billing Archives - Wisdom. Applied. https://blog.weisspc.com/tag/billing/ Wisdom Applied - Decoding the Business of Healthcare — Mark Weiss’s Perspective Fri, 22 May 2026 15:18:37 +0000 en-US hourly 1 183918279 Fraud on Fridays: No Sample Required  https://blog.weisspc.com/covid-testing-fraud-no-sample-required/ https://blog.weisspc.com/covid-testing-fraud-no-sample-required/#respond Fri, 22 May 2026 14:14:00 +0000 https://blog.weisspc.com/?p=37111 Two brothers from Naperville. Four laboratories. $293 million in claims for COVID-19 tests that were never performed. And then the gold bars, the overseas mansions, the luxury watches — and a superseding indictment.

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]]> https://blog.weisspc.com/covid-testing-fraud-no-sample-required/feed/ 0 37111 Fraud on Fridays: The Diagnosis That Wasn’t There https://blog.weisspc.com/fraud-on-fridays-the-diagnosis-that-wasnt-there/ https://blog.weisspc.com/fraud-on-fridays-the-diagnosis-that-wasnt-there/#respond Fri, 01 May 2026 13:28:00 +0000 https://blog.weisspc.com/?p=37066 $556 million. One settlement. One health system that is simultaneously the insurer and the physician group. The largest Medicare Advantage risk adjustment fraud settlement in history, and a warning for every physician group in an MA contract.

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]]> https://blog.weisspc.com/fraud-on-fridays-the-diagnosis-that-wasnt-there/feed/ 0 37066 Fraud on Fridays: Operation Never Say Die https://blog.weisspc.com/hospice-fraud-operation-never-say-die/ https://blog.weisspc.com/hospice-fraud-operation-never-say-die/#respond Fri, 10 Apr 2026 14:40:00 +0000 https://blog.weisspc.com/?p=37029 Healthy patients recruited at grocery stores, cash in envelopes, and a fraud ring that didn’t stop even when its ringleader was already sitting in a federal prison.

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]]> https://blog.weisspc.com/hospice-fraud-operation-never-say-die/feed/ 0 37029 Fraud on Fridays: Bonnie and Clyde, M.D. https://blog.weisspc.com/fraud-on-fridays-bonnie-and-clyde-md/ https://blog.weisspc.com/fraud-on-fridays-bonnie-and-clyde-md/#respond Fri, 27 Mar 2026 13:55:39 +0000 https://blog.weisspc.com/?p=37017 A husband-and-wife team, expired injections, and 15 years of fraud. This Bonnie and Clyde didn’t rob banks, they robbed their patients.

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]]> https://blog.weisspc.com/fraud-on-fridays-bonnie-and-clyde-md/feed/ 0 37017 Fraud on Fridays: It’s What Was in the Goody Bag https://blog.weisspc.com/fraud-on-fridays-goody-bag-opioid-scheme/ https://blog.weisspc.com/fraud-on-fridays-goody-bag-opioid-scheme/#respond Fri, 20 Mar 2026 14:51:00 +0000 https://blog.weisspc.com/?p=37012 Opioids, unnecessary prescriptions, unlicensed interns, and a Goody Bag no patient actually wanted.

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]]> https://blog.weisspc.com/fraud-on-fridays-goody-bag-opioid-scheme/feed/ 0 37012 Fraud on Fridays: From Telehealth to Telefraud https://blog.weisspc.com/fraud-on-fridays-telehealth-to-telefraud/ https://blog.weisspc.com/fraud-on-fridays-telehealth-to-telefraud/#respond Fri, 23 Jan 2026 13:38:00 +0000 https://blog.weisspc.com/?p=36716 Another week. Another fraud.
This Friday’s case shows how telehealth can quietly turn into federal wire fraud—without physicians realizing the risk until it’s too late.

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]]> https://blog.weisspc.com/fraud-on-fridays-telehealth-to-telefraud/feed/ 0 36716 Five Ophthalmology Practices See Eye to Eye in False Claims Act Settlement https://blog.weisspc.com/ophthalmology-kickback-false-claims-act-settlement/ https://blog.weisspc.com/ophthalmology-kickback-false-claims-act-settlement/#respond Mon, 19 Jan 2026 16:44:08 +0000 https://blog.weisspc.com/?p=36695 Five ophthalmology practices agreed to pay nearly $6M over alleged kickbacks and unnecessary testing. Learn the FCA risks every physician group must understand.

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]]> https://blog.weisspc.com/ophthalmology-kickback-false-claims-act-settlement/feed/ 0 36695 Fraud on Fridays: Bogus Billing for Botox? https://blog.weisspc.com/bogus-botox-billing-fraud/ https://blog.weisspc.com/bogus-botox-billing-fraud/#respond Sat, 17 Jan 2026 08:15:00 +0000 https://blog.weisspc.com/?p=36663 Learn why poor documentation and bad fixes can turn mistakes into criminal exposure—and how one physician allegedly blurred the lines of Botox billing.

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]]> https://blog.weisspc.com/bogus-botox-billing-fraud/feed/ 0 36663 Fraud on Fridays: Pink Slipped https://blog.weisspc.com/healthcare-executive-fraud-risks/ https://blog.weisspc.com/healthcare-executive-fraud-risks/#respond Fri, 26 Dec 2025 10:30:00 +0000 https://blog.weisspc.com/?p=36467 From sell-mates to cellmates? Used car salesmen/financiers and the lesson for healthcare leaders.

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]]> https://blog.weisspc.com/healthcare-executive-fraud-risks/feed/ 0 36467 Off to Prison. An Update on How to Almost Make Half a Billion Dollars: The Arizona Wound Graft Fraud https://blog.weisspc.com/wound-care-graft-fraud/ https://blog.weisspc.com/wound-care-graft-fraud/#respond Mon, 22 Dec 2025 16:41:12 +0000 https://blog.weisspc.com/?p=36464 Now that they’ve been sentenced to prison, I can reveal the fate of the healthcare power couple, Alexandra Gehrke and her husband, Jeffrey King, whose wound care graft graft put close to $615,000,000 in their pockets, albeit temporarily.

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]]> https://blog.weisspc.com/wound-care-graft-fraud/feed/ 0 36464 Fraud on Fridays: Deceit Was in His Genes https://blog.weisspc.com/medicare-genetic-testing-fraud/ https://blog.weisspc.com/medicare-genetic-testing-fraud/#respond Fri, 19 Dec 2025 12:25:00 +0000 https://blog.weisspc.com/?p=36462 Perhaps he should have genetically tested himself for the propensity to commit fraud.

