Best Aapc Podcasts (2025)

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Episode 361 - #TerryTuesday 26:38

2h ago26:38

26:38

Summary In this episode, Sean and Terry discuss the recent passing of Pope Francis and its impact on the world. They then transition into the complexities of healthcare audits, including SIU, CERT, TPE, UPIC, and ZPIC audits. The conversation emphasizes the importance of understanding audit types, the necessity of compliance, and the proactive meas…

1
Episode 360 - Navigating The World of Physician Oversight 25:27

9d ago25:27

25:27

Summary In this episode, Sean and Terry discuss the complexities and challenges surrounding annual well visits in healthcare compliance. They emphasize the importance of physician involvement and the risks associated with allowing non-physician providers to conduct these visits without adequate supervision. The conversation highlights the potential…

1
Episode 359 - #TerryTuesday - The Balance of Sensitivity and Accuracy 25:43

9d ago25:43

25:43

Summary In this episode, Sean and Terry discuss the critical importance of accurate claims submission in healthcare, particularly regarding the representation of patient identity and biological information. They explore the implications of inaccurate documentation on medical necessity, reimbursement, and patient safety, while also addressing the se…

1
Episode 358 - #TerryTuesday - It's All About The Documentation! 20:45

1M ago20:45

20:45

Summary In this episode, Sean and Terry discuss the importance of maintaining high standards of medical record documentation, regardless of whether patients are cash pay or insured. They emphasize that documentation integrity is crucial for all patients and should not be compromised based on financial status. The conversation also touches on recent…

1
Episode 357 - Monday Auditing, Coding and Compliance Roundtable 1:00:59

1M ago1:00:59

1:00:59

Summary In this episode of the Compliance Guy Monday Auditing, Coding, and Compliance Roundtable, the panel discusses various topics including updates on telehealth regulations, challenges in behavioral health documentation, privacy concerns under HIPAA, security risks associated with remote work, the complexities of split shared services, and the …

1
Episode 356 - #TerryTuesday - Upcoding of Services and The Risks Associated with Bad Documentation 29:31

2M ago29:31

29:31

Summary In this episode, Sean and Terry discuss the complexities and challenges surrounding upcoding in medical billing and auditing. They explore the implications of upcoding, the importance of accurate documentation, and the consequences of non-compliance. The conversation also touches on prescription drug management and the nuances of E&M coding…

1
Episode 355 - The Wild World of Healthcare Compliance 59:35

2M ago59:35

59:35

Summary The conversation delves into the evolving role of artificial intelligence (AI) in healthcare, particularly its implications for compliance, documentation, and evaluation and management services. The speakers discuss the benefits and challenges of AI, emphasizing the need for providers to understand its limitations and the importance of main…

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Episode 354 - Andrew Livingston - AI In Healthcare - Opportunities and Challenges 43:36

2M ago43:36

43:36

Summary In this conversation, Sean and Andrew Livingston explore the transformative role of artificial intelligence (AI) in healthcare. They discuss the potential benefits and challenges of AI, including its applications in diagnostics, mental health, and the importance of data privacy and regulation. Andrew shares insights on AI hallucinations, th…

1
Episode 353 - #TerryTuesday - The Importance of Authoritative Documentation in Healthcare 27:53

2M ago27:53

27:53

Summary In this episode, Sean Weiss and Terry Fletcher discuss the complexities of healthcare compliance, emphasizing the importance of understanding various regulations, authoritative documentation, and the necessity of thorough preparation for audits and investigations. They highlight the challenges faced by medical practices in navigating compli…

1
Episode 352 - #TerryTuesday - Navigating HIPAA In A Post-COVID World 27:12

2M ago27:12

27:12

Summary In this episode, Sean and Terry discuss the evolving landscape of healthcare compliance, particularly focusing on HIPAA protections and the implications of the Cures Act. They explore the changes in regulations post-COVID, the importance of safeguarding mental health information, and the need for practices to stay updated with compliance po…

1
Episode 351 - Monday Auditing, Coding and Compliance Roundtable 1:01:14

2M ago1:01:14

1:01:14

Summary The conversation explores the evolving landscape of telehealth, focusing on recent regulatory changes, challenges faced by Congress in legislating telehealth, and the implications for patient care. The panel discusses the importance of documentation, access to services, and the need for guardrails to ensure quality care. They also highlight…

1
Episode 350 - The Ethics of Compliance in Healthcare 59:49

3M ago59:49

59:49

Summary In this conversation, the panel discusses the complexities and challenges faced by external auditors in the healthcare industry. They explore the importance of maintaining integrity and ethical standards while navigating client relationships, compliance issues, and the business side of medicine. The discussion highlights the need for clear …

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Episode 349 - #TerryTuesday - Decoding Imaging Services 23:22

