I’ve had the privilege of leading and being part of compliance teams at non-profit providers, for profit payors, start-ups, and regulators. Regardless of the business model,...

As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. Unfortunately, with a...

When physicians or other clinicians submit claims for professional medical services, they select a medical code to represent the services. Procedures like a skin biopsy or an...

With children back in school, well-visit checkups and sports physical appointments are opportunities for providers to evaluate and discuss mental health. School-aged kids – ages 5...

In the business of healthcare, promoting a culture of compliance is not merely a goal – it’s a necessity. Ethical integrity and adhering to regulatory requirements are critical to...

Two of the most significant healthcare compliance risks are medical coding and billing. Enforcement agencies like to “follow the money,” so to speak, and they often find it in...

A few weeks ago, I had an interesting experience when I went into an auto-parts store to purchase a replacement air filter for my wife’s car. When I got to the counter, I told the...

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more...

Was “project manager” in your current or previous job descriptions? It definitely wasn’t in any of mine! But very quickly, as a compliance officer, I realized that I was managing...