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]]> https://blog.weisspc.com/medicare-genetic-testing-fraud/feed/ 0 36462 Surprise: The No Surprises Act Is Working, Just Not How Insurers Planned https://blog.weisspc.com/no-surprises-act-physician-reimbursement/ https://blog.weisspc.com/no-surprises-act-physician-reimbursement/#respond Mon, 27 Oct 2025 15:49:04 +0000 https://blog.weisspc.com/?p=36409 The No Surprises Act wasn’t about patients. The fine print told a different tale: it was an insurer-protection law.

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]]> https://blog.weisspc.com/no-surprises-act-physician-reimbursement/feed/ 0 36409 Double Trouble: Prosecuted and Sued for the Same Scam https://blog.weisspc.com/physician-fraud-civil-and-criminal-charges/ https://blog.weisspc.com/physician-fraud-civil-and-criminal-charges/#respond Mon, 28 Jul 2025 15:57:50 +0000 https://blog.weisspc.com/?p=35120 Out of state. Still billing for in-person care.
A physician submitted claims while vacationing in Hawaii—and now faces criminal sentencing and a $500k civil payout.

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]]> https://blog.weisspc.com/physician-fraud-civil-and-criminal-charges/feed/ 0 35120 You Can’t Lipstick That Pig: Why Physicians Must Carefully Vet Deals https://blog.weisspc.com/you-cant-lipstick-that-pig-why-physicians-must-carefully-vet-deals/ https://blog.weisspc.com/you-cant-lipstick-that-pig-why-physicians-must-carefully-vet-deals/#respond Mon, 21 Jul 2025 16:45:19 +0000 https://blog.weisspc.com/?p=35015 Deals involving management services agreements, consulting contracts, or similar structures can appear completely legal at first glance. But dig deeper, and they might turn out to be elaborate covers for kickbacks or bribes.

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]]> https://blog.weisspc.com/you-cant-lipstick-that-pig-why-physicians-must-carefully-vet-deals/feed/ 0 35015 Pain Doc Likely in Pain After Settling Allegations That Billed Procedures Weren’t Performed https://blog.weisspc.com/pain-doc-likely-in-pain-after-settling-allegations-that-billed-procedures-werent-performed/ https://blog.weisspc.com/pain-doc-likely-in-pain-after-settling-allegations-that-billed-procedures-werent-performed/#respond Wed, 11 Jun 2025 15:07:47 +0000 https://blog.weisspc.com/?p=34118 Was it a scam or an error? A settlement is just that and there’s been no determination of liability.

Neither you nor I can know for sure what went on, but either way, there’s a lesson here about billing compliance.

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]]> https://blog.weisspc.com/pain-doc-likely-in-pain-after-settling-allegations-that-billed-procedures-werent-performed/feed/ 0 34118 How Medical Group Collaboration Creeps into Fraud—Pass-Through Billing https://blog.weisspc.com/medical-group-collaboration-pass-through-billing/ https://blog.weisspc.com/medical-group-collaboration-pass-through-billing/#respond Mon, 28 Apr 2025 15:39:40 +0000 https://blog.weisspc.com/?p=32084 Hospital-based medical groups, notably anesthesiology and radiology groups, are increasingly turning to creative means to provide coverage and to improve collections.

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]]> https://blog.weisspc.com/medical-group-collaboration-pass-through-billing/feed/ 0 32084 How to Almost Make Half a Billion Dollars: The Arizona Wound Graft Fraud https://blog.weisspc.com/how-to-almost-make-half-a-billion-dollars/ https://blog.weisspc.com/how-to-almost-make-half-a-billion-dollars/#respond Mon, 10 Feb 2025 15:58:37 +0000 https://blog.weisspc.com/?p=31571 If you thought health care fraud required medical knowledge, think again.

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]]> https://blog.weisspc.com/how-to-almost-make-half-a-billion-dollars/feed/ 0 31571 Aetna Health v. Radiology Partners and the Danger of Pass-Through Billing https://blog.weisspc.com/aetna-health-v-radiology-partners-and-the-danger-of-pass-through-billing/ https://blog.weisspc.com/aetna-health-v-radiology-partners-and-the-danger-of-pass-through-billing/#respond Mon, 13 Jan 2025 19:18:22 +0000 https://blog.weisspc.com/?p=31541 There are, depending upon the particular arrangement, potential end runs around contractual pass-through billing prohibitions, but they are highly fact specific and technical.

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]]> https://blog.weisspc.com/aetna-health-v-radiology-partners-and-the-danger-of-pass-through-billing/feed/ 0 31541 More On Overturning the No Surprises Act https://blog.weisspc.com/more-on-overturning-the-no-surprises-act/ https://blog.weisspc.com/more-on-overturning-the-no-surprises-act/#respond Mon, 23 Dec 2024 17:40:21 +0000 https://blog.weisspc.com/?p=31507 It you haven’t yet read it, see my December 16, 2024, post, Now’s The Time to Overturn the No Surprises Act, for part 1 of this thread.

When that post was published on LinkedIn, my friend James Prudden commented, asking me how patients would be protected if the No Surprises Act were repealed. Here’s my response to James.

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]]> https://blog.weisspc.com/more-on-overturning-the-no-surprises-act/feed/ 0 31507 Now’s The Time to Overturn the No Surprises Act https://blog.weisspc.com/nows-the-time-to-overturn/ https://blog.weisspc.com/nows-the-time-to-overturn/#respond Mon, 16 Dec 2024 16:22:49 +0000 https://blog.weisspc.com/?p=31495 Re-frame the issue for what it really is: Surprise physician services stealing. Now’s the time for the No Surprises Act, and each state counterpart, to go.

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]]> https://blog.weisspc.com/nows-the-time-to-overturn/feed/ 0 31495 Beware of Bogus Medicare and Medicaid Billings https://blog.weisspc.com/beware-of-bogus-medicare-and-medicaid-billings/ https://blog.weisspc.com/beware-of-bogus-medicare-and-medicaid-billings/#respond Mon, 19 Aug 2024 15:22:37 +0000 https://blog.weisspc.com/?p=31352 Certifying to Medicare that you’re here when you’re really there is a ticket to nowhere, or maybe to jail.

