Investigations are a natural part of any compliance professional’s career – but that doesn’t make them any less intimidating.  We invited Eric Allen, a highly regarded compliance professional with experience spanning academia, hospital institutions, and more, to join us for an episode of Compliance Conversations! In this episode, “Compliance Investigations 101,” Eric and I discuss the nuances of investigations, including: - How to set investigations up for success from the get-go - Navigating the emotional side of interviews and ongoing investigations  - Why mannerisms and body language are crucial in the age of remote interviews

Investigations are a natural part of any compliance professional’s career – but that doesn’t make them any less intimidating. We invited Eric Allen, a highly regarded compliance professional with experience spanning academia, hospital institutions, and more, to join us for an episode of Compliance Conversations! In this episode, “Compliance Investigations 101,” Eric and I discuss the nuances of investigations, including: - How to set investigations up for success from the get-go - Navigating the emotional side of interviews and ongoing investigations - Why mannerisms and body language are crucial in the age of remote interviews

Compliance Investigations 101

“Think like a lawyer, talk like a human, and start with your audience." Those three key principles drive Kirsten Liston’s innovative approach to compliance training, and it’s why we invited her to join us on our latest episode of Compliance Conversations!  Kirsten is the CEO of Rethink Compliance and a two-time author. We’re grateful she shared her time and expertise with us on our latest episode!

“Think like a lawyer, talk like a human, and start with your audience." Those three key principles drive Kirsten Liston’s innovative approach to compliance training, and it’s why we invited her to join us on our latest episode of Compliance Conversations! Kirsten is the CEO of Rethink Compliance and a two-time author. We’re grateful she shared her time and expertise with us on our latest episode!

Communication and Compliance – A Match Made in Training Heaven

Technology is integrated into everything we do – including healthcare. But what are the regulatory implications of new software platforms in the medical industry? We invited Ali Aga, the Founder and CEO of Flowbit®, to share his insights on our latest episode of Compliance Conversations. Ali is a digital innovator, software developer, and healthcare insider with a unique perspective on the regulatory processes behind healthcare software.

Technology is integrated into everything we do – including healthcare. But what are the regulatory implications of new software platforms in the medical industry? We invited Ali Aga, the Founder and CEO of Flowbit®, to share his insights on our latest episode of Compliance Conversations. Ali is a digital innovator, software developer, and healthcare insider with a unique perspective on the regulatory processes behind healthcare software.

Is Software a Medical Device?

“The scene can’t begin until we start paying attention to each other.” -- David Pasquesi If you think improv comedy and healthcare compliance and coding require opposite skillsets, you might be surprised by our latest podcast episode... We invited Dr. Mike Smith, a multi-talented physician and improv aficionado, to join us for our latest episode of Compliance Conversations. Dr. Smith is currently an Attending Physician at the University of Nebraska Medical Center and a Consultant for Healthcare Improv.

“The scene can’t begin until we start paying attention to each other.” -- David Pasquesi If you think improv comedy and healthcare compliance and coding require opposite skillsets, you might be surprised by our latest podcast episode... We invited Dr. Mike Smith, a multi-talented physician and improv aficionado, to join us for our latest episode of Compliance Conversations. Dr. Smith is currently an Attending Physician at the University of Nebraska Medical Center and a Consultant for Healthcare Improv.

Can Improv Comedy Improve Your Compliance Program?

Doctor, firefighter, marine biologist, compliance officer?  We're not sure the last one makes many kids’ list of their dream careers, but here we all are! We love learning about how people got into compliance and how they continue advancing their own knowledge in the field. That’s why we invited Steve Naughton to join us for this episode of Compliance Conversations.

Doctor, firefighter, marine biologist, compliance officer? We're not sure the last one makes many kids’ list of their dream careers, but here we all are! We love learning about how people got into compliance and how they continue advancing their own knowledge in the field. That’s why we invited Steve Naughton to join us for this episode of Compliance Conversations.