3M ago23:22

23:22

Summary In this episode, Sean and Terry discuss the complexities of billing for imaging services, focusing on the distinctions between professional and technical components. They explore compliance issues, the importance of proper documentation, and the challenges faced by healthcare providers in navigating billing practices. The conversation also …

1
Episode 348 - #TerryTuesday - E&M Challenges and Solutions 30:52

3M ago30:52

30:52

Summary In this episode, Sean and Terry discuss various aspects of E&M audits, focusing on compliance, documentation, and the importance of accurate patient records. They share personal anecdotes and insights into the challenges faced by healthcare providers in maintaining proper documentation and the implications of upcoding. The conversation emph…

1
Episode 347 - Monday Auditing, Coding and Compliance Roundtable 1:00:31

3M ago1:00:31

1:00:31

Summary This round table discussion focuses on critical aspects of healthcare compliance, particularly around deductibles, copays, telehealth, and billing practices. The panelists emphasize the importance of understanding patient financial responsibilities, the need for modernized billing processes, and the legal implications of waiving deductibles…

1
Episode 346 - Vaccine Mandates and How To Handle Vaccine Injuries 42:42

3M ago42:42

42:42

Summary In this episode, Sean discusses the complexities of vaccine injury law with attorneys Jon Groth and Jubaile Abila. They explore the differences between various compensation programs, particularly focusing on the COVID-19 vaccine and the challenges faced by individuals seeking compensation for vaccine-related injuries. The conversation delve…

1
Episode 345 - Navigating Compliance in Healthcare: Insights from Kenneth Polite 44:29

3M ago44:29

44:29

Summary In this conversation, Sean and Kenneth Polite discuss Kenneth's transition from the head of the criminal division at the DOJ to a partner at Sidley, a global law firm. They explore the importance of compliance in healthcare, the role of data in investigations, and the implications of AI in the industry. Kenneth shares insights on the focus …

1
Episode 344 - #TerryTuesday - Navigating The New Political Landscape 25:38

3M ago25:38

25:38

Summary In this episode, Sean and Terry discuss the recent withdrawal of the United States from the World Health Organization, the implications of this decision on healthcare policy, and the political landscape surrounding healthcare administration. They explore the effectiveness of global health organizations, critique the previous administration'…

1
Season 8 - Episode -25 - #TerryTuesday - Audio Only Clarification and Guidance for Mitigating Risk 31:18

4M ago31:18

31:18

Summary In this episode, Sean and Terry discuss the complexities surrounding audio-only telehealth services, particularly in the context of evolving regulations and compliance challenges. They emphasize the importance of understanding the regulatory landscape, the need for proactive measures in healthcare practices, and the potential risks associat…

1
Season 8 - Episode -24 - #TerryTuesday - Metadata "The What, When and Who" 29:04

4M ago29:04

29:04

Summary In this episode of the Compliance Guy program, Sean and Terry discuss the importance of understanding compliance and auditing in the healthcare industry as they enter 2025. They emphasize the significance of metadata and audit trails in electronic medical records, the need for documentation integrity, and the challenges that healthcare prov…

1
Season 8 - Episode 23 - Monday Roundtable - Payor Policies for Telehealth and The OIG's Year-Long Audit of Incident-To Servics 1:06:09

4M ago1:06:09

1:06:09

Summary In this episode, the panel discusses the complexities and challenges surrounding telehealth services, particularly focusing on the regulations, compliance issues, and the evolving landscape of audio-only services. They explore the implications of recent legislative changes, the importance of understanding payer policies, and the need for ca…

1
Season 8 - Episode 22 - From Military to Medicine - Jose Vela, Jr., ESQ 1:23:58

4M ago1:23:58

1:23:58

Summary In this episode, Sean welcomes back Jose Vela Jr., a retired military officer and former federal prosecutor, to discuss his transition into healthcare law. They explore Jose's military career, his experiences as a prosecutor, and the complexities of healthcare fraud cases. The conversation delves into the impact of indictments on healthcare…

1
Season 8 - Episode 21 - #TerryTuesday - Navigating CMS' Final Rule "Key Points" 30:58

5M ago30:58

30:58

Summary In this episode, Sean and Terry discuss the recent CMS final rule and its implications for healthcare practices, focusing on telehealth regulations, direct supervision requirements, and updates in behavioral health services. They also delve into the G2211 add-on complexity code, emphasizing the importance of understanding the nuances of the…

1
Season 8 - Episode 20 - Navigating the Future of Healthcare: Challenges and Opportunities 1:02:21

5M ago1:02:21

1:02:21

Summary The conversation delves into significant healthcare issues, including the targeted assassination of a healthcare CEO, the ongoing challenges and expansion of telehealth services, and the implications of new Medicare regulations. The panel discusses the importance of compliance, the impact of the new administration on healthcare policies, an…

