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Ep9: Mohamed Rifai on Medicare Audit Challenges in Group Practice

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Manage episode 498375939 series 3670755
Content provided by VevaMedia. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by VevaMedia or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.

Medicare audit challenges can seriously affect even the most robust group practices. In this episode of Your Group Practice, Dan King talks with Dr. Mohamed Rifai, founder of BlueMountain Psychiatry, to share his experience navigating federal investigations, legal battles, and eventual vindication.

Dr. Rifai, who is board certified in internal medicine, psychiatry, and addiction medicine, built his Pennsylvania-based practice to serve over a million residents in the Lehigh Valley. As an early telehealth adopter, he pioneered psychiatric care for nursing homes years before the COVID-19 pandemic. However, misunderstandings surrounding medical coding led to allegations of fraud from the Department of Justice, risking his career and freedom. After facing trial, he was acquitted and now uses his story to educate practice owners.

In this episode, you’ll learn:

  • The hidden risks of Medicare audit challenges and telehealth billing
  • Why compliance systems and coding audits are vital for sustainability
  • How proactive insurer communication can safeguard your practice
  • Strategies to protect your team through compliance manuals and training

Dr. Rifai also introduces SHIELD, his new consulting firm helping healthcare providers navigate legal and regulatory challenges, and shares how self-care helped him rebuild after the stress of his trial.

Transform Your Group Practice

Actionable insights for practice owners and clinicians who want to lead, grow, or exit with purpose. This is the podcast shaping a stronger mental health system — one practice at a time.

About the Host

Dan King is a lawyer turned private equity founder with a passion for fixing burnout in mental health. With a background in M&A, Shark Tank deals, and psychology, he now leads Fireside Strategic — investing in group practices that put people first.

  • LinkedIn: linkedin.com/in/danmking
  • Website: firesidestrategic.com

  continue reading

Chapters

1. Ep9: Mohamed Rifai on Medicare Audit Challenges in Group Practice (00:00:00)

2. Introduction to Dr. Mohamed Rifai (00:00:59)

3. The Journey of Telehealth Adoption (00:02:39)

4. Facing Allegations of Fraud (00:03:54)

5. The Trial and Vindication (00:05:53)

6. Lessons for Group Practice Owners (00:11:12)

7. Navigating Compliance and Coding (00:17:24)

8. Proactive Strategies with Insurers (00:19:41)

9. Launching SHIELD for Legal Support (00:25:24)

10. Finding Balance and Self-Care (00:27:14)

18 episodes

Artwork
iconShare
 
Manage episode 498375939 series 3670755
Content provided by VevaMedia. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by VevaMedia or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.

Medicare audit challenges can seriously affect even the most robust group practices. In this episode of Your Group Practice, Dan King talks with Dr. Mohamed Rifai, founder of BlueMountain Psychiatry, to share his experience navigating federal investigations, legal battles, and eventual vindication.

Dr. Rifai, who is board certified in internal medicine, psychiatry, and addiction medicine, built his Pennsylvania-based practice to serve over a million residents in the Lehigh Valley. As an early telehealth adopter, he pioneered psychiatric care for nursing homes years before the COVID-19 pandemic. However, misunderstandings surrounding medical coding led to allegations of fraud from the Department of Justice, risking his career and freedom. After facing trial, he was acquitted and now uses his story to educate practice owners.

In this episode, you’ll learn:

  • The hidden risks of Medicare audit challenges and telehealth billing
  • Why compliance systems and coding audits are vital for sustainability
  • How proactive insurer communication can safeguard your practice
  • Strategies to protect your team through compliance manuals and training

Dr. Rifai also introduces SHIELD, his new consulting firm helping healthcare providers navigate legal and regulatory challenges, and shares how self-care helped him rebuild after the stress of his trial.

Transform Your Group Practice

Actionable insights for practice owners and clinicians who want to lead, grow, or exit with purpose. This is the podcast shaping a stronger mental health system — one practice at a time.

About the Host

Dan King is a lawyer turned private equity founder with a passion for fixing burnout in mental health. With a background in M&A, Shark Tank deals, and psychology, he now leads Fireside Strategic — investing in group practices that put people first.

  • LinkedIn: linkedin.com/in/danmking
  • Website: firesidestrategic.com

  continue reading

Chapters

1. Ep9: Mohamed Rifai on Medicare Audit Challenges in Group Practice (00:00:00)

2. Introduction to Dr. Mohamed Rifai (00:00:59)

3. The Journey of Telehealth Adoption (00:02:39)

4. Facing Allegations of Fraud (00:03:54)

5. The Trial and Vindication (00:05:53)

6. Lessons for Group Practice Owners (00:11:12)

7. Navigating Compliance and Coding (00:17:24)

8. Proactive Strategies with Insurers (00:19:41)

9. Launching SHIELD for Legal Support (00:25:24)

10. Finding Balance and Self-Care (00:27:14)

18 episodes

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