The below articles are all published in BC advantage
Magazine and written and contributed by Sean
Weiss
Sean Weiss Partner and Vice President of Compliance
at DoctorsManagement LLC
Knoxville, TN
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When the Government Tries to Change the Rules
We all know the government doesn't fight fair! This is why it is so critical for healthcare professionals to understand their recourse when the government does not follow their own guidelines.
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To Disclose or Not to Disclose... That's the Question
The biggest questions I receive these days are in regard to handling potential overpayments regarding internal or external audits is whether or not the errors constitute a self-disclosure protocol.
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When the Government Tries to Change the Rules
We all know that the government doesn't fight fair. This is why it is so critical for healthcare professionals to understand their recourse when the government does not follow their own guidelines.
...
Read
Compliance Plans: The Truth About Templates
As a compliance officer and someone that spends my days working with physician practices and integrated delivery health systems sorting through compliance related issues, developing corrective action plans, and ensuring steps are put into place to pr...
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The Do's and Don'ts of Audit Investigations
Audit investigations can and typically are scary for those who are being investigated. They are especially nerve-racking when you have no real understanding as to why you have been targeted.
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A Few Highlights of 2015 & The Road Ahead
It is that time of the year again where I get to remind you of what we faced during the past year and what we can expect moving into the next.
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Tip: Understanding Your Risk
The History of Present Illness (HPI), is by in large one of the most critical aspects of any progress note.
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Thinking About Cutting Corners with Incident-To; Don't!
Incident-To Services: no matter how often you clarify them, they always seem to create controversy. While many providers clearly understand the guidelines surrounding these services, they still think they can skate around the rules to capture the ext...
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Audits: What's the Big Deal?
As we approach the holiday season I can tell you that government auditors and those contracted to audit on behalf of our government are going to be in a very giving mood... they will be handing out lots of Post Payment Reviews resulting in Determinat...
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Conducting Successful Appeals: Six Steps to Success
The Centers for Medicare and Medicaid Services in cooperation with the DOJ and OIG have made reducing the amount of wasteful spending a number one priority. Through the Program Safeguard Contractors, RACs, ZPICs, MICS, and other government contractor...
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The Transition of Healthcare as an Industry
As a healthcare professional working for one of the premiere full-scale medical consultancies servicing the needs of hundreds of medical practices, hospitals, hospice facilities, and urgent care centers, and thousands of healthcare professionals, it ...
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How to value your practice
The practice of medicine has greatly changed over the years and as a result older physicians find themselves aggravated with the new generation of physicians. Many physicians coming out of school today are less worried about money and more about havi...
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Confessions of a Medical Information Analyst (aka Secrets from a Payer Coder)
I admit that I have gone to the dark side-I work for an insurance company. I used to work for doctors and ASCs so I know what most people think of payer coders: we are all ill-trained, uneducated idiots working off of a script, and have no knowledge ...
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The Fiscal Cliff - Whats next for Healthcare
With just under 3 hours left before the country went over the "Fiscal Cliff" the Senate passed legislation unanimously. Then at 11:00 on Tuesday night the House voted to pass the bill that had been passed in the Senate. However, there is a lot of cha...
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