Making the Grade: Compliance Career and Education Opportunities

It’s no secret that private equity is playing an accelerating role in the healthcare industry – but what does that mean for compliance professionals? This Compliance Conversations features a conversation about why private equity can work with – not against – healthcare organizations.

It’s no secret that private equity is playing an accelerating role in the healthcare industry – but what does that mean for compliance professionals? This Compliance Conversations features a conversation about why private equity can work with – not against – healthcare organizations.

Compliance Implications of Private Equity’s Involvement in Healthcare

The compliance and coding worlds are filled with acronyms – and we’ve got another one for you: CDI. That stands for Clinical Documentation Improvement, and it’s a crucial piece of the healthcare puzzle. We invited Joanne Spethman, a Coding, CDI, and HIM Consultant, to share insights from her 30+ year career in inpatient and professional coding, CDI and HCC auditing on our latest episode of Compliance Conversations.

The compliance and coding worlds are filled with acronyms – and we’ve got another one for you: CDI. That stands for Clinical Documentation Improvement, and it’s a crucial piece of the healthcare puzzle. We invited Joanne Spethman, a Coding, CDI, and HIM Consultant, to share insights from her 30+ year career in inpatient and professional coding, CDI and HCC auditing on our latest episode of Compliance Conversations.

Clinical Documentation Improvement – What is it and Why is it so Important?

Is your compliance effectiveness review process due for a tune-up?  Our latest episode of Compliance Conversations features Larry Plutko and CJ Wolf discussing strategies for looking under the hood of your program and preparing your organization for what’s ahead in corporate compliance.

Is your compliance effectiveness review process due for a tune-up? Our latest episode of Compliance Conversations features Larry Plutko and CJ Wolf discussing strategies for looking under the hood of your program and preparing your organization for what’s ahead in corporate compliance.

Federal Enforcement Expectations for Compliance Program Effectiveness Reviews

Does the thought of more board oversight of your compliance program inspire consternation or curiosity?  Tune in to our latest episode of Compliance Conversations to find out why board-level collaboration can benefit not just your program, but your entire organization.

Does the thought of more board oversight of your compliance program inspire consternation or curiosity? Tune in to our latest episode of Compliance Conversations to find out why board-level collaboration can benefit not just your program, but your entire organization.

How Involved Should the Board Be in Your Compliance Program?

HCCA’s 27th Annual Compliance Institute is around the corner – want a sneak peek?  Tune in to our latest episode of Compliance Conversations featuring Adam Turteltaub, the Chief Engagement &amp; Strategy Officer for the Society of Corporate Compliance and Ethics and the Health Care Compliance Association!

HCCA’s 27th Annual Compliance Institute is around the corner – want a sneak peek? Tune in to our latest episode of Compliance Conversations featuring Adam Turteltaub, the Chief Engagement &amp; Strategy Officer for the Society of Corporate Compliance and Ethics and the Health Care Compliance Association!

The Insider Track on HCCA’s Upcoming Events

Compliance Conversations is a monthly podcast for healthcare professionals and compliance officers who want to stay on top of the compliance game. Host CJ Wolf has in-depth conversations with industry experts to explore the riddles and complexities of the compliance world. Wolf chats with fellow compliance experts, auditors, physicians and government officials. Compliance Conversations is produced by Healthicity.

I really enjoyed hearing persons who know Medicare so well, actually chatting out some of the policy that seems so complicated when reading the manuals. Thank you!

Compliance Conversations is great!

Compliance Conversations by Healthicity

In this episode of our podcast, Compliance Conversations, Wolf and Dunnick tackle documentation, what to do, what not to do, and what you definitely didn’t learn in medical school. Wolf is a compliance expert who went to medical school but found a passion for the compliance side of things. Dunnick is not only a physician with years of practice experience, he’s also a full-time consultant who educates physicians on coding and documentation best practices. Documentation dream team, if we’ve ever seen one. In this detailed, thought-provoking interview, Dunnick and Wolf dive deep into compliance, coding, and audit risks. Particularly, how to use EHRs effectively and efficiently. Including, why you should be weary of copy and pasting in EHRs, and documentation best practices that every physician should know.  Listen to our Podcast, A Physician Explains Documentation Best Practices, to learn: How to Document CorrectlyWays to Reduce Audit Risk Exposure Rules You Didn’t Learn in Medical School

