Podcast terbaik National Association Of Criminal Defense Lawyers (2024)

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Season 8 - Episode 7 - #TerryTuesday - Evaluation Medical Necessity 29:05

1d ago29:05

29:05

Summary In this episode, Sean and Terry discuss the intersection of sports and healthcare, particularly focusing on the implications of sports injuries on mental health. They delve into the nuances of preventative medicine visits, the complexities of evaluation and management services, and the importance of medical necessity in billing practices. T…

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Season 8 - Episode 6 - Monday Auditing, Coding and Compliance Roundtable - 1:01:25

1d ago1:01:25

1:01:25

Summary In this conversation, Sean and his guests discuss various pressing issues in healthcare, focusing on the implications of HIPAA violations, the challenges of patient privacy, and the recent controversies surrounding the Epic EMR system. They delve into the complexities of unauthorized access to patient information, the role of AI in healthca…

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Season 8 - Episode 5 - Nicole Thorne - Understanding the Surge in Healthcare Audits and the Role of AI in Shaping Healthcare Compliance 45:46

6d ago45:46

45:46

Summary In this conversation, Sean and Nicole Thorn discuss the increasing challenges healthcare providers face regarding compliance, particularly in light of rising audit risks and overpayment demands. They explore the complexities of healthcare law, the role of attorneys in navigating disputes, and the importance of proactive compliance strategie…

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Season 8 - Episode 4 - #TerryTuesday 36:09

8d ago36:09

36:09

Summary In this episode, Sean and Terry discuss the current state of the healthcare industry, focusing on the business of medicine, the impact of external factors on healthcare operations, and the alarming rise in healthcare bankruptcies. They delve into the role of private equity in healthcare, the importance of compliance, and the need for health…

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Season 8 - Episode 3 - David Womack of Practice Management Institute 41:40

9d ago41:40

41:40

Summary In this episode, Sean and David discuss the importance of compliance education in healthcare, highlighting the diverse educational sources available, particularly through the Practice Management Institute (PMI). They explore the various certifications offered by PMI, the significance of personalized education, and the impact of recent chang…

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Season 8 - Episode - 2 - #TerryTuesday 31:16

15d ago31:16

31:16

Summary In this episode, Sean and Terry Fletcher discuss the complexities of prior authorization in healthcare, emphasizing its critical role in the reimbursement process. They explore the misconceptions surrounding prior authorization, the disconnect between healthcare providers and payers, and the challenges posed by Medicare Advantage plans. The…

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Season 8 - Episode 1 - Monday Auditing, Coding and Compliance Roundtable 59:39

15d ago59:39

59:39

Summary In this episode, the panel discusses the critical importance of honesty in healthcare compliance, the challenges posed by audits, and the responsibilities of providers in navigating vendor relationships. They explore the implications of using AI in clinical documentation, the escalation of compliance issues to law enforcement, and the risks…

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Season 7 - Episode 50 - #TerryTuesday - Independence and Objectivity in Auditing! 30:05

22d ago30:05

30:05

Summary In this conversation, Sean and Terry discuss the critical importance of conducting audits in healthcare practices, emphasizing the need for both internal and external reviews to ensure compliance and accuracy in coding and billing. They highlight real-world examples of practices that have suffered due to a lack of audits and the biases that…

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Season 7 - Episode 49 - #TerryTuesday - When It's Clear As Mud! 36:09

29d ago36:09

36:09

Summary In this episode, Sean and Terry discuss various topics related to healthcare compliance. They start by sharing their recent experiences, including Sean's trip to Alaska. Then, they dive into the theme of the episode, which is when things are as clear as mud in the healthcare community. They discuss the challenges of finding clear guidelines…

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Season 7 - Episode 48 - Monday Auditing, Coding and Compliance Roundtable 1:01:15

29d ago1:01:15

1:01:15

Summary The conversation revolves around the topic of padding medical bills and the importance of clear communication with patients regarding their financial responsibilities. The speakers discuss instances where unnecessary charges are added to the bill, such as billing for lifestyle medicine codes during a visit for a finger fracture or adding ch…

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Season 7 - Episode 47 - #TerryTuesday - Navigating the Challenges of Telehealth Services and Billing 42:49

2M ago42:49

42:49

In this episode, Sean and Terry discuss the recent incident where Sean accidentally went live with colorful language during a recording. They also dive into the proposed changes to the telehealth services and fee structure for 2025. Terry explains the challenges and limitations of telehealth services, especially when it comes to billing and coding.…

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Season 7 - Episode 46 - #TerryTuesday - Privilege or No Privilege "That is the Question" 29:50

2M ago29:50

29:50

This is a controversial topic depending on which side of the yellow line you stand on... The question is does all work with a consultant require attorney client privilege... This is a great discussion for those of you looking to engage in coding and billing audits.