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]]> https://blog.weisspc.com/beware-of-bogus-medicare-and-medicaid-billings/feed/ 0 31352 What’s Not in Your Wallet? Preventing Fraud Perpetrated Against Your Medical Practice. https://blog.weisspc.com/whats-not-in-your-wallet/ https://blog.weisspc.com/whats-not-in-your-wallet/#respond Mon, 12 Aug 2024 15:51:41 +0000 https://blog.weisspc.com/?p=31347 It’s a no-brainer that you can be more effective at finding and correcting potential fraud by conducting periodic audits on both internal and outsourced operations.

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]]> https://blog.weisspc.com/whats-not-in-your-wallet/feed/ 0 31347 Conviction for $70 Million in Fake Medicare Claims Likely Sending Doc to Big House – Medical Group Minute https://blog.weisspc.com/conviction-for-70-million-in-fake-claims-video/ https://blog.weisspc.com/conviction-for-70-million-in-fake-claims-video/#respond Wed, 31 Jul 2024 08:24:00 +0000 https://blog.weisspc.com/?p=31214 Although health care fraud doesn’t require the involvement of telemedicine, with advances in telemedicine come “advances” in criminal schemes.

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]]> https://blog.weisspc.com/conviction-for-70-million-in-fake-claims-video/feed/ 0 31214 Hamburger or Health Care? Why You Must Understand the Dilemma. – Podcast https://blog.weisspc.com/healthcare-payments-economic-pressure-audio/ https://blog.weisspc.com/healthcare-payments-economic-pressure-audio/#respond Thu, 18 Jul 2024 10:06:00 +0000 https://blog.weisspc.com/?p=31135 Many medical groups have come to expect that their businesses run like vending machines. Push the button and out comes collections.

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]]> https://blog.weisspc.com/healthcare-payments-economic-pressure-audio/feed/ 0 31135 Hamburger or Health Care? Why You Must Understand the Dilemma. – Medical Group Minute https://blog.weisspc.com/healthcare-payments-economic-pressure-video/ https://blog.weisspc.com/healthcare-payments-economic-pressure-video/#respond Wed, 10 Jul 2024 09:27:00 +0000 https://blog.weisspc.com/?p=31126 Many medical groups have come to expect that their businesses run like vending machines. Push the button and out comes collections.

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]]> https://blog.weisspc.com/healthcare-payments-economic-pressure-video/feed/ 0 31126 Surprise Hospital Billing – Podcast https://blog.weisspc.com/surprise-hospital-billing-audio/ https://blog.weisspc.com/surprise-hospital-billing-audio/#respond Thu, 13 Jun 2024 16:45:12 +0000 https://blog.weisspc.com/?p=31105 What’s a hospital surprise bill? Well, it’s something slightly different from the concept applied to physicians.

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]]> https://blog.weisspc.com/surprise-hospital-billing-audio/feed/ 0 31105 Conviction for $70 Million in Fake Medicare Claims Likely Sending Doc to Big House https://blog.weisspc.com/conviction-for-70-million-in-fake-claims/ https://blog.weisspc.com/conviction-for-70-million-in-fake-claims/#respond Mon, 03 Jun 2024 14:44:00 +0000 https://blog.weisspc.com/?p=31051 Although health care fraud doesn’t require the involvement of telemedicine, with advances in telemedicine come “advances” in criminal schemes.

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]]> https://blog.weisspc.com/conviction-for-70-million-in-fake-claims/feed/ 0 31051 Are Medicare Recovery Auditors Submitting False Claims? – Success in Motion https://blog.weisspc.com/medicare-auditors-submitting-false-claims-sim/ https://blog.weisspc.com/medicare-auditors-submitting-false-claims-sim/#respond Tue, 28 May 2024 08:14:35 +0000 https://blog.weisspc.com/?p=30889 Ride along with Mark as he muses over whether Medicare recovery auditors are themselves committing fraud.

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]]> https://blog.weisspc.com/medicare-auditors-submitting-false-claims-sim/feed/ 0 30889 Hamburger or Health Care? Why You Must Understand the Dilemma. https://blog.weisspc.com/healthcare-payments-economic-pressure/ https://blog.weisspc.com/healthcare-payments-economic-pressure/#respond Mon, 18 Mar 2024 15:21:24 +0000 https://blog.weisspc.com/?p=30790 Many medical groups have come to expect that their businesses run like vending machines. Push the button and out comes collections.

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]]> https://blog.weisspc.com/healthcare-payments-economic-pressure/feed/ 0 30790 Payor Agreements and Hidden False Claims Act and Criminal Traps – Podcast https://blog.weisspc.com/payor-agreements-and-hidden-traps-audio/ https://blog.weisspc.com/payor-agreements-and-hidden-traps-audio/#respond Thu, 01 Feb 2024 12:16:00 +0000 https://blog.weisspc.com/?p=30633 Criminal and, at least, serious civil, liability lurks in many neat neighborhoods. Create your own neighborhood watch to make sure that it's not lurking behind your medical group's otherwise metaphorical neat lawn.

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]]> https://blog.weisspc.com/payor-agreements-and-hidden-traps-audio/feed/ 0 30633 Jury Convicts Chief Compliance Officer For $50 Million Medicare Fraud Scheme – Medical Group Minute https://blog.weisspc.com/compliance-officer-health-fraud-risk-video/ https://blog.weisspc.com/compliance-officer-health-fraud-risk-video/#respond Wed, 17 Jan 2024 12:00:00 +0000 https://blog.weisspc.com/?p=30186 We all know the expression “life imitating art”, but hardly anyone talks about “crimes imitating compliance”. That is, until today.

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]]> https://blog.weisspc.com/compliance-officer-health-fraud-risk-video/feed/ 0 30186 Jury Convicts Chief Compliance Officer For $50 Million Medicare Fraud Scheme – Podcast https://blog.weisspc.com/compliance-officer-health-fraud-risk-audio/ https://blog.weisspc.com/compliance-officer-health-fraud-risk-audio/#respond Thu, 30 Nov 2023 10:57:00 +0000 https://blog.weisspc.com/?p=30196 We all know the expression “life imitating art”, but hardly anyone talks about “crimes imitating compliance”. That is, until today.

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]]> https://blog.weisspc.com/compliance-officer-health-fraud-risk-audio/feed/ 0 30196 You Can Outsource the Task, but You Can’t Outsource Responsibility – Success in Motion https://blog.weisspc.com/you-cant-outsource-responsibility-sim/ https://blog.weisspc.com/you-cant-outsource-responsibility-sim/#respond Tue, 28 Nov 2023 11:50:00 +0000 https://blog.weisspc.com/?p=30219 Sit back and ride along with Mark as he reminds you that billing and collection can be outsourced, but responsibility still lies within your group.

