Created with Sketch.
Compliance Conversations by Healthicity
33 minutes | Jun 28, 2022
Compliance Pathways Part 3: Regrets, Redo's, and the Realities of a Compliance Career
For an honest and informative dialogue on what it's really like to spend your days in compliance. This episode is for folks looking for a new career and seasoned professionals alike. In this episode, we cover: - A snapshot of a compliance officer’s unpredictable day - Career regrets and wisdom gained - Tips to help you understand if compliance is right for you
37 minutes | May 23, 2022
Lessons Learned From a Travel Auditor
We chat about everything from the various routes one might take to land the position, the do’s and don’ts of packing for a work trip (and embarrassing packing fails), the complexities of things like acquisitions, and how to take a proactive approach to auditing.
30 minutes | May 16, 2022
Artificial Intelligence in Healthcare Compliance
In this episode, you’ll learn how AI is used to reduce compliance risks and inform the FDA about adverse events.
32 minutes | May 5, 2022
Pathways to Compliance: What Happens Once You’ve Got the Job?
Listen in for a lively and educational chat on what to do once you find yourself in compliance. This episode is for folks just beginning their journey and folks who have been at it for a while.
31 minutes | Mar 29, 2022
Pathways to Compliance with Guest Brian Burton
During our discussion, we chatted about our journeys to compliance, how folks can begin or transition to a career in compliance, and we outline precisely what a compliance expert does every day. And? It’s not nearly as dull as our kids think.
34 minutes | Mar 7, 2022
The Gray Areas of HIPAA in Mental Health and Substance Abuse
This conversation covered a lot of ground. They chatted about the requirements around consent and group therapy, rules around disclosure to help a patient, HIPAA standard practices with teens, and the often hidden realities of the Opioid epidemic. Listen to the episode now or on your commute.
40 minutes | Jan 20, 2022
All Things Therapy and Compliance Risks
When it comes to compliance for mental health services, you’ve got to pay extra attention to your billing and coding. Learn a brief history of Psychotherapy and compliance risks associated with therapy services.
31 minutes | Dec 21, 2021
Suicide and Prevention
As compliance professionals in a healthcare setting, we can never know too much about physical and mental health. Plus as human beings, there’s nothing more important than the health and wellness of our friends, family, and coworkers.
36 minutes | Nov 17, 2021
How to Optimize Mental Health Outcomes with Psychiatrist Dave Paulson
Learn from our compliance expert, CJ Wolf, and Psychiatrist, Dave Paulson, about how to optimize mental health outcomes in this episode.
36 minutes | Nov 10, 2021
Integrative Health For Compliance Officers: Understanding Energy Healing and Reiki
Our compliance expert, CJ Wold M.D., spoke with two Reiki practitioners, Justin Larsen and Julie Crane R.N., about the history, science, and practical uses of Reiki.
31 minutes | Dec 16, 2020
A Pro’s Guide to Conducting Your Annual Privacy and Security Risk Assessment
Recently, I sat down with Brian Burton, our new Chief Compliance and Privacy Officer, for an all-new episode of the Compliance Conversations podcast. Given the time of year, and his area of expertise, we focused our discussion on a topic on many people’s minds: Privacy and Security Risk Assessments. I know these assessments can be daunting to approach or, as Brian put it, “I think a lot of organizations struggle with what does that mean, and how can I accomplish this activity with the minimum amount of effort, but still know that it’s accurate, and that your organization is protected from cyber security threats.” Having worked in the healthcare industry for more than 15 years, Brian become an expert in all things project management and technology. He's devoted most of his career to developing, implementing, and providing oversight for Compliance and Privacy program initiatives, working with more than one hundred healthcare facilities. Considering Brian’s vast experience, we discussed the symbiosis between project management and risk assessments, and how organizations should “initiate a project, then execute, monitor, control, and close,” in order to successfully identify and mitigate their risks. To hear more of Brian’s advice and best practices, listen to our latest episode of Compliance Conversations, “A Pro’s Guide to Conducting Your Annual Privacy and Security Risk Assessment,” where we cover topics including: • How to Protect Your Organization from Cyber Security Threats • What Tools You Should Use to Conduct Your Annual Security Risk Assessment • Which Cyber Security Framework Your Organization Should Deploy
24 minutes | Dec 16, 2019
Ask an Auditor Anything (Dec 2019)
Around Healthicity, we love nothing more than to provide answers to some of your most pressing questions. And boy, do we get a lot of them. Because of this, we asked you to send us the questions that most perplex you while on the job. We got a ton of great questions (thank you), some of which even had us scratching our heads, too. So, I took a bunch of your questions to our resident auditing experts, Stephani Scott and Lori Cox, and sat down for a little chat. What we Then, we took a handful of those questions and and sat down to discuss them during this episode of Compliance Conversations, titled “Ask an Auditor Anything.” Here’s a sneak peak at some of the questions we discussed, and answered: Can Documentation of a Previous Allergic Reaction be Used Under ROS, or Only PMH? If the physician states "same/unchanged from last visit" to History will they receive credit for reviewing the last visit information? If the Documentation States “NO PFSH," Is This Applicable On a New PT or Consult Visit?