In this episode of our podcast, Compliance Conversations, Wolf and Dunnick tackle documentation, what to do, what not to do, and what you definitely didn’t learn in medical school. Wolf is a compliance expert who went to medical school but found a passion for the compliance side of things. Dunnick is not only a physician with years of practice experience, he’s also a full-time consultant who educates physicians on coding and documentation best practices. Documentation dream team, if we’ve ever seen one. In this detailed, thought-provoking interview, Dunnick and Wolf dive deep into compliance, coding, and audit risks. Particularly, how to use EHRs effectively and efficiently. Including, why you should be weary of copy and pasting in EHRs, and documentation best practices that every physician should know. Listen to our Podcast, A Physician Explains Documentation Best Practices, to learn: How to Document Correctly Ways to Reduce Audit Risk Exposure Rules You Didn’t Learn in Medical School

A Physician Explains Documentation Best Practices

I recently spoke with Brooklyn Trumpy on what it’s like to be new to compliance. Trumpy graduated in 2009 with a degree in Operations Management and ended up in compliance five years ago when she took a role at Community Health Systems and worked her way into a compliance role. Trumpy found that being new to compliance was a challenge. She explained how it can be intimidating to learn all of the new rules and regulations and how to piece together the puzzle that is compliance. She initially struggled to make connections and find her tribe within Compliance and it took some time to learn how to stay organized. Trumpy had some expert advice for new compliance professionals that will help them have an easier transition into the world of compliance.     Listen to this episode of Compliance Conversations, "Tips for When You’re the New Kid on the Compliance Block," to learn: * Which Personality Types are Drawn to Compliance in the First Place * How to Set Expectations as a New Compliance Professional* Why It's Okay not to Know Everything Right Out of the Gate

I recently spoke with Brooklyn Trumpy on what it’s like to be new to compliance. Trumpy graduated in 2009 with a degree in Operations Management and ended up in compliance five years ago when she took a role at Community Health Systems and worked her way into a compliance role. Trumpy found that being new to compliance was a challenge. She explained how it can be intimidating to learn all of the new rules and regulations and how to piece together the puzzle that is compliance. She initially struggled to make connections and find her tribe within Compliance and it took some time to learn how to stay organized. Trumpy had some expert advice for new compliance professionals that will help them have an easier transition into the world of compliance. Listen to this episode of Compliance Conversations, "Tips for When You’re the New Kid on the Compliance Block," to learn: * Which Personality Types are Drawn to Compliance in the First Place * How to Set Expectations as a New Compliance Professional * Why It's Okay not to Know Everything Right Out of the Gate

Tips for When You’re the New Kid on the Compliance Block

In this episode of Compliance Conversations, I sat down with Senior Consultant, Brenden O’Neil, who works in Intermountain’s professional coding and reimbursement department. O’Neil and I had a fascinating discussion on CPT codes and the complicated gray area of coding a laminectomy. The code has changed, physicians are in limbo, and revenue is being lost. And, there are a number of compliance issues that might arise. If you’re a compliance officer in an organization with neurosurgeons, you should perform an audit and run some data analytics for the code 22633 or that range of codes that represent fusions anytime a 63047 or laminectomy is reported. Otherwise, there could be trouble on the horizon. If you’re in healthcare, you won’t want to miss this. Listen to our newest podcast, Complex Coding, Complicated Compliance, to brush up on: Laminectomy and Potential Compliance IssuesSpecific Updates to Code 63047Payers, Medicaid, and more!

