The Compliance Guy

By: Sean M. Weiss
  • Summary

  • 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.

    Sean M. Weiss
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Episodes
  • Season 8 - Episode - 17 - #TerryTuesday - The Role of AI in Provider Documentation
    Nov 19 2024

    Summary

    In this conversation, Sean and Terry discuss the implications of artificial intelligence (AI) in healthcare, emphasizing its role as a tool rather than a replacement for human oversight. They explore the potential benefits and risks associated with AI in clinical documentation, the importance of maintaining patient privacy, and the legal ramifications of relying on AI for medical decision-making. The discussion highlights the need for careful implementation and monitoring of AI technologies in healthcare settings.

    Takeaways

    • AI is a tool that requires human interaction.
    • The accuracy of AI in healthcare is still under scrutiny.
    • Providers must ensure the integrity of AI-generated documentation.
    • AI can improve clinical documentation but has limitations.
    • Human oversight is essential to prevent errors in AI usage.
    • Legal implications arise from the misuse of AI in healthcare.
    • Patient privacy must be protected when using AI tools.
    • AI can enhance efficiency but should not replace medical judgment.
    • The healthcare industry must vet AI tools thoroughly.
    • AI's biases can affect its performance in clinical settings.
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    24 mins
  • Season 8 - Episode 16 - Monday Auditing, Coding and Compliance Roundtable
    Nov 19 2024

    Summary

    The conversation delves into the complexities and changes surrounding telehealth services, particularly in light of the 2025 Medicare physician fee schedule final rule. Key topics include the confusion regarding telehealth reimbursement post-public health emergency, the implications of new regulations, compliance challenges, malpractice concerns, and the importance of equitable access to telehealth services. The discussion emphasizes the need for healthcare providers to adapt to these changes and ensure compliance to avoid legal repercussions.

    Takeaways

    • Telehealth reimbursement will change significantly after January 1, 2025.
    • Providers must return to originating sites for many telehealth services.
    • Compliance with telehealth regulations is critical to avoid malpractice issues.
    • Many practices are unprepared for the upcoming changes in telehealth policy.
    • Patients may feel pressured to use telehealth services even when they prefer in-person visits.
    • The lack of clarity from CMS has led to confusion among providers.
    • Telehealth services must be accessible to all patients, including those with disabilities.
    • Providers need to ensure they are using HIPAA-compliant platforms for telehealth.
    • The importance of having effective policies in place for telehealth services cannot be overstated.
    • Congressional intervention is uncertain, leaving many providers in a difficult position.
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    42 mins
  • Season 8 - Episode 15 - #TerryTuesday The Unsung Heroes of Healthcare
    Nov 13 2024

    Summary

    In this episode, Sean and Terry discuss the critical role of support staff in healthcare, and the necessity of listening to compliance experts to avoid legal pitfalls. They emphasize the need for collaboration and communication within healthcare practices to ensure compliance and effective billing practices.

    Takeaways

    • Support staff play a crucial role in healthcare compliance.
    • Listening to compliance experts can prevent legal issues.
    • Healthcare providers must trust their support staff.
    • Collaboration is key in healthcare practices.
    • Ignoring staff advice can lead to serious consequences.
    • Healthcare professionals should be aware of billing regulations.
    • Open forums for policy suggestions can empower healthcare professionals.
    • Maintaining communication can enhance workplace relationships.
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    26 mins

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