20 minutes | Dec 11, 2019
What You Must Do to be HIPAA Compliant in 2020
It’s that time of year again, when everyone is either breathing a sigh of relief because they’ve just completed their annual HIPAA risk assessment, or they’re cramming to get it done before year’s end. In the spirit of HIPAA season, we decided to turn the tables on CJ. So in this latest episode of Compliance Conversations, we had our very own SVP, Jeremy Schow, interview our local HIPAA expert, CJ Wolf, MD, to discuss all things HIPAA. And he had a lot to say. “The number one reason we do a risk assessment is it's a requirement. Number two though, it's good practice, right? We're in the business of helping patients, and we want to keep that information private and confidential. So, it's a good business practice,” CJ observed, before going on to answer all sorts of questions around HIPAA, including: Should I Conduct an Assessment Every Year? How Do I Conduct an Effective HIPAA Risk Assessment? What are Some Common HIPAA Mistakes I Should Avoid?
25 minutes | Oct 2, 2019
A Deep Dive Into the NCCI Policy Manual
In part two of my conversation with Christopher Chandler, a Technical Manager of Professional Documentation and Coding, at Intermountain Healthcare, we dove into the NCCI policy manual. It’s been a hot topic, as of late. Mostly because, as Chandler put it with a grin, “people hate the NCCI Policy Manual. They see it as a big book of rules that stops them from getting paid for the stuff they are doing.” But as you’ll hear, the manual is so much more. For instance, sometimes you can bill two codes together and, other times, you can’t. And when you need to know the answer, you consult the NCCI manual. Because many commercial payers have adopted these edits as well, it’s become an indispensable resource for any compliance billing department that’s using today’s best practices. But the manual can be daunting, and oftentimes difficult to decipher. Which is why during this episode of Compliance Conversations, "A Deep Dive Into the NCCI Policy Manual," Chandler and I jump right into the ins-and-outs of the manual, and discuss the three main topics of the manual, including: Knowing Exactly What’s Included in a Surgical Package Understanding Multiple Procedure Overlaps Billing Protocols for Inherent Services
22 minutes | Sep 25, 2019
Understanding the Nuance of NPP Coding
Recently, I sat down with Christopher Chandler, a Technical Manager of Professional Documentation and Coding, and we had a lot to cover during our podcast. So much so, that we actually recorded two new podcast episodes. In this first episode, Understanding the Nuance of NPP Coding, we dove into the world of non-physician practitioner (NPP) coding. NPPs, as Medicare calls them, are made up of a number of different provider types. They include nurse practitioners, physician assistants, certified nurse anesthetists, clinical nurse specialists, amongst others. The world of NPPs is ever-changing as hospitals are, in Chandler’s words, “developing new ways of providing care to patients… and help alleviate the burden that physicians are feeling, with the amount of patient load that they have.” If your hospital or clinic has a number of NPPs, it could be a signal to payers to keep an eye on your claim submissions. Which makes it all the more critical that your billing department has the tools to correctly code your NPPs. Listen to our newest episode of Compliance Conversations:, where Chandler and I discussed everything NPP, including: Identifying the Difference Between Shared Services and Incident Two Avoiding Double Billing the Patient and the Payer Following the Intense Guidelines of Shared Services
25 minutes | Sep 11, 2019
How to Provide Access to Telehealth, While Maintaining Compliance
For this installment of Compliance Conversations, we interviewed Jake Geertsen, a Technical Manager in the documentation and coding, who specializes in telehealth. It’s a fast-growing segment of healthcare, which has spawned a lot of questions around the field. Not least of which is: What exactly is telehealth? According to Geertsen, telehealth is “a collection of means or methods for enhancing healthcare, public health, and health education delivery and support, using telecommunication technologies.” Just ten years ago, few of us were carrying around the computing power we commonly find in our pockets and purses today. Nor did we know the benefits this technology could have to, as Geertsen puts it, “to the patient, the healthcare organization looking to cut costs, to insurance companies also looking to cut costs. In many scenarios, this is an area of innovation and improvement.” Understand the History and Evolution of Telehealth Implement Proper Coding and Billing Compliance Practices Stay Current with Ever-changing Medicare Regulations and Payer Policie
