Compliance Conversations By Healthicity

Tune in to this episode of "Compliance Conversations" where we dive deep into the world of innovation and biotech with our special guest, Steve VanNurden! In this episode, CJ Wolf, MD, talks with Steve VanNurden, CEO of Fitzsimons Innovation Community and Associate Vice Chancellor of Biotechnology at the University of Colorado Anschutz Medical Campus. Listen in as they explore the unique integration of academic and entrepreneurial ecosystems, discuss the reinvention of tech transfer, and reveal the keys to building a thriving biotech community. You'll hear: The vision behind Fitzsimons Innovation Community and its role in advancing healthcare innovation. - The unique benefits of integrating academic medical centers and biotech communities. - Real-life examples of startups and research breakthroughs happening in Colorado – and why it’s a powerful hub for healthcare innovation. - How the Community addresses regulatory and funding challenges to accelerate innovation. - Whether you're in healt

In this episode, Maeve O'Neill, MEd, LPC-S, CHC, CDTLF, the National Compliance Director for Circa Behavioral Healthcare Solutions, joins us to share insights from her three decades of experience in mental health and addiction services as she provides valuable insights into the unique challenges and best practices for compliance in this field. Tune in as we discuss: - The complex web of regulations: The intricate layers of compliance in behavioral health, from state regulations to accreditation standards, and how organizations can effectively navigate them. - Building effective compliance programs: The importance of simplifying compliance processes and aligning them with organizational goals to create robust and practical programs. - The role of compliance in patient care: The critical connection between compliance and quality care, highlighting how a strong compliance program can support staff well-being and ultimately benefit patient outcomes. We appreciate Maeve’s time and expertise in talking about

Medicare audits can be a daunting challenge for any healthcare provider. With a maze of regulations, different types of audits, and a complex appeal process, it’s easy to feel overwhelmed. That’s why we invited Alicia Shickle, AHFI, CHC, CPC, CPCO, CPMA, CRC, the President and CEO of ProCode Compliance Solutions LLC, to share the knowledge and strategies you need to navigate this tricky terrain. Tune in to the episode as we discuss: - The top issues that trigger Medicare audits - How to prepare your practice and avoid common pitfalls - The five levels of Medicare appeals and how to effectively manage them - Why proactive compliance programs are crucial for your practice Thank you, Alicia, for sharing your time and expertise with us! About Alicia Shickle Alicia has decades of clinical and administrative healthcare experience. Her areas of expertise include revenue cycle integrity, documentation, coding and billing compliance, Medicare, MSP, and Medicaid regulations, practice workflow and operations, complianc

Heidi McKinnon, PharmD, CHC, a seasoned compliance expert, shares insights from her journey from retail pharmacy to head of compliance at Capital Rx, a leading pharmacy benefit manager. In this episode, Heidi shares her unique path and extensive experience in the compliance world. We delve into the evolving landscape of digital pharmacy, discussing: - The true meaning of digital pharmacy and how it differs from telepharmacy and online pharmacies. - The regulatory challenges faced by digital pharmacies and strategies to stay ahead of ever-changing rules. - The impact of digital pharmacies on patient care and medication access. - The intricacies of reimbursement and licensing in the digital pharmacy space. - Practical tips for compliance officers new to the digital pharmacy sector. Heidi McKinnon, PharmD, CHC Heidi McKinnon is a dedicated healthcare professional with a Doctor of Pharmacy (PharmD) degree and a Certified Healthcare Compliance (CHC) credential. With extensive experience in the pharmacy and healthc

In this episode, we welcome back Hal McCard, Counsel at Spencer Fane, to delve into the complexities of financial relationships with physicians, including essential insights on compliance with STARK and Anti-Kickback statutes. CJ Wolf, MD, and Hal McCard discuss: - Hal’s extensive career in healthcare law and his journey to becoming a leading expert in the field. - Detailed explanations of STARK and Anti-Kickback statutes and their implications for healthcare organizations. - Practical advice on maintaining compliance in physician contracting, from fair market value documentation to auditing processes. - The importance of centralized arrangements tracking systems and how they can help mitigate compliance risks. - Real-world examples and valuable insights from Hal’s experiences as in-house counsel and external advisor. Check out the episode to gain valuable knowledge and practical tips to enhance your compliance programs and safeguard your organization against potential pitfalls. Thank you for listening! Pleas

