Sean M. Weiss - DoctorsManagement

Jul 18 2019

Do You Trust Your Employees?

By Karen | 2019, Regulatory Compliance, Sean Weiss

Do You Trust Your Employees? "Skepticism, the Professional Suicide" by Sean Weiss, Partner & VP of Compliance Camillo Benso DI Cavour said, “The man who trusts men will make fewer mistakes than he who distrusts them.” What do you think about that? Do you trust your employees and/or coworkers? Why or why not? I have...

Jul 16 2019

Credit Balances and the False Claims Act

By Karen | 2019, Regulatory Compliance, Sean Weiss

Credit Balances and the False Claims Act "Complying With the 60 Day Rule" by Sean Weiss, Partner & VP of Compliance Dating back as far as I can remember to when I first began working in health care, the debate regarding voluntary refunds of overpayments has been in place. Back in the late 80s and...

Jul 11 2019

Why Doing the Right Thing is Viewed as Wrong

By Karen | 2019, Regulatory Compliance, Sean Weiss

Why Doing the Right Thing is Viewed as Wrong "The Negative Stigma with Being a Relator" by Sean Weiss, Partner & VP of Compliance Charles Simmons said, “No man has a right to do as he pleases, except when he pleases to do right.” I have spent the last 20 of my 25-years working in...

Jul 09 2019

Beneficiary Anti-Inducement Statute

By Karen | 2019, Regulatory Compliance, Sean Weiss

Beneficiary Anti-Inducement Statute "Implicating the Anti-Kickback Law" by Sean Weiss, Partner & VP of Compliance Ahh… the age-old argument of “It’s my practice and I can do what I want” until reality sets in and it becomes “Why can’t I do what I want in my practice?” For the most part, you can do what...

Jul 02 2019

Auditing Standards or The Lack of …

By Karen | 2019, Regulatory Compliance, Sean Weiss

Auditing Standards or The Lack of... "Making a Case for Standardizing Auditing Guidelines" by Sean Weiss, Partner & VP of Compliance Change, no matter how positive it is will always be met with resistance. But what if the changes aren’t really changes but actual adoption of standards for the very first time in an industry...

Jun 27 2019

Anti-Markup Rule – CMS vs. State Regulations

By Karen | 2019, Regulatory Compliance, Sean Weiss

Anti-Markup Rule "CMS vs. State Regulations" by Sean Weiss, Partner & VP of Compliance This Blog Post is a bit longer than usual, but I am only scratching the surface of issues related to diagnostic tests and anatomic pathology as well as a statute and law that could be potentially violated in addition to the...

Jun 25 2019

Artificial Intelligence and Compliance – An Interview With Frank Cohen

By Karen | 2019, Regulatory Compliance, Sean Weiss

Artificial Intelligence and Compliance "An Interview With Frank Cohen" by Sean Weiss, Partner & VP of Compliance Artificial Intelligence (AI) in healthcare has become the sexy new term and what everyone is making so much noise about. So, what’s the big deal and how does AI work in the word of healthcare compliance? February of...

Jun 20 2019

Steps to Conducting an Effective Investigation

By Karen | 2019, Regulatory Compliance, Sean Weiss

Steps to Conducting an Effective Investigation by Sean Weiss, Partner & VP of Compliance A week ago, I had the privilege of speaking for the National Alliance of Medical Auditing Specialists at their all-day virtual conference on Conducting a Fraud Investigation. During this talk, I focused on the importance of using a “Common Sense” approach...

Jun 18 2019

Annual Audit Elements

By Karen | 2019, Regulatory Compliance, Sean Weiss

Annual Audit Elements "What Should Be Reviewed” by Sean Weiss, Partner & VP of Compliance Six months into 2019 and the question is, how far along is your audit of high, medium and low-risk services? If you are like most practices or health systems, something always gets in the way and causes audits to take...

Jun 13 2019

Using an Improvement Standard to Deny Claims – Part 2

By Karen | 2019, Regulatory Compliance, Sean Weiss

Using an Improvement Standard to Deny Claims, Part 2 "Another Illegal and Unfair Tactic by Some at Payors” by Sean Weiss, Partner & VP of Compliance As I sat down to write the remainder of Part II today, I received an email from one of our employees whose family member has been waiting for both...

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THE COMPLIANCE GUY BLOG

Do You Trust Your Employees?

Credit Balances and the False Claims Act

Why Doing the Right Thing is Viewed as Wrong

Beneficiary Anti-Inducement Statute

Auditing Standards or The Lack of …

Anti-Markup Rule – CMS vs. State Regulations

Artificial Intelligence and Compliance – An Interview With Frank Cohen

Steps to Conducting an Effective Investigation

Annual Audit Elements

Using an Improvement Standard to Deny Claims – Part 2

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