1
Season 8 - Episode 19 - #Terry Tuesday - HIPAA Audits and OIG Identification of Significant Failures by OCR 28:29

5M ago28:29

28:29

Summary In this episode, Sean and Terry discuss the current state of healthcare regulations, focusing on HIPAA compliance and government oversight. They provide a critical analysis of the effectiveness of HIPAA audits and the contradictions within healthcare regulations. The conversation emphasizes the need for accountability in government and heal…

1
Season 8 - Episode 18 - Daily Dose - The Role of DOJ and OIG in Healthcare Compliance 35:08

5M ago35:08

35:08

Summary In this conversation, Sean discusses the critical issue of healthcare fraud, emphasizing the roles of the Department of Justice and the Office of the Inspector General. He outlines various laws and regulations, shares alarming statistics about fraud losses, and highlights emerging challenges in the healthcare landscape. Sean also explores t…

1
Season 8 - Episode - 17 - #TerryTuesday - The Role of AI in Provider Documentation 24:02

5M ago24:02

24:02

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 ra…

1
Season 8 - Episode 16 - Monday Auditing, Coding and Compliance Roundtable 42:02

5M ago42:02

42:02

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 con…

1
Season 8 - Episode 15 - #TerryTuesday The Unsung Heroes of Healthcare 25:34

6M ago25:34

25:34

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 c…

1
season 8 - Episode 14 - #TerryTuesday - The Final Rule is A Critical Mistake 34:36

6M ago34:36

34:36

Summary In this episode, Sean and Terry discuss the implications of the recent Medicare final rule, particularly focusing on the challenges facing telehealth services. They explore the political dynamics surrounding healthcare access, the importance of equitable access to telehealth, and the need for legislative action to address these issues. The …

1
Season 8 - Episode 13 - Navigating Post-Pandemic Audits in Healthcare 45:00

6M ago45:00

45:00

Summary In this episode of the Compliance Guy Podcast, Sean engages with Dean Viskovich, a healthcare attorney with extensive experience in lab-related compliance and reimbursement. They discuss the challenges faced by healthcare providers in the wake of post-pandemic audits, the importance of documentation, and proactive measures that can be taken…

1
Season 8 - Episode 12 - #TerryTuesday - Navigating The World of Consultants in Healthcare 35:03

6M ago35:03

35:03

Summary In this episode, Sean and Terry discuss the challenges faced by consultants in the healthcare industry, particularly regarding collaboration requests and the importance of maintaining credibility. They share personal experiences with scams and the necessity of due diligence when engaging with potential partners. The conversation also touche…

1
Season 8 - Episode 11 - Dr. Muhamad Aly Rifai - Lessons Learned from a High-Stakes Trial 1:25:20

6M ago1:25:20

1:25:20

SummaryIn this episode, Sean discusses the complexities of compliance in healthcare with Dr. Muhammad Ali Rafai, who faced a criminal indictment for healthcare fraud. The conversation covers the emotional toll of the indictment, the audit process, trial preparation, expert testimonies, and the eventual acquittal. Dr. Rifai shares insights on the ch…

1
Season 8 - Episode 10 - #TerryTuesday - Demystifying Compliance 22:39

6M ago22:39

22:39

Summary In this episode, Sean and Terry discuss the critical importance of compliance in healthcare, focusing on the need for consequences for non-compliance, the implementation of financial penalties, and the role of documentation in ensuring patient safety. They emphasize the necessity of creating a culture of compliance within medical practices …

1
Season 8 - Episode 9 - Monday Auditing, Coding and Compliance Roundtable 1:03:28

6M ago1:03:28

1:03:28

Summary The conversation delves into the complexities of Medicare Advantage plans, highlighting concerns about their effectiveness and the implications of recent changes in coding. The panel discusses the challenges faced by patients under these plans, the deceptive marketing tactics used, and the potential shift towards remote patient monitoring a…

1
Season 8 - Episode 8 - The Complex World of Qui Tam Cases - Dismissal Dynamics: With and Without Prejudice 35:00

7M ago35:00

35:00

Summary Eric Rubenstein and Ron Chapman join The Compliance Guy to discuss the implications of a recent dismissal of a False Claims Act case based on the appointment clause. The guys explore the historical context of key tam cases, the role of relators, and the complexities surrounding the appointment clause. The conversation delves into the differ…

1
Season 8 - Episode 7 - #TerryTuesday - Evaluation Medical Necessity 29:05

7M ago29:05

29:05

Summary In this episode, Sean and Terry discuss the intersection of sports and healthcare, particularly focusing on the implications of sports injuries on mental health. They delve into the nuances of preventative medicine visits, the complexities of evaluation and management services, and the importance of medical necessity in billing practices. T…