Are you intrigued by the rapid evolution of telehealth and its impact across the globe? Then you won’t want to miss our latest podcast episode where Keisha Wilson and CJ Wolf discusses the nuances, challenges, and opportunities in international telehealth services! In this episode, we discuss: COVID-19’s Impact on Telehealth: Learn how the pandemic prompted a reevaluation of international telehealth practices and regulations. Compliance and Legalities: Keisha dives into the intricate details of understanding and navigating international laws and compliance issues, ensuring seamless and legal telehealth services across borders. Challenges and Solutions: From infrastructure limitations to insurance hurdles, Keisha shares real-world examples and innovative solutions to delivering healthcare to remote and underserved populations. Global Collaborations: Get insights into how organizations like the International Society for Telemedicine and eHealth (ISfTeH) and the World Health Organization are shaping the future o

In this episode, our host CJ Wolf sits down with Laidy Diana Martinez, a coding supervisor, to discuss the world of GI coding and compliance. Episode Highlights: - Introduction to GI Coding Challenges: Understand the common hurdles and how to overcome them. - Screening vs. Diagnostic Colonoscopies: Learn the critical differences and their coding implications. - Essential Modifiers: Find out which modifiers to use and when. - Documentation Best Practices: Discover what’s needed for accurate and compliant GI procedure billing. - Medicare and Payer Policies: Stay up to date with the latest changes and requirements. Laidy Diana Martinez, with her extensive experience as a coding supervisor, brings valuable insights and practical advice that can help enhance your coding accuracy and compliance efforts. Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our

Our latest episode of Compliance Conversations features Johanna Brown, the recipient of Healthicity's 2023 Compliance Officer of the Year Award! Join our host, CJ Wolf, as he delves into Johanna’s journey in compliance, her leadership philosophy, and the qualities that make her an outstanding compliance officer. Here’s what you can expect: - Career Journey: Learn about Johanna’s path from journalism to compliance. - Leadership Insights: Discover her secrets to fostering teamwork, maintaining work-life balance, and navigating the complex world of healthcare compliance. - Heartfelt Recognition: Hear the glowing recommendations from her colleagues and what they appreciate most about her approach to compliance. Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and weekly compliance newsletter for additional compliance and auditi

We’re excited to announce a new episode of Compliance Conversations! Join CJ Wolf and special guest Kimberly Jolivette Williams as they explore the complexities of anesthesia coding and billing. In this episode: - Kimberly’s journey from unit secretary to compliance expert. - Unique aspects of anesthesia coding and essential resources. - The importance of modifiers in compliance and billing. - Tips for accurate documentation and minimizing compliance risks. Don't miss out on Kimberly's expert advice and passion for lifelong learning. Here are some additional resources around this important topic: Centers for Medicare & Medicaid Services Anesthesiologists Center - https://www.cms.gov/medicare/payment/fee-schedules/physician/anesthesiologists-centerCertified Anesthesiologist Assistants Now Authorized to Practice in Washington State - https://www.asahq.org/about-asa/newsroom/news-releases/2024/03/certified-anesthesiologist-assistants-now-authorized-to-practice-in-washington-state#:~:text=SEATTLE%20

Our latest episode of Compliance Conversations features CJ Wolf, MD, and Brian Burton, our Chief Compliance and Privacy Officer, sharing their key takeaways from two of the most prominent industry conferences: HCCA's Compliance Institute and AAPC's HEALTHCON. Find out what they had to say about insights on the OIG’s new General Compliance Program Guidance, industry-specific updates, and so much more. From discussions on artificial intelligence in compliance to the latest developments in Medicare Advantage and risk adjustment, this episode offers valuable insights for professionals across the healthcare spectrum. We also wanted to share a few resources CJ and Brian mentioned during their chat: - Our webinar on Leveraging Data Analytics for Proactive Compliance Management (https://www.healthicity.com/resources/leveraging-data-analytics-proactive-compliance-management-webinar)- The section of our Resource Center dedicated to the OIG’s General Compliance Program Guidance (https://www.healthicity.com/res

