The Compliance Guy

The Panel takes on the most pressing issues facing healthcare providers today!

1. Medicare Physician Fee Schedule Update

2. G0136 - SD0H HCPCSII Code Dos and Don'ts

3. TPE Targeting Level II and IV EM Services

It was such a treat to have Christine Hall of Stirling Global Solutions (https://www.stirlingglobalsolutions.com/) join The Compliance Guy Podcast to discuss compliance and coding issues surrounding Chronic Care Management (CCM), Providers Failing to Issue Voluntary Refunds, and so much more!

In this episode Terry and Sean take on the updated Compliance Program Guidance from the OIG and more specifically the section dealing with quality and substandard care leading to prosecution. Don't miss this one!

Join Sean, Stephanie, Scott, Christine, and Terry as they take on:

1. Collaboration Agreements

2. CERT Studies and error rate

Terry and Sean take on providers who render services but choose to bill for a higher level of service than what was actually performed or what they are able to support with their documentation. Oh, but there is more... so much more!

The panel is back for a much-needed discussion on two critical topics that are generating a ton of issues for providers. We'll be addressing G2211, a code that requires specific requirements and documentation components to support it, and Incident-to, a provisional billing service that continues to wreak havoc on providers. Unfortunately, self-proclaimed "experts" in the area are leading providers and others to poor outcomes. Join Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM, Christine Hall CHC, John Paul Spencer, and Scott Kraft, along with me, as we take on these two critical topics.

Dan Cohen of PainScript joined Sean to discuss their innovative solution for managing opioid prescriptions. As the focus on prescriber compliance intensifies, Dan and his team have developed a HIPAA-compliant app that connects physicians with their chronic pain and SUD patients daily. Through real-time data and daily digital care, patients are more engaged in their health, improving treatment plan and medication adherence. Join us for this fascinating discussion with a true pioneer in the industry.

Terry joined Sean to discuss some of the more obscure aspects of HIPAA and what practices should be doing to cover their assets!

What do you do when a State Medicaid program and their contractor fail to comply with their own published guidance... you call The Compliance Guy! Listen to this episode and hear an unbelievable story of incompetence and what happens when folks dig their heels in to deep and lose in the end.

Paul Spencer Joins Sean to discuss all the details of this case.

Sean and Terry take on the risks associated with not following audit results whether internal or external results. Don't miss this one!