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The Compliance Guy
By Sean M. WeissBusiness
The Compliance Guy episodes
- Season 6 - Episode 2 - Legal with Liles / Parker - AdQIC
This episode is hands-down one of Sean's favorites to date... This episode exposes the Medicare Administrative Appeals Process for what it really is... Smoke and mirrors! The fact is, even if you prevail at the ALJ level there is a significant chance you can still lose the case based on an AdQIC referring the case to the Departmental Appeals Board (DAB)!
Sean is definitely in a rare and irritated mood, which makes this episode that much more enjoyable!
Charity of the Month - The Tafida Raqeeb Foundation was formally launched on 22 March 2022 in London, United Kingdom. The Foundation believes that every child deserves a chance to live after any suffering from any form of neurological condition. Every year over 300,000 children attend A&E in the UK with a head injury. Website: www.tr-foundation.org
54 min - Season 6 - Episode 1 - Jenna Godlewski - OIG Compliance Program Guidance Update
For the first time in 25-years the Office of Inspector General is updating the Compliance Program Guidance (CPG) for the entire healthcare industry! No more are the days of searching and reading the Federal Register... What will be the new delivery method? Tune in to find out!
Jenna K. Godlewski -
Jenna focuses solely on health care law and assists medical practices across the country on reimbursement, regulatory, and compliance matters. She helps clients reduce exposure, develop corrective action plans, and successfully appeal Medicare, Medicaid, and other federal payor recoupment claims. Another primary focus of her practice is handling CMS enrollment issues, payment suspensions, and revocation/exclusion appeals. Since joining the firm, she has also had the opportunity to assist clients with developing and restructuring their internal compliance programs.Jenna served for three years as a prosecutor for the City of Chicago where she handled over 100 cases at a time from filing through resolution. This experience has been beneficial in her current work of representing her clients in Administrative Law Judge hearings to appeal Medicare overpayments and in supporting her colleagues on healthcare litigation matters.Please take a look at our Charity of the Month - The Tafida Raqeeb Foundation was formally launched on 22 March 2022 in London, United Kingdom. The Foundation believes that every child deserves a chance to live after any suffering from any form of neurological condition. Every year over 300,000 children attend A&E in the UK with a head injury.Website: www.tr-foundation.org26 min - TCG - Season 5 - Episode 50 - #TerryTuesday - Concierge Medicine and Health Coaches
In this final episode of Season 5, Terry and Sean sit down to discuss concierge medicine and health coaches... when, where and how these services come into play and the pitfalls with providing them.
31 min - TCG - Season 5 - Episode 49 - Monday Coding and Compliance RoundtableThe entire #allstar panel (Terry A Fletcher BS CPC CEMC CCC CCS CCSP CMC ACS-CA SCP-CA, QMPM Christine Hall CHC CPC , CPB, CPMA, CRC, CEMC, CPC-I Stephanie Allard, CPC, CEMA, RHIT Scott Kraft and John Paul Spencer) are back and armed with a ton of new information to discuss and offer solutions for!
#coding and #compliance are the focus and the topics will include:
1. A breakdown of #telehealthservices now that the #publichealthemergency is over May 11th (or is it for these services...)
2. Handling #diagnosis code Denials...
3. Split/Shared Services; these will lead to #audits and #overpayment demands...
4. Cut and Paste (#cloning) in the #inpatient setting... is there a smart-phrase that can help mitigate risk?
5. #cigna and the #modifier25 conundrum...1 hr 5 min - TCG - Season 5 - Episode 48 - #TerryTuesday - Three Midnight Rule
Terry joined Sean to discuss all the intricacies and pitfalls of the three-midnight- rule... Didn't know there was one, well there is. The dynamic duo also took on the two-midnight-rule just to cover all of the bases!
39 min - TCG - Season 5 - Episode 47 - Attorneys Jeana Singleton and Colin Callahan
Sean was joined by Colin Callahan of Flannery Georgalis, LLC and Jeana Singleton of Brennan Manna Diamond to discuss issues impacting #healthcareprofessionals in the #coding, #auditing, #compliance, #documentation, and #leagal areas of healthcare!
Todays Topics Include:
The intersection of prevention and prosecution/enforcement
How preventative measures help defense
Recent DOJ guidelines (self-referrals, cooperation by entities, etc.)
The value of active compliance program
Self-reporting of issues
Telehealth
Expiration of the PHE
Telehealth and lab marketing
Proposed DEA rules
and so much more!1 hr 2 min - TCG - Season 5 - Episode 46 - #TerryTuesday - Urgent Care and Retail Clinics
Terry and Sean take on the coding and compliance surrounding Urgent Care Centers and Retail Clinics and all of the "gotchas"... There are a lot of hidden gems in this one.
37 min - TCG - Season 5 - Episode 45 - Monday Coding and Compliance Roundtable
The all star panel of Terry Fletcher, Stephanie Allard, Scott Kraft and Paul Spencer are back to take on Auditor vs. Coder! Sounds contentious but the fact is, this was a dynamic discussion with a ton of thoughtful dialogue!
1 hr 4 min - Season 5 - Episode 44 - Legal with Liles/Parker - The Reach of a UPIC and Affirmative Actions
Robert Liles and Ashley Morgan join Sean to discuss the power of UPICs and their reach and affirmative actions! This was a brilliant discussion. Don't miss this one!
52 min - Season 5 - Episode 43 - #TerryTuesday on The Compliance Guy
Terry and Sean are at it again with another hard-hitting topic impacting health care operations... identifying a problem but not wanting to issue a refund! This one gets interesting.
31 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.