We're thrilled to share the latest episode of Compliance Conversations featuring a Jeni Colarusso, a seasoned nurse and an expert in telehealth and Tele-ICU systems. In this episode, Jeni dives deep into the transformative power of telehealth, particularly in critical care environments. Episode Highlights: - Jeni’s extensive experience in surgical and cardiac ICU settings. - An in-depth look at Tele-ICU and its role in expanding access to specialist care in remote areas. - The impact of technology on patient outcomes and hospital efficiency. - Insightful discussion on overcoming healthcare disparities through innovative telehealth solutions. Jeni shares not only her professional journey but also gives us a peek into the future of healthcare where geography no longer limits access to top-notch medical expertise. Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instag

Are you navigating the complex world of healthcare compliance, particularly when it comes to Medicare and Advanced Beneficiary Notices (ABNs)? We've got you covered in the latest episode of Compliance Conversations, featuring industry expert Keisha Wilson, founder of KW Advanced Consulting. Keisha brings over two decades of healthcare experience to the table, offering invaluable insights into the intricacies of ABNs. This episode delves deep into what ABNs mean for healthcare professionals and patients alike, recent changes to ABN forms, compliance risks, and the importance of proper education and implementation within healthcare settings. Why Tune In? - Uncover the essentials of ABNs: Learn what ABNs are and why they're critical in healthcare from a seasoned expert. - Stay updated: Get the scoop on the latest ABN form changes effective from June 2023 and how they impact practices. - Avoid common pitfalls: Keisha discusses frequent compliance risks and how to navigate them effectively. - Engage in c

In this episode, we're joined by Kandi O'Brien, the Founder of Delegated Credentialing Pro’s and an expert with extensive experience in credentialing and compliance. Kandi shares her fascinating journey in healthcare, from clinical roles to owning urgent cares, and ultimately specializing in compliance and credentialing. We discuss the importance of credentialing, its various aspects, and why it's crucial for patient safety, regulatory compliance, and maintaining organizational reputation. Tune in to our conversation to learn more about: - The significance of credentialing as the first step for providers entering healthcare facilities. - The distinction between facility credentialing and professional (provider) credentialing. - The complexities of enrollment and why it's not synonymous with credentialing. - The concept of delegated credentialing and its benefits for organizations, including improved efficiency and revenue generation. - The primary source verification process and ongoing mo

This Compliance Conversations episode is a must-listen for anyone in healthcare compliance or coding. We invited Leslie Boles, Co-Owner and President of Revu Healthcare, to chat about identifying coding compliance risks within healthcare organizations. Tune in to Leslie and CJ Wolf’s discussion for more on: - The importance of staying curious and adaptable - The significance of regular audits and assessments in proactively identifying compliance risks - Common coding compliance risks and blind spots within organizations - Strategies for mitigating compliance risks, including the role of data analytics and technology They also talk about one of the most important things to keep top-of-mind – staying humble and acknowledging gaps in knowledge to drive continuous improvement. Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and week

Biometric technology can sometimes feel like sci-fi – which is why it raises so many great compliance questions. That’s why we invited Dr. Mohamed Lazzouni, the Chief Technology Officer at Aware, a leading company in the field of biometrics, to join us for our latest episode of Compliance Conversations. In this episode, Dr. Lazzouni shares insights into the exciting developments in biometrics and its pivotal role in healthcare. From access control to fraud prevention, Dr. Lazzouni and I discuss the impact on compliance and security in the healthcare industry. Listen now to gain a deeper understanding of: - How biometrics enhance healthcare access control - Real-world applications of biometrics in preventing fraud - The intersection of biometrics and compliance in healthcare - The future of wearables and AI in biometric healthcare interventions Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. Link