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]]> https://blog.weisspc.com/you-cant-outsource-responsibility-sim/feed/ 0 30219 Surprise Hospital Billing – Medical Group Minute https://blog.weisspc.com/surprise-hospital-billing-video/ https://blog.weisspc.com/surprise-hospital-billing-video/#respond Wed, 25 Oct 2023 11:15:00 +0000 https://blog.weisspc.com/?p=30403 What’s a hospital surprise bill? Well, it’s something slightly different from the concept applied to physicians.

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]]> https://blog.weisspc.com/surprise-hospital-billing-video/feed/ 0 30403 The Devaluation of Value-Based Billing – Medical Group Minute https://blog.weisspc.com/the-devaluation-of-value-based-billing-medical-group-minute-rebroadcast/ https://blog.weisspc.com/the-devaluation-of-value-based-billing-medical-group-minute-rebroadcast/#respond Wed, 04 Oct 2023 09:37:00 +0000 https://blog.weisspc.com/?p=30311 "Value based billing" remains dominant in the medical industry news, chiefly from the MACRA angle.

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]]> https://blog.weisspc.com/the-devaluation-of-value-based-billing-medical-group-minute-rebroadcast/feed/ 0 30311 The Problem Is the Cure – Podcast https://blog.weisspc.com/the-problem-is-the-cure-audio/ https://blog.weisspc.com/the-problem-is-the-cure-audio/#respond Thu, 28 Sep 2023 08:34:00 +0000 https://blog.weisspc.com/?p=30307 Listen to Mark as he discusses how many medical group leaders come to him for help when they’ve got a “problem” and they’re looking for a solution.

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]]> https://blog.weisspc.com/the-problem-is-the-cure-audio/feed/ 0 30307 Surprise Hospital Billing https://blog.weisspc.com/surprise-hospital-billing/ https://blog.weisspc.com/surprise-hospital-billing/#respond Mon, 14 Aug 2023 14:48:45 +0000 https://blog.weisspc.com/?p=30066 What’s a hospital surprise bill? Well, it’s something slightly different from the concept applied to physicians.

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]]> https://blog.weisspc.com/surprise-hospital-billing/feed/ 0 30066 Surprise Hospital Billing – Success in Motion https://blog.weisspc.com/surprise-hospital-billing-success-in-motion/ https://blog.weisspc.com/surprise-hospital-billing-success-in-motion/#respond Tue, 25 Jul 2023 07:22:00 +0000 https://blog.weisspc.com/?p=29931 Sit back as Mark talks about how surprise billing has come home to roost for hospitals.

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]]> https://blog.weisspc.com/surprise-hospital-billing-success-in-motion/feed/ 0 29931 Jury Convicts Chief Compliance Officer For $50 Million Medicare Fraud Scheme https://blog.weisspc.com/compliance-officer-health-fraud-risk/ https://blog.weisspc.com/compliance-officer-health-fraud-risk/#respond Mon, 12 Jun 2023 15:32:59 +0000 https://blog.weisspc.com/?p=29862 We all know the expression “life imitating art”, but hardly anyone talks about “crimes imitating compliance”. That is, until today.

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]]> https://blog.weisspc.com/compliance-officer-health-fraud-risk/feed/ 0 29862 Big Development in False Claims Act Liability: Supreme Court Defines the Required Knowledge of Falsity https://blog.weisspc.com/big-development-in-false-claims-act-liability-supreme-court-defines-the-required-knowledge-of-falsity/ https://blog.weisspc.com/big-development-in-false-claims-act-liability-supreme-court-defines-the-required-knowledge-of-falsity/#respond Mon, 05 Jun 2023 15:54:54 +0000 https://blog.weisspc.com/?p=29848 What you know, both about the FCA and about the falsity of claims is now even more relevant.

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]]> https://blog.weisspc.com/big-development-in-false-claims-act-liability-supreme-court-defines-the-required-knowledge-of-falsity/feed/ 0 29848 Don’t Be Surprised By the No Surprises Act Notice and Good Faith Estimate Requirements – Medical Group Minute https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act-video/ https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act-video/#respond Wed, 12 Oct 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27869 These regulations require that patients be given a notice of rights and, should they so request, a good faith estimate of charges.

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]]> https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act-video/feed/ 0 27869 Doctor Settles Allegations but Doesn’t Admit She Can’t Be Two Places at the Same Time – Podcast https://blog.weisspc.com/physician-coverage-allegations-podcast/ https://blog.weisspc.com/physician-coverage-allegations-podcast/#respond Thu, 06 Oct 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27894 That’s odd, because physicians sometime demonstrate that ability, at least on billing records.

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]]> https://blog.weisspc.com/physician-coverage-allegations-podcast/feed/ 0 27894 Doctor Settles Allegations but Doesn’t Admit She Can’t Be Two Places at the Same Time – Medical Group Minute https://blog.weisspc.com/physician-coverage-allegations-video/ https://blog.weisspc.com/physician-coverage-allegations-video/#respond Wed, 28 Sep 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27867 That’s odd, because physicians sometime demonstrate that ability, at least on billing records.

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]]> https://blog.weisspc.com/physician-coverage-allegations-video/feed/ 0 27867 Don’t Be Surprised By the No Surprises Act Notice and Good Faith Estimate Requirements – Podcast https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act-audio/ https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act-audio/#respond Thu, 21 Jul 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27880 These regulations require that patients be given a notice of rights and, should they so request, a good faith estimate of charges.

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]]> https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act-audio/feed/ 0 27880 Same Old Scam, This Time Involving Medical Billing https://blog.weisspc.com/same-old-scam-this-time-involving-medical-billing/ https://blog.weisspc.com/same-old-scam-this-time-involving-medical-billing/#respond Mon, 18 Jul 2022 16:06:36 +0000 https://blog.weisspc.com/?p=27855 The moral of the story is to exercise tremendous diligence and implement operational checks and balances in connection with the presentation, and in some cases, payment, of invoices.

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]]> https://blog.weisspc.com/same-old-scam-this-time-involving-medical-billing/feed/ 0 27855 Risky Business: Outsourcing Coding, Billing, Collection . . . but not Risk https://blog.weisspc.com/risky-business-outsourcing-coding-billing-collection-but-not-risk/ https://blog.weisspc.com/risky-business-outsourcing-coding-billing-collection-but-not-risk/#respond Mon, 11 Jul 2022 17:46:06 +0000 https://blog.weisspc.com/?p=27829 Data risk itself can be sliced like cold cuts: HIPAA risk, state confidentiality of medical information risk, credit card data risk, and so on.