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Season 7 - Episode 45 - Monday Auditing, Coding, and Compliance Roundtable 58:35

2M ago58:35

58:35

This was a great live show! Sean was joined by Terry, Christine, and Paul to discuss Medical Decision-Making for levels of EM service when Rx Management is involved. There was a lot to unpack in this episode so don't miss this one!

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Season 7 - Episode 44 - #TerryTuesday - Words Matter 22:43

2M ago22:43

22:43

Terry and Sean take on the importance of words in the medical record. There is no slowing of the audit trend so providers better buckle up!

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Season 7 - Episode 43 - #TerryTuesday - Flat-lining! 29:09

2M ago29:09

29:09

In this episode Terry and Sean take on what it means to flat-line with your coding and how to avoid unnecessary scrutiny!

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Season 7 - Episode 42 - Defending Your Claims Action 29:21

3M ago29:21

29:21

This one is a head-scratcher for The Compliance Guy for so many reasons... Not going to give it away but this is a really good episode you are gonna want to catch!

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Season 7 - Episode 41 - Monday Auditing, Coding and Compliance Roundtable 52:50

3M ago52:50

52:50

We had a great program on Monday with Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM Christine Hall Stephanie Allard, CPC, CEMA, RHIT Scott Kraft and John Paul Spencer and their take on some hard-hitting issues: 1. Practices wanting to use RNs or MAs to do post of visits after 90-global surgery 2. Medical necessity for E/M servic…

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Season 7 - Episode 40 - #TerryTuesday - G2211 and Some Payors Refusal to Pay 27:49

3M ago27:49

27:49

Terry Fletcher CPC CEMC CCC CCS CCS-P CMC ACS-CA SCP-CA PACS QMPM and #TheComplianceGuy, addressed critical issues in the latest #TerryTuesday episode. In this episode, we delved into current events affecting our country, marking a significant departure from our usual content. Listeners can fast forward to the 15-minute mark for an insightful discu…

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Season 7 - Episode 39 - Dana McMahon Chief Compliance Officer / Stryker 34:39

3M ago34:39

34:39

Sean sat down with Dana McMahon, Chief Compliance Officer for Stryker to discuss all the great things she and her team are doing to ensure a culture of compliance and to lead Stryker into the future. Beyond that Dana is the Global President for Stryker Women's Network (see bio below)! This is one great discussion you do not want to miss! Bio Dana s…

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Season 7 - Episode 38 - #TerryTuesday 32:37

3M ago32:37

32:37

Terry and Sean sat down to discuss credentialing vs contracting. What are the main differences, how do you handle various aspects of each and the pitfalls to avoid.

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Season 7 - Episode 37 - Monday Auditing, Coding and Compliance Roundtable 1:02:12

3M ago1:02:12

1:02:12

The full panel was back this week taking on an array of topics impacting healthcare organizations across the country! Join Stephanie, Paul, Scott, Christine and Terry as they discuss and debate HCC Coding Issues, No Charging Physicians and others who refer to the practice and so much more...

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Season 7 - Episode 36 - #TerryTuesday 35:13

3M ago35:13

35:13

This episode Terry and Sean take on adding services to your revenue mix and the costs for doing so if "Medical Necessity" is not met. There is a ton to unpack in the episode. Sean also blogged about this topic on LinkedIn Monday, July 1, 2024... take a look at that blog!

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Season 7 - Episode 35 - #TerryTuesday 29:34

4M ago29:34

29:34

Terry and Sean are back at it once again taking on the big issues impacting healthcare providers! It's all about risk mitigation and creating a culture of compliance!

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Season 7 - Episode 34 - Monday Auditing, Coding and Compliance Roundtable 1:02:47

4M ago1:02:47

1:02:47

The Monday Roundtable is back with all new segments and compliance centered topics. Join Sean, Terry, Christine, Scott, Paul and Stephanie as they tackle the biggest issues in healthcare.

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Season 7 - Episode 33 - #TerryTuesday - Employment Requirement of Incident-To 24:31

4M ago24:31

24:31

Don't let the title fool you... this is not just another incident-to podcast. This episode focuses on the employee/employment requirement(s) and how organizations continue to make significant mistakes.

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Season 7 - Episode 32 - Monday Auditing, Coding and Compliance Roundtable 1:03:31

4M ago1:03:31

1:03:31

Terry, Christine, Stephanie, Paul, and Scott were all back for this new episode of the Monday Roundtable. It was quite the discussion on various payor guidelines regarding G2211, The Anatomy of CPT Codes, Split/Shared Services, EMR as a Tool, and so much more...

