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The Compliance Guy
Sean M. Weiss
391 episodes
1 day ago

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.

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Business
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All content for The Compliance Guy is the property of Sean M. Weiss and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.

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.

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Business
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Episode - 380 - #TerryTuesday - Hospitalists "Major Risk" for Hospitals!
The Compliance Guy
24 minutes 36 seconds
2 months ago
Episode - 380 - #TerryTuesday - Hospitalists "Major Risk" for Hospitals!

Summary

In this episode, Sean and Terry discuss the critical role of hospitalists in patient care, emphasizing the importance of understanding their responsibilities and the challenges posed by overutilization and compliance issues. They highlight the necessity of medical necessity in documentation and the potential risks associated with billing practices that may violate regulations. The conversation underscores the need for proper protocols, audits, and a focus on patient care to ensure that hospitalists fulfill their roles effectively without contributing to unnecessary costs or compliance violations.

Takeaways

  • Hospitalists play a vital role in patient care within hospitals.
  • Overutilization of hospitalists can lead to compliance issues and denials.
  • Medical necessity is crucial for billing and documentation.
  • Providers should avoid creating unnecessary encounters for revenue generation.
  • Hospitalists are often not part of insurance programs, leading to out-of-network costs for patients.
  • Proper policies and procedures are essential for hospitalist practices.
  • Regular audits can help identify vulnerabilities in billing practices.
  • Understanding the roles of different providers is key to effective patient care.
  • Documentation should reflect actual patient interactions and medical necessity.
  • Healthcare organizations must prioritize compliance to avoid legal issues.
The Compliance Guy

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.