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]]> https://blog.weisspc.com/risky-business-outsourcing-coding-billing-collection-but-not-risk/feed/ 0 27829 Don’t Be Surprised By the No Surprises Act Notice and Good Faith Estimate Requirements https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act/ https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act/#respond Mon, 11 Apr 2022 16:36:40 +0000 https://blog.weisspc.com/?p=27550 These regulations require that patients be given a notice of rights and, should they so request, a good faith estimate of charges.

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]]> https://blog.weisspc.com/dont-be-surprised-by-the-no-surprises-act/feed/ 0 27550 This Ophthalmologist Wasn’t Seeing Very Clearly – Success in Motion https://blog.weisspc.com/ophthalmologist-wasnt-seeing-clearly-sim/ https://blog.weisspc.com/ophthalmologist-wasnt-seeing-clearly-sim/#respond Tue, 05 Apr 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27469 Ride along with Mark as he discusses how a short-sighted lapse in judgement can invite serious consequences.

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]]> https://blog.weisspc.com/ophthalmologist-wasnt-seeing-clearly-sim/feed/ 0 27469 Doctor Settles Allegations but Doesn’t Admit She Can’t Be Two Places at the Same Time https://blog.weisspc.com/physician-coverage-allegations/ https://blog.weisspc.com/physician-coverage-allegations/#respond Mon, 04 Apr 2022 15:29:07 +0000 https://blog.weisspc.com/?p=27515 That’s odd, because physicians sometime demonstrate that ability, at least on billing records.

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]]> https://blog.weisspc.com/physician-coverage-allegations/feed/ 0 27515 Relax, They Just Want to Steal Your Identity – Success in Motion https://blog.weisspc.com/relax-they-just-want-to-steal-your-identity-sim/ https://blog.weisspc.com/relax-they-just-want-to-steal-your-identity-sim/#respond Tue, 15 Mar 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27382 Ride along with Mark as he discusses a new tactic in management schemes.

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]]> https://blog.weisspc.com/relax-they-just-want-to-steal-your-identity-sim/feed/ 0 27382 The Devaluation of Value-Based Billing – Podcast https://blog.weisspc.com/the-devaluation-of-value-based-billing-podcast/ https://blog.weisspc.com/the-devaluation-of-value-based-billing-podcast/#respond Thu, 27 Jan 2022 12:00:00 +0000 https://blog.weisspc.com/?p=27313 "Value based billing" remains dominant in the medical industry news, chiefly from the MACRA angle. Mostly, though, it’s a lie because value is determined by the customer, not by some bean counter at CMS. Sure, CMS may be paying the bill for Medicare patients, but the patients are the actual customers and only they can assess whether value was truly delivered.

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]]> https://blog.weisspc.com/the-devaluation-of-value-based-billing-podcast/feed/ 0 27313 Was the Cure Worse Than the Disease? Surprise Medical Billing and U.S. Anesthesia Partners v. UnitedHealthcare – Podcast https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare-audio/ https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare-audio/#respond Thu, 22 Jul 2021 11:00:00 +0000 https://blog.weisspc.com/?p=24526 There is nothing inherently fair in the notion of paying a purported “fair fee”. If there were, insurers would never have been in favor of it.

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]]> https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare-audio/feed/ 0 24526 Was the Cure Worse Than the Disease? Surprise Medical Billing and U.S. Anesthesia Partners v. UnitedHealthcare – Medical Group Minute https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare-video/ https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare-video/#respond Wed, 30 Jun 2021 11:00:00 +0000 https://blog.weisspc.com/?p=24493 There's nothing inherently fair in this notion of paying a purported “fair fee”. If there were, insurers would never have been in favor of it.

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]]> https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare-video/feed/ 0 24493 Physician Extender Sentenced to Prison for Fraud – Success in Motion https://blog.weisspc.com/physician-extender-sentenced-to-prison-sim/ https://blog.weisspc.com/physician-extender-sentenced-to-prison-sim/#respond Tue, 01 Jun 2021 11:00:00 +0000 https://blog.weisspc.com/?p=24479 Ride along with Mark as he discusses the danger of identity fraud on physicians.

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]]> https://blog.weisspc.com/physician-extender-sentenced-to-prison-sim/feed/ 0 24479 Was the Cure Worse Than the Disease? Surprise Medical Billing and U.S. Anesthesia Partners v. UnitedHealthcare https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare/ https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare/#respond Mon, 05 Apr 2021 15:04:48 +0000 https://blog.weisspc.com/?p=24266 There is nothing inherently fair in the notion of paying a purported “fair fee”. If there were, insurers would never have been in favor of it.

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]]> https://blog.weisspc.com/surprise-medical-billing-us-anesthesia-partners-v-unitedhealthcare/feed/ 0 24266 Can You Make it Any More Difficult for Your Patients to Pay You? – Success in Motion https://blog.weisspc.com/patient-payment-difficulties-sim/ https://blog.weisspc.com/patient-payment-difficulties-sim/#respond Tue, 02 Mar 2021 12:00:00 +0000 https://blog.weisspc.com/?p=24013 Ride along with Mark as he tells the story of having to work hard to pay his physician.

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]]> https://blog.weisspc.com/patient-payment-difficulties-sim/feed/ 0 24013 Let’s Find the Cure for Surprise Physician Services Stealing – Podcast https://blog.weisspc.com/surprise-physician-services-framing-audio/ https://blog.weisspc.com/surprise-physician-services-framing-audio/#respond Thu, 28 Jan 2021 12:00:00 +0000 https://blog.weisspc.com/?p=19465 There is a crisis. But it's not the one you've heard about. It's time to fix that. It's time to change the conversation. But to do that, you have to change the frame.

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]]> https://blog.weisspc.com/surprise-physician-services-framing-audio/feed/ 0 19465 Let’s Find the Cure for Surprise Physician Services Stealing – Medical Group Minute https://blog.weisspc.com/surprise-physician-services-framing-video/ https://blog.weisspc.com/surprise-physician-services-framing-video/#respond Wed, 18 Nov 2020 12:00:00 +0000 https://blog.weisspc.com/?p=19430 There is a crisis. But it's not the one you've heard about. It's time to fix that. It's time to change the conversation. But to do that, you have to change the frame.