1
Season 8 - Episode 6 - Monday Auditing, Coding and Compliance Roundtable - 1:01:25

7M ago1:01:25

1:01:25

Summary In this conversation, Sean and his guests discuss various pressing issues in healthcare, focusing on the implications of HIPAA violations, the challenges of patient privacy, and the recent controversies surrounding the Epic EMR system. They delve into the complexities of unauthorized access to patient information, the role of AI in healthca…

1
Season 8 - Episode 5 - Nicole Thorne - Understanding the Surge in Healthcare Audits and the Role of AI in Shaping Healthcare Compliance 45:46

7M ago45:46

45:46

Summary In this conversation, Sean and Nicole Thorn discuss the increasing challenges healthcare providers face regarding compliance, particularly in light of rising audit risks and overpayment demands. They explore the complexities of healthcare law, the role of attorneys in navigating disputes, and the importance of proactive compliance strategie…

1
Season 8 - Episode 4 - #TerryTuesday 36:09

7M ago36:09

36:09

Summary In this episode, Sean and Terry discuss the current state of the healthcare industry, focusing on the business of medicine, the impact of external factors on healthcare operations, and the alarming rise in healthcare bankruptcies. They delve into the role of private equity in healthcare, the importance of compliance, and the need for health…

1
Season 8 - Episode 3 - David Womack of Practice Management Institute 41:40

7M ago41:40

41:40

Summary In this episode, Sean and David discuss the importance of compliance education in healthcare, highlighting the diverse educational sources available, particularly through the Practice Management Institute (PMI). They explore the various certifications offered by PMI, the significance of personalized education, and the impact of recent chang…

1
Season 8 - Episode - 2 - #TerryTuesday 31:16

7M ago31:16

31:16

Summary In this episode, Sean and Terry Fletcher discuss the complexities of prior authorization in healthcare, emphasizing its critical role in the reimbursement process. They explore the misconceptions surrounding prior authorization, the disconnect between healthcare providers and payers, and the challenges posed by Medicare Advantage plans. The…

1
Season 8 - Episode 1 - Monday Auditing, Coding and Compliance Roundtable 59:39

7M ago59:39

59:39

Summary In this episode, the panel discusses the critical importance of honesty in healthcare compliance, the challenges posed by audits, and the responsibilities of providers in navigating vendor relationships. They explore the implications of using AI in clinical documentation, the escalation of compliance issues to law enforcement, and the risks…

1
Season 7 - Episode 50 - #TerryTuesday - Independence and Objectivity in Auditing! 30:05

7M ago30:05

30:05

Summary In this conversation, Sean and Terry discuss the critical importance of conducting audits in healthcare practices, emphasizing the need for both internal and external reviews to ensure compliance and accuracy in coding and billing. They highlight real-world examples of practices that have suffered due to a lack of audits and the biases that…

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Season 7 - Episode 49 - #TerryTuesday - When It's Clear As Mud! 36:09

8M ago36:09

36:09

Summary In this episode, Sean and Terry discuss various topics related to healthcare compliance. They start by sharing their recent experiences, including Sean's trip to Alaska. Then, they dive into the theme of the episode, which is when things are as clear as mud in the healthcare community. They discuss the challenges of finding clear guidelines…

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Season 7 - Episode 48 - Monday Auditing, Coding and Compliance Roundtable 1:01:15

8M ago1:01:15

1:01:15

Summary The conversation revolves around the topic of padding medical bills and the importance of clear communication with patients regarding their financial responsibilities. The speakers discuss instances where unnecessary charges are added to the bill, such as billing for lifestyle medicine codes during a visit for a finger fracture or adding ch…

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Season 7 - Episode 47 - #TerryTuesday - Navigating the Challenges of Telehealth Services and Billing 42:49

8M ago42:49

42:49

In this episode, Sean and Terry discuss the recent incident where Sean accidentally went live with colorful language during a recording. They also dive into the proposed changes to the telehealth services and fee structure for 2025. Terry explains the challenges and limitations of telehealth services, especially when it comes to billing and coding.…

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Season 7 - Episode 46 - #TerryTuesday - Privilege or No Privilege "That is the Question" 29:50

9M ago29:50

29:50

This is a controversial topic depending on which side of the yellow line you stand on... The question is does all work with a consultant require attorney client privilege... This is a great discussion for those of you looking to engage in coding and billing audits.

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Season 7 - Episode 45 - Monday Auditing, Coding, and Compliance Roundtable 58:35

9M ago58:35

58:35

This was a great live show! Sean was joined by Terry, Christine, and Paul to discuss Medical Decision-Making for levels of EM service when Rx Management is involved. There was a lot to unpack in this episode so don't miss this one!