26 minutes | Aug 21, 2019
How to Earn a Huge ROI from Medicare’s IOMs
I sat down with Tyler Griffeth, a Technical Manager of Professional Documentation and Coding at Intermountain Healthcare, to discuss a couple of his favorite Medicare Internet Only Manuals (IOMs), specifically the National Correct Coding Initiative (NCCI) Policy Manual and the Claims Processing Manual. The NCCI Manual, about which he jokingly said, “I’ve got mine laminated, I can read it in the tub with a little bit of bubbly” is just one of his favorites. Meanwhile, the Claims Processing Manual, “Is a really great resource if you’re dealing with things like denials, but also if you’re involved in a RAC audit.” Tune in to my most recent episode of Compliance Conversations, How to Earn a Huge ROI from Medicare’s IOMs, and learn how to: Use the NCCI Policy Manual to Clarify Procedure Codes to Physicians Leverage the Claims Processing Manual to Avoid Denials Apply Situational Modifiers in Conjunction with Codes
34 minutes | Aug 7, 2019
Export Controls: The Most Important Compliance Element You Probably Haven’t Heard Of
Whether you’re dealing with medical devices or new drugs–regardless if it’s a product or a service, and whether that product or service ever even leaves the United States, export controls affect every organization in one way or another. That’s why I was so excited to sit down with Export Controls and Compliance expert, Wendy Epley, the president of Epley Consulting, for this episode of Compliance Conversations. As a compliance professional in healthcare, you might hear the word “export” and think ‘I don’t ship anything out of the country, so export controls don’t apply to me.’ But surprisingly it does! Epley explained, “[export controls] is referring to a very complicated network of federal agencies and regulations that are interconnected to regulate or control how things are to be protected in order that they are not used in a way that would cause harm...regardless of where those persons are located, including if they are here within the United States.” Epley also went into detail about the foreign corrupt practices act, an important act for many of you in various healthcare compliance roles. “Just a few years ago, Teva Pharmaceutical Industries paid nearly five hundred and twenty million...for its role in violations with the FCPA.” Said Epley. Find out how export controls apply to all of you healthcare compliance professionals out there. Tune in to my latest episode of Compliance Conversations, Export Controls: The Most Important Compliance Element You Probably Haven’t Heard Of, to learn why: One Doctor Went to Prison For His Research Some Medical Equipment and New Drugs Pose A Risk You Need to Institute Export Protocols and Training in a Research Uni Setting Teva Pharmaceutical Industries Paid Nearly $520 Million in Violations
31 minutes | Jul 25, 2019
How to Build a Mutually Beneficial Relationship with Your Compliance Committee
Listen to this most recent episode of Compliance Conversations, How to Build a Mutually Beneficial Relationship with Your Compliance Committee, with special guest, Judith Maber-Fox, to learn how to: Build a Mutually Beneficial Relationship with your Compliance Committee Engage Sr. Leadership to Actively Support the Committee Create Opportunities That Give You a Seat at the Table
27 minutes | Jun 19, 2019
The Psychology Behind Why Physicians Undercode
For this Compliance Conversations episode, I’ve got a special treat for you: Dr. Ira Specter. He spent many years as a practicing OBGYN physician and is also a certified coder and medical auditor. After practicing medicine for a few decades he went on to run a large medical management company, where they did billing collection, coding, compliance, and ICC10 courses for sixty-five physicians. Because of his unique perspective, we tackled bridging the gap between coding and auditing and physician documentation. I asked Dr. Specter, “what’s the biggest area for improvement for physician documentation?” After a brief pause, he said, “Let me start by saying, by and large, most physicians are under coding.” It seems, according to Specter, that physicians are “cutting off their own legs,” and also “cherry picking” codes. What does that mean? Listen to this episode to find out what Dr. Specter views as the biggest mistakes physicians are currently making and learn: What Coders/Auditors Should Look Out For in Physicians Documentation Why Physicians Should Never Cherry Pick Codes The Pitfalls of Copying and Cloning.
Terms of Service
Do Not Sell My Personal Information
© Stitcher 2022