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]]> https://blog.weisspc.com/surprise-physician-services-framing-video/feed/ 0 19430 The Problem Is the Cure – Medical Group Minute https://blog.weisspc.com/the-problem-is-the-cure-video/ https://blog.weisspc.com/the-problem-is-the-cure-video/#respond Wed, 19 Aug 2020 11:00:39 +0000 https://blog.weisspc.com/?p=19020 Many medical group leaders come to me for help when they’ve got a “problem” and they’re looking for a solution.

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]]> https://blog.weisspc.com/the-problem-is-the-cure-video/feed/ 0 19020 The Problem Is the Cure https://blog.weisspc.com/the-problem-is-the-cure/ https://blog.weisspc.com/the-problem-is-the-cure/#respond Mon, 29 Jun 2020 19:04:42 +0000 https://blog.weisspc.com/?p=18977 Most problems, maybe even all problems, are themselves the kernel of the solution.

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]]> https://blog.weisspc.com/the-problem-is-the-cure/feed/ 0 18977 I Can See Clearly Now. Ophthalmology Group Settles Fraud Claim – Podcast https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons-audio/ https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons-audio/#respond Thu, 21 May 2020 11:00:00 +0000 https://blog.weisspc.com/?p=16388 Arguably, a Southern California ophthalmology group should have had its compliance eyes checked a few years ago.

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]]> https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons-audio/feed/ 0 16388 I Can See Clearly Now. Ophthalmology Group Settles Fraud Claim – Medical Group Minute https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons-video/ https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons-video/#respond Wed, 08 Apr 2020 11:00:00 +0000 https://blog.weisspc.com/?p=16376 Arguably, a Southern California ophthalmology group should have had its compliance eyes checked a few years ago.

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]]> https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons-video/feed/ 0 16376 Let’s Find the Cure for Surprise Physician Services Stealing https://blog.weisspc.com/surprise-physician-services-framing/ https://blog.weisspc.com/surprise-physician-services-framing/#respond Mon, 09 Mar 2020 13:00:00 +0000 https://blog.weisspc.com/?p=16516 There is a crisis. But it's not the one you've heard about.

It's time to fix that. It's time to change the conversation.

But to do that, you have to change the frame.

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]]> https://blog.weisspc.com/surprise-physician-services-framing/feed/ 0 16516 I Can See Clearly Now. Ophthalmology Group Settles Fraud Claim. https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons/ https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons/#respond Mon, 14 Oct 2019 13:00:54 +0000 https://blog.weisspc.com/?p=11056 Ah, hindsight. It's always 20/20.

Arguably, a Southern California ophthalmology group should have had its compliance eyes checked a few years ago.

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]]> https://blog.weisspc.com/ophthalmology-fraud-settlement-lessons/feed/ 0 11056 Another Hospital System Settles Whistleblower Allegations That Outpatients Were “Turned Into” Inpatients – Podcast https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement-audio/ https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement-audio/#respond Thu, 25 Apr 2019 17:21:08 +0000 https://blog.weisspc.com/?p=10652 Alchemists struggled without success for centuries attempting to turn lead into gold.

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]]> https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement-audio/feed/ 0 10652 Another Hospital System Settles Whistleblower Allegations That Outpatients Were “Turned Into” Inpatients – Medical Group Minute https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement-video/ https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement-video/#respond Wed, 03 Apr 2019 17:39:15 +0000 https://blog.weisspc.com/?p=10678 Alchemists struggled without success for centuries attempting to turn lead into gold.

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]]> https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement-video/feed/ 0 10678 Don’t Shoot the Messenger! Reduce False Claims Act Liability – Success in Motion https://blog.weisspc.com/dont-shoot-the-messenger-false-claims-act-liability-sim/ https://blog.weisspc.com/dont-shoot-the-messenger-false-claims-act-liability-sim/#respond Tue, 02 Apr 2019 17:40:15 +0000 https://blog.weisspc.com/?p=10680 Ride along with Mark as he discusses why medical groups shoot themselves in the compliance foot by shooting the messenger.

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]]> https://blog.weisspc.com/dont-shoot-the-messenger-false-claims-act-liability-sim/feed/ 0 10680 Another Hospital System Settles Whistleblower Allegations That Outpatients Were “Turned Into” Inpatients https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement/ https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement/#respond Mon, 25 Feb 2019 12:00:12 +0000 https://blog.weisspc.com/?p=10575 Alchemists struggled without success for centuries attempting to turn lead into gold. Will hospitals struggle that long in their quest to turn outpatients into inpatients? Prime Healthcare Services, Inc. (“Prime”), headquartered in Ontario, California, and Prime’s Founder and Chief Executive Officer, Dr. Prem Reddy. On February 14, 2019, the Department of Justice announced that Prime...

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]]> https://blog.weisspc.com/hospital-whistleblower-inpatient-outpatient-settlement/feed/ 0 10575 How Many Felonies Have You Committed Today? – Medical Group Minute https://blog.weisspc.com/unwitting-compliance-violations-healthcare-video/ https://blog.weisspc.com/unwitting-compliance-violations-healthcare-video/#respond Wed, 30 Jan 2019 17:30:34 +0000 https://blog.weisspc.com/?p=10460 How many compliance related crimes have you or your colleagues or employees committed today?

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]]> https://blog.weisspc.com/unwitting-compliance-violations-healthcare-video/feed/ 0 10460 One Giant Leap Toward Success: Avoid One Simple Misstep for “Fraud-kind” – Podcast https://blog.weisspc.com/fraud-risk-healthcare-billing-misstep-audio/ https://blog.weisspc.com/fraud-risk-healthcare-billing-misstep-audio/#respond Thu, 27 Dec 2018 17:30:20 +0000 https://blog.weisspc.com/?p=10169 If you're a physician, it's all too likely that you're uncertain about the future, feel the pressure of an all too real governmentally imposed ceiling on your income, and have even less control than ever over your time.

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]]> https://blog.weisspc.com/fraud-risk-healthcare-billing-misstep-audio/feed/ 0 10169 How Many Felonies Have You Committed Today? – Podcast https://blog.weisspc.com/unwitting-compliance-violations-healthcare-audio/ https://blog.weisspc.com/unwitting-compliance-violations-healthcare-audio/#respond Thu, 06 Dec 2018 17:30:54 +0000 https://blog.weisspc.com/?p=10162 How many compliance related crimes have you or your colleagues or employees committed today, whether purposefully or, completely inadvertently?