In this episode of Compliance Conversations, I sat down with Senior Consultant, Brenden O’Neil, who works in Intermountain’s professional coding and reimbursement department. O’Neil and I had a fascinating discussion on CPT codes and the complicated gray area of coding a laminectomy. The code has changed, physicians are in limbo, and revenue is being lost. And, there are a number of compliance issues that might arise. If you’re a compliance officer in an organization with neurosurgeons, you should perform an audit and run some data analytics for the code 22633 or that range of codes that represent fusions anytime a 63047 or laminectomy is reported. Otherwise, there could be trouble on the horizon. If you’re in healthcare, you won’t want to miss this. Listen to our newest podcast, Complex Coding, Complicated Compliance, to brush up on: Laminectomy and Potential Compliance Issues Specific Updates to Code 63047 Payers, Medicaid, and more!

Complex Coding, Complicated Compliance

Nick Merkin, CEO of Compliagent, chatted with me from his home in sunny California about compliance from an attorney’s perspective. Merkin is a lawyer by training and spent the first ten years of his career in healthcare law, primarily in litigation defense. Merkin explained why it’s so important for organizations to see compliance from an attorney’s perspective. And how his unique point of view provides an additional layer of protection from compliance violations. In this compelling interview, Merkin explains how organizing compliance functions is, “worth it’s weight in gold.” Tune in to this podcast, An Attorney Talks Compliance, to find out how to: Focus Compliance on Processes and InfrastructureOrganize Compliance Functions to Protect Against LitigationMitigate Legal Liabilities That Might Arise in Healthcare

Nick Merkin, CEO of Compliagent, chatted with me from his home in sunny California about compliance from an attorney’s perspective. Merkin is a lawyer by training and spent the first ten years of his career in healthcare law, primarily in litigation defense. Merkin explained why it’s so important for organizations to see compliance from an attorney’s perspective. And how his unique point of view provides an additional layer of protection from compliance violations. In this compelling interview, Merkin explains how organizing compliance functions is, “worth it’s weight in gold.” Tune in to this podcast, An Attorney Talks Compliance, to find out how to: Focus Compliance on Processes and Infrastructure Organize Compliance Functions to Protect Against Litigation Mitigate Legal Liabilities That Might Arise in Healthcare

An Attorney Talks Compliance

In this episode of Compliance Conversations: I asked compliance and healthcare law expert Marcie Swenson, “What do you think the hot topics will be for 2018.” And she gave us two answers: “Benchmarking and data breaches and cyber security.” Organizations will be utilizing OIG guidance to create their own benchmarks and rate their own compliance program. I also asked Marci what she hoped to see differently in 2018 and she passionately responded, “more risk assessments. To be proactive in compliance you have to perform a risk assessment.”  Tune in to this episode of Compliance Conversations: Benchmarking Your Way to Compliance, for hot topic predictions and tips for 2018 including how to: Use the OIG Guide to Benchmark Your ProgramPrepare for Cyber Threats and Data BreachesUtilize Risk Assessments

In this episode of Compliance Conversations: I asked compliance and healthcare law expert Marcie Swenson, “What do you think the hot topics will be for 2018.” And she gave us two answers: “Benchmarking and data breaches and cyber security.” Organizations will be utilizing OIG guidance to create their own benchmarks and rate their own compliance program. I also asked Marci what she hoped to see differently in 2018 and she passionately responded, “more risk assessments. To be proactive in compliance you have to perform a risk assessment.” Tune in to this episode of Compliance Conversations: Benchmarking Your Way to Compliance, for hot topic predictions and tips for 2018 including how to: Use the OIG Guide to Benchmark Your Program Prepare for Cyber Threats and Data Breaches Utilize Risk Assessments

Benchmarking Your Way to Compliance

In this episode of Compliance Conversations, I chatted with Charla Prillaman, the Regional Vice President of Audit Services and 30-year compliance veteran, about the crucial differences between Medical Necessity and Medical Decision Making (MDM). Prillaman pointed out that both terms are incorrectly used interchangeably, though they have distinctly different meanings. “Medical Necessity is the foundation for payment for all medical services. We find the original or the beginning statement about medical necessity being the overarching criteria all the way back into the social security act…Now the complexity of medical decision making is that it’s intended to somehow or another quantify a provider’s cognitive work in a specific encounter with the patient.” Said Prillaman. In this highly requested conversation, Prillaman breaks down how to properly document medical necessity and medical decision making and how to quantify something as difficult as “cognitive effort” for MDM. Tune into this episode of Compliance Conversations, “Recognizing the Differences Between Medical Necessity and Medical Decision Making” with me, CJ Wolf, and Charla Prillaman for the full scoop on Medical Necessity and MDM, including: The History of Both Medical Necessity and MDMKey Differences of Medical Necessity and MDMWays to Properly Quantify and Document MDM