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Season 7 - Episode 31 - Brian Lobley - CEO Tango 46:38

5M ago46:38

46:38

Brian Lobley brings over 20 years of experience leading healthcare businesses, operations, and strategy. Prior to joining tango, he served as the executive vice president, chief operating officer, and president of Health Markets at Independence Health Group, the parent company of Independence Blue Cross, LLC. He was responsible for leading Commerci…

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Season 7 - Episode 30 - #TerryTuesday 35:08

5M ago35:08

35:08

In this episode Sean and Terry take on Addendums, Corrections, and Late Entries, and when you can make them, when you shouldn't, and when clinical summaries are a better options.

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Season 7 - Episode 29 - #TerryTuesday 27:17

5M ago27:17

27:17

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

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Season 7 - Episode 28 - Monday Auditing, Coding, and Compliance Roundtable 1:00:29

5M ago1:00:29

1:00:29

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 code…

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Season 7 - Episode 27 - Non-compete Agreements - "The Road Ahead" 45:29

5M ago45:29

45:29

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!

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Season 7 - Episode 26 - #TerryTuesday 28:17

5M ago28:17

28:17

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!

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Season 7 - Episode 25 - Monday Auditing, Coding and Compliance Roundtable 1:00:52

5M ago1:00:52

1:00:52

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!

1
Season 7 - Episode 24 - #TerryTuesday 28:06

6M ago28:06

28:06

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

1
Season 7 - Episode 23 - Monday Auditing, Coding and Compliance Roundtable 1:01:36

6M ago1:01:36

1:01:36

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

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Season 7 - Episode 22 - #TerryTuesday - IPPE and AWE (Medicare) 43:59

7M ago43:59

43:59

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.

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Season 7 - Episode 21 - Monday Auditing, Coding and Compliance Roundtable 1:03:55

7M ago1:03:55

1:03:55

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

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Season 7 - Episode - 20 - Christine Hall - Coding and Compliance 45:01

7M ago45:01

45:01

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!

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Season 7 - Episode 19 - #TerryTuesday - OIG Compliance Program Guidance 36:32

7M ago36:32

36:32

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!

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Season 7 - Episode 18 - Monday Auditing, Coding and Compliance Roundtable 1:03:52

7M ago1:03:52

1:03:52

Join Sean, Stephanie, Scott, Christine, and Terry as they take on: 1. Collaboration Agreements 2. CERT Studies and error rate

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Season 7 - Episode - 17 - #TerryTuesday - Bad Coding = Bad Business 25:39

8M ago25:39

25:39

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!

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Season 7 - Episode 16 - Monday Auditing, Coding and Compliance Roundtable 56:22

8M ago56:22

56:22

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-proc…

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Season 7 - Episode 15 - Dan Cohen - PainScript 50:27

8M ago50:27

50:27

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…

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Season 7 - Episode 14 - #TerryTuesday - HIPAA and The Unknown 22:48

8M ago22:48

22:48

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

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Season 7 - Episode 13 - The AI Modifier and Taking on Medicaid 39:09

8M ago39:09

39:09

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 thi…

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Season 7 - Episode 12 - #TerryTuesday - When Audit Results Are Ignored 37:47

8M ago37:47

37:47

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

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Season 7 - Episode 11 - Monday Coding and Compliance Roundtable 1:01:19

8M ago1:01:19

1:01:19

The team was back and took on when it does and does not make sense to employ remote workers as well as the do's and don'ts. The team also took on AI and the inherent risks associated with EHRs deploying this technology into their systems.

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Season 7 - Episode 10 - #TerryTuesday - Incident-To 38:30

8M ago38:30

38:30

Before you say, "not again" keep in mind these are the problem child of providers and the government. The provisional services continue to create problems and until the ambiguous aspects of these services are more clearly defined we will have to continue threading the needle to keep you compliant.

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Season 7 - Episode - 9 - Monday Auditing, Coding and Compliance Roundtable 1:00:32

8M ago1:00:32

1:00:32

The entire cast is back this week taking on the most complex and challenging issues tied to medical auditing, coding, and compliance...

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TCG The Best of The Best "Effective Leadership" 43:00

9M ago43:00

43:00

In this episode Sean takes on effective leadership and what it takes to lead a team. While Sean is known as "The Compliance Guy" he started his professional career in practice management back in the mid-90s amid all the consolidation and acquisitions by the health systems "Physician Services" Groups. Take a listen... you just may be surprised at wh…

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