The Compliance Guy

The one and only Ronald Chapman II of the Chapman Law Group joins Sean to discuss their latest (5 in 12 months) of acquittals for Dr. Loey Kousa. Sean and Ron lay out what went right for the defense and why the prosecution's case failed. If you are a provider charged with a crime in healthcare or an attorney looking for strategies to ensure a level playing field and due process for your client then this episode is a must!

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.

Sean and Terry are back with an all new #TerryTuesday episode that you are not going to want to miss!

 The full panel! Scott Kraft, John Paul Spencer, Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM, Stephanie Allard, CPC, CEMA, RHIT and Christine Hall CHC was back with all new topics! 1. Weight loss drugs and all the confusion on medical necessity 2. Physician disclaimers and the misnomers 3. Developing the next generation of coders, and the difficulties practices are having retaining experienced coders in this economy

Bryan Meek of Brennan, Manna, and Diamond joins Sean to discuss last weeks final rule issued by the Federal Trade Commission and what it means at this point, where things are headed and how to navigate through all the noise. Don't miss this episode!

Sean and Terry are at it again, taking on the most perplexing and head-scratching auditing, coding and compliance topics and bringing a sense of sanity to insane situations!

Most of the all star team was back for this one and it was an outstanding discussion of the G2211, Medical Necessity vs. Correct Coding, SNF Visits and Medical Necessity, and so much more!

Sean and Terry are back at it with another great episode focusing on the most challenging issues facing healthcare providers and their organizations.

The all star panel is back together again with an all new episode. 1. Clean Claims 2. Misapplication of Diagnosis Codes 3. Change Healthcare Debacle

Terry and Sean take on Medicare's IPPE and AWV and all the misinformation and dos and don'ts! Hear directly from a Medicare Auditor on her thoughts and opinions on direct supervision / incident-to regarding these services.

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!