In this episode of Compliance Conversations, I chatted with Charla Prillaman, the Regional Vice President of Audit Services and 30-year compliance veteran, about the crucial differences between Medical Necessity and Medical Decision Making (MDM). Prillaman pointed out that both terms are incorrectly used interchangeably, though they have distinctly different meanings. “Medical Necessity is the foundation for payment for all medical services. We find the original or the beginning statement about medical necessity being the overarching criteria all the way back into the social security act…Now the complexity of medical decision making is that it’s intended to somehow or another quantify a provider’s cognitive work in a specific encounter with the patient.” Said Prillaman. In this highly requested conversation, Prillaman breaks down how to properly document medical necessity and medical decision making and how to quantify something as difficult as “cognitive effort” for MDM. Tune into this episode of Compliance Conversations, “Recognizing the Differences Between Medical Necessity and Medical Decision Making” with me, CJ Wolf, and Charla Prillaman for the full scoop on Medical Necessity and MDM, including: The History of Both Medical Necessity and MDM Key Differences of Medical Necessity and MDM Ways to Properly Quantify and Document MDM

Recognizing the Differences Between Medical Necessity and Medical Decision Making

In this episode, compliance expert CJ Wolf sits down with product development expert Jeff Young to discuss tools that can simplify compliance and make you so much more effective as a compliance officer. Young explains how tools are changing healthcare organizations, “with the tools that are out there today you can gather data consistently in one location, identify risks based on data trends and decide what to do. Maybe you need to put a new policy in place, or you need to introduce training to your organization. The idea is that it gives you the power to get away from some of this manual work by utilizing technology to help automate and optimize what you’re doing as a compliance officer.” Regarding random audits, Young asks, “if you’re looking at just ten random records, how do you know those are representative of what the physicians doing, and how does it really help you to understand where you need to focus for that physician?” Listen to this episode to learn how to utilize technology to decrease manual labor, improve training, easily identify risks, and much, much more!

In this episode, compliance expert CJ Wolf sits down with product development expert Jeff Young to discuss tools that can simplify compliance and make you so much more effective as a compliance officer. Young explains how tools are changing healthcare organizations, “with the tools that are out there today you can gather data consistently in one location, identify risks based on data trends and decide what to do. Maybe you need to put a new policy in place, or you need to introduce training to your organization. The idea is that it gives you the power to get away from some of this manual work by utilizing technology to help automate and optimize what you’re doing as a compliance officer.” Regarding random audits, Young asks, “if you’re looking at just ten random records, how do you know those are representative of what the physicians doing, and how does it really help you to understand where you need to focus for that physician?” Listen to this episode to learn how to utilize technology to decrease manual labor, improve training, easily identify risks, and much, much more!

Tools That Make Compliance Easier

For this installment of Compliance Conversations, we interviewed Jake Geertsen, a Technical Manager in the documentation and coding, who specializes in telehealth. It’s a fast-growing segment of healthcare, which has spawned a lot of questions around the field. Not least of which is: What exactly is telehealth? According to Geertsen, telehealth is “a collection of means or methods for enhancing healthcare, public health, and health education delivery and support, using telecommunication technologies.”Just ten years ago, few of us were carrying around the computing power we commonly find in our pockets and purses today. Nor did we know the benefits this technology could have to, as Geertsen puts it, “to the patient, the healthcare organization looking to cut costs, to insurance companies also looking to cut costs. In many scenarios, this is an area of innovation and improvement.” Understand the History and Evolution of TelehealthImplement Proper Coding and Billing Compliance PracticesStay Current with Ever-changing Medicare Regulations and Payer Policie

