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The Compliance Guy
By Sean M. WeissBusiness
The Compliance Guy episodes
- Eason 6 - Episode 42 - Monday Coding and Compliance Roundtable
Terry, Christine, and Stephanie joined Sean to discuss a variety of pressing topics impacting compliance and operations.
Topics for Discussion:
- Billing for bundled or non-covered services “hoping” to get paid and then writing it off if you don’t.
- trying to bill to insurance an injection code when it’s on the list of “likely self administered” because the patient doesn’t want to self Inject.
- not verifying patient's insurance coverage, getting denials and then billing the patient-
So much to discuss!53 min - Season 6 - Episode 41 - #TerryTuesday - Don't Do That... It's Stupid!
This is a very special episode of The Compliance Guy #TerryTuesday... There is some signing, and somethings that we refer to as "Don't Do That... It's Stupid!
26 min - Season 6 - Episode 40 - Monday Coding and Compliance Roundtable
Join Stephanie, Terry, Christine, Scott, and Paul as they sit down with Sean to discuss a variety of coding and compliance topics including:
1. Traveling overseas and needing medical attention... who is going to pay for it?
2. Modifier 25 CMS/AMA Joint Definitional Change...
1 hr 4 min - Season 6 - Episode 39 - #TerryTuesday - RCM
In this episode, Sean and Terry take on Revenue Cycle Management and the role of compliance in operations.
31 min - Season 6 - Episode 38 - #Terry Tuesday
You favorite dynamic duo is back and at it again! In this episode Sean and Terry take on the different types of audits... This episode is a must for every type of healthcare organization!
24 min - Season 6 - Episode 37 - Monday Coding and Compliance Roundtable
The entire crew (Christine, Terry, Scott, Paul, and Stephanie) is back for an outstanding roundtable discussion that is wide-ranging and full of great content!
1. Orders for tests and how the EMR impacts how specific tests are displayed in a note and the impact given for credit for towards data and MDM.
2. Cyber Security Attacks on healthcare providers (CMS Warning) and how to be diligent in your efforts!
3. The impact of private equity money and the latest claims of price gouging by the government against anesthesia groups!
4. What it means to be the subject of an investigation, the impact on your professional and personal life and that of the people surrounding you!
5. Being convicted of a healthcare crime and whether it leads to OIG Exclusion even if you are cooperating with the DOJ.Don't miss this one!
1 hr 5 min - Season 6 - Episode 36 - #Terry Tuesday
Terry and Sean take on can I do this because the doctor down the street does it... and what happens when you don't stay in your lane!
28 min - Season 6 - Episode 35 - Monday Coding and Compliance Roundtable
We had a great line-up of topics on this episode:
1. Orders for tests and how the EMR impacts how specific tests are displayed in a note and the impact given for credit for towards data and MDM.
2. Cyber Security Attacks on healthcare providers (CMS Warning) and how to be diligent in your efforts!
3. The impact of private equity money and the latest claims of price gouging by the government against anesthesia groups!
4. What it means to be the subject of an investigation, the impact on your professional and personal life and that of the people surrounding you!
5. Being convicted of a healthcare crime and whether it leads to OIG Exclusion even if you are cooperating with the DOJ.1 hr 2 min - Season 6 - Episode 34 - Dr. Carolyn Ward / Particle Health
Sean was joined by Dr. Carolyn Ward, Director of Clinical Strategy for Particle Health to discuss challenges with interoperability and other dynamic challenges facing healthcare professionals...
About Dr. Ward:
Carolyn Ward is a dynamic and driven internal medicine physician with a passion for physician empowerment and data-driven decision making. With over eight years of experience in healthcare, including as Chief Resident at Rutgers Robert Wood Johnson Medical School, she has established herself as a leader in the field. As the Director of Clinical Strategy at Particle Health, Carolyn has taken her experience to the next level. She is responsible for developing the clinical product roadmap for the organization, ensuring that providers and patients are represented throughout the research and development process.
Carolyn's mission is to enable simple and secure access to actionable patient data through Particle's modern API platform. She believes that the health data system must be more cohesive to prevent digital friction and to promote positive patient outcomes. Carolyn is an ideal fit for podcasts targeting audiences of C-suite executives and founders for health tech companies, physicians, and women in tech. She can offer unique insights on topics such as healthcare interoperability, AI in health data management, digital health innovation, and value based care innovation. Her knowledge, experience, and her passion make her an outstanding guest for any podcast looking to explore the challenges facing the industry and the opportunities for innovation.43 min - Season 6 - Episode 33 - Dr. Brian Fengler of EvidenceCare
On this episode, Sean was joined by Dr. Brian Fengler of EvidenceCare to discuss the state of healthcare and what he as an Emergency Room Physician has see as opportunities to gain access to evidence based care information to assist in the treatment of patients at bedside faster and more accurately.
About Dr. Fengler: (https://evidence.care/)
Dr. Brian Fengler is the co-founder and Chief Medical Officer of EvidenceCare. During his career as an emergency medicine physician, Brian saw and experienced a provider struggle to access evidence-based content quickly and at the bedside. Looking to fill this gap, Brian founded EvidenceCare in 2014.
After finishing his residency at the University of Virginia Health System in 2008, Brian moved to Nashville where he began his practice in the emergency department of St. Thomas Health System. He was also a founding physician and managing director of Physicians Urgent Care and a partner-owner of Middle Tennessee Emergency Partners physician group. During these ventures, he served as an assistant professor of emergency medicine for the University of Tennessee/St. Thomas residency program. In 2016, Dr. Fengler left the daily practice of medicine to focus full-time on his work at EvidenceCare.
42 min
About The Compliance Guy
From the publisher's feed
Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals.
The show features interviews of industry leaders, government officials, and others helping to shape the healthcare landscape.
Sean M. Weiss (AKA – The Compliance Guy) has been an industry respected name for more than 25-years. A physician and health system advocate, Sean engages with clients to ensure a “level-playing-field” and due process when allegations and/or accusations of impropriety are leveled by a payor or government investigation agency.
When Sean is not engaging in administrative, civil and criminal matters on behalf of more than 30 nationally recognized law firms and clients, he is serving as a third-party compliance officer for a dozen organization across the country ranging in size and specialty to ensure a “Culture of Compliance”!
Sean is a proud member in good-standing with the National Society of Certified Healthcare Business Consultants (NSCHBC), American Health Lawyers Association (AHLA), National Alliance of Medical Auditing Specialists (NAMAS), and the American Academy of Professional Coders (AAPC). Sean holds (CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC, CMC, CMIS, CMOM) national certifications from the Health Care Compliance Association, The National Alliance of Medical Auditing Specialists, The American Academy of Professional Coders and Practice Management Institute.