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]]> https://blog.weisspc.com/unwitting-compliance-violations-healthcare-audio/feed/ 0 10162 One Giant Leap Toward Success: Avoid One Simple Misstep for “Fraud-kind” https://blog.weisspc.com/fraud-risk-healthcare-billing-misstep/ https://blog.weisspc.com/fraud-risk-healthcare-billing-misstep/#respond Mon, 22 Oct 2018 18:32:53 +0000 https://blog.weisspc.com/?p=10072 If you’re a physician, it’s all too likely that you’re uncertain about the future, feel the pressure of an all too real governmentally imposed ceiling on your income, and have even less control than ever over your time. It’s also likely that you seek a bigger and better future in which you have increased opportunities...

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]]> https://blog.weisspc.com/fraud-risk-healthcare-billing-misstep/feed/ 0 10072 Alchemist Can’t Turn Outpatients into Inpatients for Less Than $18.3 Million – Podcast https://blog.weisspc.com/outpatient-inpatient-fraud-risk-audio/ https://blog.weisspc.com/outpatient-inpatient-fraud-risk-audio/#respond Thu, 04 Oct 2018 16:00:48 +0000 https://blog.weisspc.com/?p=9960 You know that I strongly believe that the future of hospitals isn’t hospitals, it’s outpatient facilities.

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]]> https://blog.weisspc.com/outpatient-inpatient-fraud-risk-audio/feed/ 0 9960 Alchemist Can’t Turn Outpatients Into Inpatients for Less Than $18.3 Million – Medical Group Minute https://blog.weisspc.com/outpatient-inpatient-fraud-risk-video/ https://blog.weisspc.com/outpatient-inpatient-fraud-risk-video/#respond Wed, 01 Aug 2018 18:10:35 +0000 https://blog.weisspc.com/?p=9859 You know that I strongly believe that the future of hospitals isn’t hospitals, it’s outpatient facilities.

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]]> https://blog.weisspc.com/outpatient-inpatient-fraud-risk-video/feed/ 0 9859 How Many Felonies Have You Committed Today? https://blog.weisspc.com/unwitting-compliance-violations-healthcare/ https://blog.weisspc.com/unwitting-compliance-violations-healthcare/#respond Mon, 07 May 2018 15:00:25 +0000 https://blog.weisspc.com/?p=9573 A friend, a former federal prosecutor, recently told me about a book called Three Felonies a Day - almost everyone unknowingly commits a number of acts each day that could be charged as federal crimes by overzealous prosecutors.

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]]> https://blog.weisspc.com/unwitting-compliance-violations-healthcare/feed/ 0 9573 Alchemist Can’t Turn Outpatients Into Inpatients for Less Than $18.3 Million https://blog.weisspc.com/outpatient-inpatient-fraud-risk/ https://blog.weisspc.com/outpatient-inpatient-fraud-risk/#respond Mon, 23 Apr 2018 15:00:21 +0000 https://blog.weisspc.com/?p=9257 As a frequent reader of the blog, you know that I strongly believe that the future of hospitals isn’t hospitals, it’s outpatient facilities. (In fact, if you haven’t already, grab a free copy of my book, The Impending Death of Hospitals, here.) I’m not sure whether the folks at Banner Health read my book and...

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]]> https://blog.weisspc.com/outpatient-inpatient-fraud-risk/feed/ 0 9257 Extrapolation: How the Government Turns One Alleged Bad Claim Into Thousands of Violations – Medical Group Minute https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims-video/ https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims-video/#respond Wed, 04 Oct 2017 16:00:25 +0000 https://blog.weisspc.com/?p=8562 Compliance – it’s the multi-zillion dollar reason why your medical group’s or healthcare business venture’s efforts must constantly be tested, reviewed, and returned.

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]]> https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims-video/feed/ 0 8562 Aetna Obtains $37+ Million Judgment Against ASC Manager – Medical Group Minute https://blog.weisspc.com/aetna-judgment-against-asc-manager-video/ https://blog.weisspc.com/aetna-judgment-against-asc-manager-video/#respond Wed, 27 Sep 2017 16:00:24 +0000 https://blog.weisspc.com/?p=8557 Earlier this year, a Santa Clara County, California jury awarded the insurer Aetna a $37,452,199.00 judgment in a lawsuit against Bay Area Surgical Management, LLC, a surgery center management company, a number of its managed ASCs, and three of Bay Area’s executives.

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]]> https://blog.weisspc.com/aetna-judgment-against-asc-manager-video/feed/ 0 8557 Extrapolation: How the Government Turns One Alleged Bad Claim Into Thousands of Violations – Podcast https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims-audio/ https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims-audio/#respond Thu, 24 Aug 2017 16:00:05 +0000 https://blog.weisspc.com/?p=8391 Compliance - it’s the multi-zillion dollar reason why your medical group’s or healthcare business venture’s efforts must constantly be tested, reviewed, and returned.

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]]> https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims-audio/feed/ 0 8391 Payor Agreements and Hidden False Claims Act and Criminal Traps https://blog.weisspc.com/payor-agreement-fca-criminal-risk/ https://blog.weisspc.com/payor-agreement-fca-criminal-risk/#respond Mon, 24 Jul 2017 12:15:12 +0000 https://blog.weisspc.com/?p=8351 Hidden language in payor agreements can trigger False Claims Act liability and criminal risk—understand and avoid the traps.

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]]> https://blog.weisspc.com/payor-agreement-fca-criminal-risk/feed/ 0 8351 Extrapolation: How the Government Turns One Alleged Bad Claim Into Thousands of Violations https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims/ https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims/#respond Mon, 15 May 2017 15:00:17 +0000 https://blog.weisspc.com/?p=8123 Compliance. Ah, what a funny world we live in. Government regulators at the SEC force those offering investment opportunities to issue disclaimers that past performance is not indicative of future results. Extrapolation is bad. Yet a few miles away, other government regulators at the OIG alchemize a handful of discovered violations into thousands more. Extrapolation...

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]]> https://blog.weisspc.com/government-extrapolation-healthcare-fraud-claims/feed/ 0 8123 How to Avoid “Check the Box” Compliance https://blog.weisspc.com/effective-compliance-medical-groups/ https://blog.weisspc.com/effective-compliance-medical-groups/#respond Mon, 06 Mar 2017 14:41:44 +0000 https://blog.weisspc.com/?p=7880 In the rush to meet compliance requirements, the defect is focusing solely on the checklist of notions that are said to demonstrate compliance.