For this installment of Compliance Conversations, we interviewed Jake Geertsen, a Technical Manager in the documentation and coding, who specializes in telehealth. It’s a fast-growing segment of healthcare, which has spawned a lot of questions around the field. Not least of which is: What exactly is telehealth? According to Geertsen, telehealth is “a collection of means or methods for enhancing healthcare, public health, and health education delivery and support, using telecommunication technologies.” Just ten years ago, few of us were carrying around the computing power we commonly find in our pockets and purses today. Nor did we know the benefits this technology could have to, as Geertsen puts it, “to the patient, the healthcare organization looking to cut costs, to insurance companies also looking to cut costs. In many scenarios, this is an area of innovation and improvement.” Understand the History and Evolution of Telehealth Implement Proper Coding and Billing Compliance Practices Stay Current with Ever-changing Medicare Regulations and Payer Policie

How to Provide Access to Telehealth, While Maintaining Compliance

In this episode of Compliance Conversations, I sat down with Stephani Scott, VP of Audit Services for Healthicity, to chat about her twenty years of experience and pick her brain on important auditing issues. As all of you know, auditing is a crucial component of an effective compliance program. Stephani explains how she approaches post-audit education with difficult providers, “I always tell them to be prepared first and foremost.” Then she adds, “make sure you’ve reviewed the audit and you know where they did well. Sometimes the effectiveness depends on your approach.” Scott provides rules for post-audit education, like how to deal with a physician who inherently distrusts auditors or bad apples who code incorrectly on purpose. Tune in to learn the auditing ropes with expert Stephani Scott and learn how to: • Build Trust with Providers• Effectively Change Behaviors• Approach Post Audit Educations Like a Pro• Deal with Bad Apples

In this episode of Compliance Conversations, I sat down with Stephani Scott, VP of Audit Services for Healthicity, to chat about her twenty years of experience and pick her brain on important auditing issues. As all of you know, auditing is a crucial component of an effective compliance program. Stephani explains how she approaches post-audit education with difficult providers, “I always tell them to be prepared first and foremost.” Then she adds, “make sure you’ve reviewed the audit and you know where they did well. Sometimes the effectiveness depends on your approach.” Scott provides rules for post-audit education, like how to deal with a physician who inherently distrusts auditors or bad apples who code incorrectly on purpose. Tune in to learn the auditing ropes with expert Stephani Scott and learn how to: • Build Trust with Providers • Effectively Change Behaviors • Approach Post Audit Educations Like a Pro • Deal with Bad Apples

Essential Steps to Post-Audit Education (That Actually Works)

Everything You Never Knew You Needed to Know About ACO Compliance by CJ Wolf

Everything You Never Knew You Needed to Know About ACO Compliance

Let’s say you’re a Medicare Advantage organization and one day you receive a notification from CMS that you’ve been selected for program audit. What should you do? Recently, I sat down with Scott Robinson, director of compliance at Davis Vision, and former medicare contractor who used to accompany the folks at CMS to conduct effectiveness audits. Robinson gave me the details on what to do and what not to do when and if you receive the news. “The first thing is to not panic,” Robinson said, “All you really need to do is explain yourself. You just need to articulate your usual business practices in a way that CMS will understand and agree with.” But doing this requires you to be ready for it.  Tune into this episode to learn how to:Prepare for a CMS Audit Before it HappensStay Calm During a CMS AuditEffectively Explain Yourself to CMS

Let’s say you’re a Medicare Advantage organization and one day you receive a notification from CMS that you’ve been selected for program audit. What should you do? Recently, I sat down with Scott Robinson, director of compliance at Davis Vision, and former medicare contractor who used to accompany the folks at CMS to conduct effectiveness audits. Robinson gave me the details on what to do and what not to do when and if you receive the news. “The first thing is to not panic,” Robinson said, “All you really need to do is explain yourself. You just need to articulate your usual business practices in a way that CMS will understand and agree with.” But doing this requires you to be ready for it. Tune into this episode to learn how to: Prepare for a CMS Audit Before it Happens Stay Calm During a CMS Audit Effectively Explain Yourself to CMS