Ready for a crash course into regulatory considerations in health tech? In this episode of Compliance Conversations featuring Susan Walberg, a seasoned regulatory and compliance professional and published author of fiction and non-fiction In this interesting interview, Susan shares her journey from novels to HIPAA, offering a behind-the-scenes look at the challenges and triumphs of navigating compliance in the rapidly evolving health tech landscape. Tune in to the episode to discover: - Some surprising realities of health tech compliance - Real-word intriguing cases (like the Jelly Bean dilemma!) - Key lessons for startups and small organizations as they navigate compliance concerns Thanks to Susan for joining us for this episode – we hope you enjoy! Susan Walberg has worked in health care for nearly 30 years, from working as a fraud investigator at a health plan, to a regulatory attorney and privacy officer for a very large health system. She has worked as a compliance officer, and a subcontractor working

Tune in to this episode of Compliance Conversations interview with Maya Turner, a seasoned expert in the healthcare industry with close to 30 years of experience in auditing, coding, billing, compliance – you name it. Maya shares her perspective on the evolution of telehealth, especially in the context of recent changes and challenges brought by the COVID-19 pandemic. Maya and CJ also discuss: - Significant changes in telehealth regulations from its early days to the present - Telehealth’s crucial role in addressing healthcare disparities - The importance of proper documentation in telehealth visits - Compliance issues and risks that auditors and coders should be aware of We welcomed an unexpected guest during the episode – Maya's dog! See if you can hear the friendly canine interruption. Maya is a seasoned certified coder and auditor, boasting nearly 30 years of experience and subject matter expertise to many coding compliance subjects; she especially is sought after for her in-depth knowledge base of

Dr. Adam Robinson, an internal medicine physician and founder of Aimedica, joined CJ Wolf, MD to explore the promises and pitfalls presented by AI in the healthcare landscape. Dr. Robinson provides valuable insights into the current state of electronic medical records, the impact of the 21st Century Cures Act, and the potential for AI to revolutionize patient care. Tune in to our latest episode, “Beyond the Buzzwords: Understanding AI's Role in Healthcare,” to hear CJ and Adam's discussion on: - Existing challenges with electronic medical records, such as data interoperability issues and the siloed nature of patient information. - The implications of the 21st Century Cures Act and its role in making healthcare data more transparent and interoperable. - Successful applications of AI in imaging specialties, highlighting the potential for improved diagnostics. - The current lack of comprehensive regulations for AI in healthcare and predictions around the emergence of potential FDA regulations in the fu

In this episode, Jenny Hamilton the Clinical Project Research Manager at Barrow Neurologic Institute, joins CJ Wolf, MD for an in-depth discussion on compliance considerations for clinical trials. From the complexities of protocol deviations to the vital role of Institutional Review Boards, they cover a wide range of topics. Tune in for valuable insights into the compliance landscape of clinical trials and learn more about the crucial role patients play in advancing medical research. Jenny and CJ also cover: - The importance of informed consent in clinical trials - Insights into FDA audits and the role of Clinical Research Associates - The fascinating and diverse landscape of global clinical trials You can also learn more about Jenny’s work here. https://www.barrowneuro.org/centers-programs/als-neuromuscular-disease/ Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Insta

If you haven’t had the time yet to read all 90+ pages of the OIG’s New Compliance Program Guidance, we’ve got a great place for you to start. We invited Sarah Couture, a nurse turned compliance consultant, to discuss the new guidance with us in our latest episode of Compliance Conversations. Join Sarah and CJ Wolf, MD as they break down the essential elements and updates, including: - The evolving role of Chief Compliance Officers - The significance of incentives in compliance programs - Collaborative risk management approaches - Emphasizing medical necessity in billing audits Sarah is the Principal of Couture Compliance, an organization dedicated to elevating compliance program effectiveness through tailored compliance solutions. You can reach her at sarah@couturecompliance.co. Thank you for listening! Please share, like, and subscribe. If you'd like to see more compliance and auditing content feel free to follow us on social media. LinkedIn Youtube Facebook Instagram Check out our resource center and