be-simple/id1853309920

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.comLinkedIn: Dr. Natasha Guess

Vendors can make running a healthcare practice easier. They bring technology, testing, billing support, new services, and sometimes new revenue opportunities. But there is one question leadership needs to ask before letting a vendor's process into the clinical workflow: who is actually making the healthcare decision?

In this episode, Dr. Natasha Guess breaks down a case that is not an isolated incident. It is part of a pattern federal investigators have been working through for nearly two years, across practices that never worked with each other, all tied to the exact same kind of vendor arrangement.

You will learn:

• Why convenience from a vendor is never a compliance defense
• The specific sequencing detail that can turn an ordinary vendor relationship into a federal case
• How to map what actually happens, in what order, from the moment a vendor enters your workflow to the moment a claim goes out
• The one question every vendor relationship touching diagnosis, testing, or referrals should be able to answer

If your practice works with any outside vendor for labs, diagnostic testing, technology, billing, AI tools, or marketing, this episode is worth twenty minutes of your time.

Resources mentioned in this episode:Compliance Confidence Assessment: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Listen now:Spotify: https://open.spotify.com/show/0PiHkaXMXOJk2NfWm5UfUmApple Podcasts: https://podcasts.apple.com/us/podcast/guess-what-compliance-can-be-simple/id1853309920

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.comLinkedIn: Dr. Natasha Guess

Hiring someone with an active license does not mean that license stays active forever. So when was the last time anyone actually checked?

In this episode, Dr. Natasha Guess breaks down a real self-disclosure case, and several others like it, that all trace back to the same operational gap: credential monitoring that lives in someone's memory instead of in a system.

You will learn:

• The difference between two checks most practices only run one of, and why missing either one creates real exposure
• Why self-disclosing a problem you find yourself is often the smarter financial and reputational path
• What a real credentialing system needs to include, beyond what happens during hiring
• A practical five-person exercise you can run this week to find your own credentialing gaps

If your credentialing process stops the day someone gets hired, this episode is for you.

Resources mentioned in this episode:Compliance Confidence Assessment: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.com
LinkedIn: Dr. Natasha Guess

Finding a compliance problem sounds like a success story. It is not always one.

In this episode, Dr. Natasha Guess breaks down a real enforcement action that shows exactly what can happen in the space between finding a problem and actually doing something about it, and why that gap is where a good compliance story can quietly turn into a serious one.

You will learn:

• Why finding a problem is only half the job, and what actually happens next determines everything
• The federal deadline most practices do not even know exists once a problem has been identified
• The honest, unglamorous reasons money that has already been identified as owed still does not get returned
• A practical way to trace one finding all the way through, from discovery to resolution, so you can see exactly where your own process breaks down

If your practice has ever run an internal audit, a billing review, or a chart review, this episode is worth twenty minutes of your time.

Resources mentioned in this episode:

Compliance Confidence Assessment: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.com
LinkedIn: Dr. Natasha Guess

A signed Business Associate Agreement feels like proof that your vendor relationships are covered. It is not.

In this episode, Dr. Natasha Guess breaks down two real enforcement actions that show exactly where the gap between a signed BAA and actual vendor oversight tends to show up, and why that gap is one of the most common operational risks in small and mid-size healthcare practices today.

You will learn:

• Why a signed BAA is the starting point of vendor governance, not the finish line
• What regulators are actually looking for when a vendor is involved in a breach or a patient rights complaint
• The two questions every practice owner and office manager should be able to answer about their vendors right now
• A practical, five-question exercise you can run this week to find your own vendor oversight gaps before regulators do

If your practice relies on any outside vendor for your EHR, billing, IT, cloud storage, or AI tools, this episode is worth twenty minutes of your time.

Resources mentioned in this episode:Compliance Confidence Assessment: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Connect with Dr. Natasha Guess:Website: https://guesscomplianceconsultingllc.comLinkedIn: Dr. Natasha Guess

Most people assume federal enforcement only happens to large health systems. This episode looks at a real case involving a physician practice and a $1.45 million settlement, and why the actual lesson has nothing to do with the dollar amount.

Dr. Natasha Guess breaks down what regulators are really looking for when they investigate a practice's billing operations, why "I trust my staff" isn't a compliance strategy, and what it actually costs a practice once an investigation begins, far beyond the settlement figure itself.

In this episode, you'll learn:

• Why every claim a practice submits represents a chain of operational decisions, not just a billing transaction
• The difference between trusting your team and having a system that actually verifies their work
• What happens to a practice's reputation, referral relationships, and leadership capacity once a federal investigation starts
• A practical action step you can start on this week to find your own compliance blind spot

Resources mentioned in this episode:

Take the Compliance Confidence Assessment™ to find your practice's operational gaps before they become audit findings, enforcement actions, or costly disruptions: https://guesscomplianceconsulting.myflodesk.com/compliance-confidence-assessment

Listen to this episode:

Apple Podcasts: https://podcasts.apple.com/us/podcast/guess-what-compliance-can-be-simple/id1853309920Spotify: https://open.spotify.com/show/0PiHkaXMXOJk2NfWm5UfUm

About the Show:Guess What? Compliance Can Be Simple! is hosted by Dr. Natasha Guess, Founder and CEO of Guess Compliance Consulting LLC, helping small and mid-size healthcare practices build compliance operations that function in real day-to-day workflows, not just on paper.

Connect with Natasha:Website: guesscomplianceconsultingllc.comLinkedIn: www.linkedin.com/in/dr-natasha-guess-dlp-msl-bs-chc-chpc-306a0963

#HealthcareCompliance #OperationalCompliance #HIPAA #PracticeManagement