What Not to Do When CMS Audits You

For this Compliance Conversations episode, I’ve got a special treat for you: Dr. Ira Specter. He spent many years as a practicing OBGYN physician and is also a certified coder and medical auditor. After practicing medicine for a few decades he went on to run a large medical management company, where they did billing collection, coding, compliance, and ICC10 courses for sixty-five physicians. Because of his unique perspective, we tackled bridging the gap between coding and auditing and physician documentation. I asked Dr. Specter, “what’s the biggest area for improvement for physician documentation?” After a brief pause, he said, “Let me start by saying, by and large, most physicians are under coding.” It seems, according to Specter, that physicians are “cutting off their own legs,” and also “cherry picking” codes. What does that mean?Listen to this episode to find out what Dr. Specter views as the biggest mistakes physicians are currently making and learn: What Coders/Auditors Should Look Out For in Physicians DocumentationWhy Physicians Should Never Cherry Pick CodesThe Pitfalls of Copying and Cloning.

For this Compliance Conversations episode, I’ve got a special treat for you: Dr. Ira Specter. He spent many years as a practicing OBGYN physician and is also a certified coder and medical auditor. After practicing medicine for a few decades he went on to run a large medical management company, where they did billing collection, coding, compliance, and ICC10 courses for sixty-five physicians. Because of his unique perspective, we tackled bridging the gap between coding and auditing and physician documentation. I asked Dr. Specter, “what’s the biggest area for improvement for physician documentation?” After a brief pause, he said, “Let me start by saying, by and large, most physicians are under coding.” It seems, according to Specter, that physicians are “cutting off their own legs,” and also “cherry picking” codes. What does that mean? Listen to this episode to find out what Dr. Specter views as the biggest mistakes physicians are currently making and learn: What Coders/Auditors Should Look Out For in Physicians Documentation Why Physicians Should Never Cherry Pick Codes The Pitfalls of Copying and Cloning.

The Psychology Behind Why Physicians Undercode

There are a lot of barriers in compliance. In this installment of Compliance Conversations, I chat with Eric Dominguez, the chief compliance officer at Emerus, a management company that specializes in healthcare systems. “Part of the services we provide to these joint ventures is a compliance program.” Dominguez explains some of the common hurdles of aligning with partners. “It’s a challenge and at the same time, it’s really a great opportunity for growth.” So how do Dominguez and his group manage compliance on such a big scale? And how can we get better at it ourselves? Listen to this episode to learn how to: Tackle Compliance Like a Large Hospital GroupManage the Unique Challenges of Micro-Hospitals Navigate Policies and Procedures for Hospital Licensing

There are a lot of barriers in compliance. In this installment of Compliance Conversations, I chat with Eric Dominguez, the chief compliance officer at Emerus, a management company that specializes in healthcare systems. “Part of the services we provide to these joint ventures is a compliance program.” Dominguez explains some of the common hurdles of aligning with partners. “It’s a challenge and at the same time, it’s really a great opportunity for growth.” So how do Dominguez and his group manage compliance on such a big scale? And how can we get better at it ourselves? Listen to this episode to learn how to: Tackle Compliance Like a Large Hospital Group Manage the Unique Challenges of Micro-Hospitals Navigate Policies and Procedures for Hospital Licensing

How the Pros Implement a Compliance Program

Back in February, CMS announced changes that seem to allow medical students a lot more freedom to document a patient’s medical record. Which could sound like a dream to physicians who might be thinking that the students will help ease the heavy burden of bureaucracy, but auditors are a little worried. Auditors are going, “Wait, hold on, we’ve got to really look at this before we jump the gun.” I spoke with expert compliance auditor, Charla Prillaman, who’s lived and breathed auditing for decades. The hard part, it turns out, isn’t understanding the new rule; the hard part is re-educating doctors. Tune into our latest episode of Compliance Conversations, The Teaching Physician Rule: A Blessing or a Curse, to learn the:New Specifics of Student Documentation for E/M Services and HPI, Dangers of Improper Documentation Teaching Physician’s Responsibility to Verify and Attest to Student Documentation.

