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 ...
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Season 7 - Episode 47 - #TerryTuesday - Navigating the Challenges of Telehealth Services and Billing
42:49
42:49
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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
29:50
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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
58:35
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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
22:43
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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
29:09
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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
29:21
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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
52:50
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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
27:49
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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
34:39
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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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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
1:02:12
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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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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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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
1:02:47
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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
24:31
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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
1:03:31
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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
46:38
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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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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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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
1:00:29
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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
45:29
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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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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
1:00:52
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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!
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Sean and Terry are back at it with another great episode focusing on the most challenging issues facing healthcare providers and their organizations.
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Season 7 - Episode 23 - Monday Auditing, Coding and Compliance Roundtable
1:01:36
1:01:36
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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
43:59
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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
1:03:55
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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
45:01
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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
36:32
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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
1:03:52
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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
25:39
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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
56:22
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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
50:27
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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
22:48
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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
39:09
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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
37:47
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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
1:01:19
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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
38:30
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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
1:00:32
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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
43:00
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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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Season 7 - Episode - 8 The Return of Clint Pulver
45:08
45:08
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The one and only Clint Pulver returns to The Compliance Guy to provide an update on his upcoming 2024 speaking tour, his new documentary (Finding Hill on YouTube), The Master Class Program, and so many more unbelievable amazing things Clint and his team are undertaking! Clint Pulver is a professional keynote speaker, author, musician, pilot, and wo…
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Season 7 - Episode 7 - Legal with Liles/Parker
57:49
57:49
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In the first Legal with Liles/Parker episode of 2024, Robert and Ashley sit down with Sean to discuss Compliance Risks in 2024! The list is long and distinguished...
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Season 7 - Episode 6 - #TerryTuesday - Cloning and Clinical Plagiarism
30:38
30:38
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Terry and Sean take on Cloning, Cut and Paste and Clinical Plagiarism... It is not as clear cut as you would think it is! Don't miss this one because the end-results could cost you dearly!
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Season 7 - Episode 5 - Monday Coding and Compliance Roundtable
58:07
58:07
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58:07
The All Star Panel was back taking on the latest in auditing, coding and compliance challenges for healthcare professionals.
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Katie Deming, MD sits down with Sean to discuss engaging with those diagnosed with cancer. Dr. Deming, host of the Born to Heal Podcast and a #tedxspeaker, provides insightful and invaluable advice on communication. Don't miss this opportunity to change your outlook on how we engage with those diagnosed with cancer...…
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Season 7 - Episode 3 - #TerryTuesday - Artificial Intelligence in Healthcare
31:50
31:50
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31:50
There is no doubt the machines are taking over! Terry and Sean explore how AI both helps and hurts providers of medical services and what they need to do to ensure they don't find themselves in a trap!
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Season 7 - Episode 2 - Monday Coding and Compliance Roundtable
1:01:41
1:01:41
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The All Star Panel is back for the first roundtable discussion of 2024 and what a great discussion it was. Topics Include: 1. G2211 - The New Add-on for Evaluation and Management Codes... The Dos and Don'ts 2. Medical Students - What they can and cannot provide as a services and the PATH Guidelines... 3. Laboratory Compliance - The world of lab ser…
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David sits down with Sean to discuss avoiding 2024 pitfalls with provider enrollment, credentialing, and contracting in addition to so much more. David is one of the most celebrated healthcare professionals and for good reason. Don't miss this one! Zetter Consulting Website: https://zetter.com/ NSCHBC Website: https://nschbc.org/…
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Season 6 - Episode 50 - #TerryTuesday - Non-retaliation
26:23
26:23
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26:23
In this final episode of season 6 and the overall final episode of 2023 Terry joins sean to take on the critical nature of having a non-retaliation policy for your organization! You can't have a compliance program without one of these!
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Season 6 - Episode 49 - Monday Coding and Compliance Roundtable
26:23
26:23
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In this final roundtable discussion of 2023 the all star cast was back to address: 1. CPT Coding Changes for 2024 2. Impact of a transmittal change by CMS for chemo and Rheumatology Infusion Drugs 3. The impact of medical necessity 4. Documentation standards 5. The impact bad behavior has on a case at trial…
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