Sean Weiss serves as a vice president and chief compliance officer for DoctorsManagement.
Sean specializes in medical audit and appeal representation. He and the DM
team of coding and compliance experts work with large and small healthcare practices
that have been targeted by federal (Medicare), state (Medicaid), and commercial
insurance payors. Sean delivers measurable financial results while helping clients
reduce their financial risk of noncompliance with government agencies as well
as providing quality care to their patients. Clients benefit from his knowledge
of the inner workings of federal and state agencies such as the Office of Inspector
General, Department of Justice and The United States Attorneys Office.
Having protected thousands of physicians, medical practice groups, hospitals,
and medical management societies from undue penalties, he is recognized as an
expert in the field of medical compliance.
Whether a client has received an overpayment demand for thousands of dollars
or millions of dollars, Seans understandings of the various payors
systems ensures that recoupment efforts or offsets are blocked until due process
has been concluded and that refunds are eliminated or minimized. Navigating
the labyrinth of confusion inherent in the compliance process in a timely fashion
helps to protect clients and to minimize the stress that comes with being under
Sean also develops custom compliance plans for healthcare organizations and
serves as the third-party compliance officer for facilities that do not have
the capacity for hiring this position.
Agencies such as the Office of Inspector General routinely contact Sean for
guidance on interpretation of complex Medicare guidelines, regulations and statutes
and on methodologies for structuring studies to be conducted. He represents
the voice of healthcare providers, medical societies, and integrated health
systems on key legislative issues when working with members of Congress and
other government agencies. Sean serves as an adviser on the Industry Relations
Committee of the American Association of Orthopaedic Executives (AAOE).
Sean is a sought-after speaker and has delivered keynote addresses for countless
professional societies and healthcare organizations across the country. With
an engaging yet no-nonsense style, he presents workable solutions to the latest
issues surrounding healthcare compliance, medical auditing, practice and revenue
cycle management as well as other topics.
Sean is a published author and also a contributing author to several model
programs for HIPAA, OIG, and OSHA and he has provided input to medical organizations
personnel policies and compliance procedures. Additionally, Sean has shared
his experience with tens of thousands of readers each month through contributions
to print and online publications on the topics of Medicare, evaluation and management
services, coding, fraud and abuse compliance, and medical practice management.
These publications include JAMA, Medical Economics, Part B News, BC Advantage,
The Coding Edge, and MGMA Connections.
Prior to joining DoctorsManagement, Sean held executive and senior level positions
with some of the industry's largest and most respected organizations. He helped
these organizations secure financial stability and growth through the application
of streamlined compliance systems. These organizations include DecisionHealth,
The CMC Group, Tenet Health Systems of the Southeast, The Medical Management
Institute, and Columbia/HCA The Healthcare Company. Sean also served
on the Ethics and Compliance Steering Committee at Columbia/HCA, which developed
policies and procedures to help decipher complex regulatory issues.
Sean attended Life College in Marietta, Georgia, where he studied Business
Administration with a concentration in Health Care Management. He also attended
Capella University where his concentration was in Legal Studies. Sean holds
numerous national certifications including Certified Compliance Professional
(CCP-P), Certified Professional Medical Auditor (CPMA), Certified Professional
Coder (CPC), Certified Professional Coder-Physician Practices (CPC-P), Certified
Professional Coder-Payers (CPC-P), and Advanced Certification Specialist-Evaluation
and Management Services (ASC-EM).