Back in February, CMS announced changes that seem to allow medical students a lot more freedom to document a patient’s medical record. Which could sound like a dream to physicians who might be thinking that the students will help ease the heavy burden of bureaucracy, but auditors are a little worried. Auditors are going, “Wait, hold on, we’ve got to really look at this before we jump the gun.” I spoke with expert compliance auditor, Charla Prillaman, who’s lived and breathed auditing for decades. The hard part, it turns out, isn’t understanding the new rule; the hard part is re-educating doctors. Tune into our latest episode of Compliance Conversations, The Teaching Physician Rule: A Blessing or a Curse, to learn the: New Specifics of Student Documentation for E/M Services and HPI, Dangers of Improper Documentation Teaching Physician’s Responsibility to Verify and Attest to Student Documentation.

The Teaching Physician Rule: A Blessing or a Curse

We kicked off this episode of Compliance Conversations with a guest host, our very own compliance expert, Marcie Swenson, and her special guest, Emily Haley, who has worked as a Chief Privacy Officer and Compliance Director at Intermountain healthcare and is currently working in Care Transformation. In the first half of the show, Haley gave us a full fledged rundown on gap analysis, risk analysis and risk management plans. In the second half of the show, we dove unapologetically into the OCR’s phase 2 desk audits and what we can all learn from them. “Everybody is familiar with OCR’s phase 2 desk audits, where they audited 63 covered entities, and I think 40 something business associates. They used a scale 1 through 5, 1 being the very best risk analysis or risk management plan, and 5 being the very worst...more than half both business associates and the covered entities had scored a 4 and a 5. That’s shocking. That means most of us are not doing the right things.” Tune into our latest episode of Compliance Conversations, Smart Strategies to Holistically Tackle Your Organization’s Risks, with guest host Marcie Swenson. In this podcast we’ll cover how: Every Department Must Work Together to Reduce RisksRisk Analysis is Dependent on Gap Analysis and Management PlansTo Mitigate the Lack of Updated Risk Analysis Information From the OCR

We kicked off this episode of Compliance Conversations with a guest host, our very own compliance expert, Marcie Swenson, and her special guest, Emily Haley, who has worked as a Chief Privacy Officer and Compliance Director at Intermountain healthcare and is currently working in Care Transformation. In the first half of the show, Haley gave us a full fledged rundown on gap analysis, risk analysis and risk management plans. In the second half of the show, we dove unapologetically into the OCR’s phase 2 desk audits and what we can all learn from them. “Everybody is familiar with OCR’s phase 2 desk audits, where they audited 63 covered entities, and I think 40 something business associates. They used a scale 1 through 5, 1 being the very best risk analysis or risk management plan, and 5 being the very worst...more than half both business associates and the covered entities had scored a 4 and a 5. That’s shocking. That means most of us are not doing the right things.” Tune into our latest episode of Compliance Conversations, Smart Strategies to Holistically Tackle Your Organization’s Risks, with guest host Marcie Swenson. In this podcast we’ll cover how: Every Department Must Work Together to Reduce Risks Risk Analysis is Dependent on Gap Analysis and Management Plans To Mitigate the Lack of Updated Risk Analysis Information From the OCR

Smart Strategies to Holistically Tackle Your Organization's Risks

The best podcasts on investing. For anyone interested in the stories in the investing industry, whether it's an interview with Ray Dalio or Ed Thorp to the writer of The Big Short. This topic includes the most fascinating stories from all the best investors. Add episodes you're interested into your queue below!

Best Investing Podcasts

The best podcast episodes on global issues affecting everyone. Covering topics such as the #metoo movement, climate change, the impact of technology and some of the biggest global issues facing us right now. For anyone interested in learning more about the world, and some of the issues we're facing, pick an episode below and start listening! Add episodes you're interested into your queue below!