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]]> https://blog.weisspc.com/effective-compliance-medical-groups/feed/ 0 7880 The Devaluation of Value-Based Billing https://blog.weisspc.com/devaluation-value-based-billing/ https://blog.weisspc.com/devaluation-value-based-billing/#respond Mon, 07 Nov 2016 16:00:34 +0000 https://blog.weisspc.com/?p=7573 Explore the truth behind value based billing in healthcare. Understand how value is defined by patients, not bureaucrats.

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]]> https://blog.weisspc.com/devaluation-value-based-billing/feed/ 0 7573 How to Build A Whistleblower – Medical Group Minute https://blog.weisspc.com/build-healthcare-whistleblower-program-video/ https://blog.weisspc.com/build-healthcare-whistleblower-program-video/#respond Wed, 26 Oct 2016 16:00:54 +0000 https://blog.weisspc.com/?p=7508 When I was a kid, I built models, usually of airplanes and of cars.Some hospitals and medical groups build whistleblowers.

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]]> https://blog.weisspc.com/build-healthcare-whistleblower-program-video/feed/ 0 7508 Bamboozled Over the “Cure” for Balance Billing – Medical Group Minute https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing-video/ https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing-video/#respond Wed, 31 Aug 2016 16:00:00 +0000 https://blog.weisspc.com/?p=7319 I just read an article on Modern Healthcare’s website about balance billing in the out-of-network context.

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]]> https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing-video/feed/ 0 7319 Aetna Obtains $37 Million+ Judgment Against ASC Manager – Podcast https://blog.weisspc.com/aetna-judgment-against-asc-manager-audio/ https://blog.weisspc.com/aetna-judgment-against-asc-manager-audio/#respond Thu, 18 Aug 2016 16:00:22 +0000 https://blog.weisspc.com/?p=7294 Earlier this year, a Santa Clara County, California jury awarded the insurer Aetna a $37,452,199.00 judgment in a lawsuit against Bay Area Surgical Management, LLC, a surgery center management company, a number of its managed ASCs, and three of Bay Area’s executives.

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]]> https://blog.weisspc.com/aetna-judgment-against-asc-manager-audio/feed/ 0 7294 How to Build a Whistleblower https://blog.weisspc.com/build-healthcare-whistleblower-program/ https://blog.weisspc.com/build-healthcare-whistleblower-program/#respond Mon, 18 Jul 2016 15:00:42 +0000 https://blog.weisspc.com/?p=7256 Learn how to build a whistleblower program with secure reporting channels, anti-retaliation policy, and oversight for healthcare organizations.

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]]> https://blog.weisspc.com/build-healthcare-whistleblower-program/feed/ 0 7256 Aetna Obtains $37-plus Million Judgment Against ASC Manager https://blog.weisspc.com/aetna-judgment-against-asc-manager/ https://blog.weisspc.com/aetna-judgment-against-asc-manager/#respond Mon, 18 Apr 2016 15:30:52 +0000 https://blog.weisspc.com/?p=7050 Aetna won a $37M+ judgment against an ASC manager, underscoring insurers’ tactics to secure network integrity and punish providers.

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]]> https://blog.weisspc.com/aetna-judgment-against-asc-manager/feed/ 0 7050 Bamboozled Over the “Cure” for Balance Billing – Podcast https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing-audio/ https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing-audio/#respond Thu, 14 Apr 2016 16:00:14 +0000 https://blog.weisspc.com/?p=6994 I just read an article on Modern Healthcare’s website about balance billing in the out-of-network context.

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]]> https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing-audio/feed/ 0 6994 Why You Must Kill the Notion of a “Compliance Plan” https://blog.weisspc.com/compliance-plan-vs-compliance-reality/ https://blog.weisspc.com/compliance-plan-vs-compliance-reality/#respond Mon, 21 Mar 2016 13:02:08 +0000 https://blog.weisspc.com/?p=6947 You might not think that you are your brother’s keeper, but in the context of a medical group in which you’re an owner, you certainly are. I’m talking in terms of liability for billing errors.

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]]> https://blog.weisspc.com/compliance-plan-vs-compliance-reality/feed/ 0 6947 Bamboozled Over the “Cure” for Balance Billing https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing/ https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing/#respond Mon, 07 Sep 2015 15:00:21 +0000 https://blog.weisspc.com/?p=6437 The fact is that the farther we get away from market based concepts, the more the political hacks masquerading as economists screw with market balance, the more it’s obvious that there are no mandated or political solutions. There are only mandated or political tradeoffs.

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]]> https://blog.weisspc.com/bamboozled-over-the-cure-for-balance-billing/feed/ 0 6437 Have You Forgotten This Contract Termination Provision? – Success in Motion Series https://blog.weisspc.com/know-contract-termination-provisions-sim/ https://blog.weisspc.com/know-contract-termination-provisions-sim/#respond Tue, 25 Aug 2015 13:00:29 +0000 https://blog.weisspc.com/?p=6353 Do you know what happens upon the termination of the contract? What obligations do you continue to owe?  And, what obligations continue to be owed to you?

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]]> https://blog.weisspc.com/know-contract-termination-provisions-sim/feed/ 0 6353 Is Your Group Running on Autopilot? – Medical Group Minute https://blog.weisspc.com/medical-group-strategic-awareness-video/ https://blog.weisspc.com/medical-group-strategic-awareness-video/#respond Wed, 19 Nov 2014 14:00:06 +0000 https://blog.weisspc.com/?p=5734 Your group's practice metrics indicate all is OK. But you're about to crash.

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]]> https://blog.weisspc.com/medical-group-strategic-awareness-video/feed/ 0 5734 Is Your Group Running on Autopilot? – Podcast https://blog.weisspc.com/medical-group-strategic-awareness-audio/ https://blog.weisspc.com/medical-group-strategic-awareness-audio/#respond Fri, 20 Dec 2013 15:46:47 +0000 https://blog.weisspc.com/?p=4376 Your group's practice metrics indicate all is OK. But you're about to crash.

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]]> https://blog.weisspc.com/medical-group-strategic-awareness-audio/feed/ 0 4376 Is Your Group Running on Autopilot? https://blog.weisspc.com/medical-group-strategic-awareness/ https://blog.weisspc.com/medical-group-strategic-awareness/#respond Wed, 10 Jul 2013 16:00:38 +0000 https://blog.weisspc.com/?p=3776 My unfortunate observation is this this type of problem, in varying costume, is far too common.

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