PODCAST · business
The Compliance Guy
by Sean M. Weiss
Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals. The show features interviews of industry leaders, government officials, and others helping to shape the healthcare landscape. Sean M. Weiss (AKA – The Compliance Guy) has been an industry respected name for more than 25-years. A physician and health system advocate, Sean engages with clients to ensure a “level-playing-field” and due process when allegations and/or accusations of impropriety are leveled by a payor or government investigation agency. When Sean is not engaging in administrative, civil and criminal matters on behalf of more than 30 nationally recognized law firms and clients, he is serving as a third-party compliance officer for a dozen organization across the country ranging in size and specialty to ensure a “Cul
Episodes
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Season 10 - Episode 439 - #TerryTuesday - RAC Audits, TPE Reviews, and Why Ignoring Requests Can Hurt
Sean and Terry cover a practical warning for providers and billing teams: do not ignore audit letters, documentation requests, or compliance notices just because the language says you can if you agree. They also break down how RAC and TPE reviews work, why silence can be read as weakness, and why...
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Season 10 - Episode 438 - #TerryTuesday - Stay in Your Lane: The Advice Healthcare Consultants Ignore
In this episode Sean and Terry take on a very real issue plaguing healthcare! Our dynamic duo in this episode focuses on a deceptively simple idea with high stakes in healthcare and consulting: verify claims before you trust them. Sean and Terry discuss why vetting staff, contractors, and...
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Season 10 - Episode 437 - #TerryTuesday - Proposed CMS Changes 2027
Summary In this episode, Terry Fletcher and Sean Weiss discuss the latest Medicare final rule, its implications for healthcare providers, and how stakeholders can engage in the comment process to influence policy changes. They explore key topics like telehealth flexibilities, modifiers, and...
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Season 10 - Episode 436 - #TerryTuesday - The Complexities of Lifestyle Medicine
In this episode, Terry Fletcher and Sean discuss the complexities of lifestyle medicine, insurance reimbursement, and the importance of understanding what services are covered. They explore how providers can navigate insurance limitations while advocating for patient care. Key Topics Insurance...
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Season 10 - Episode 435 - #TerryTuesday: Incident Two, Split Shared Visits, and Why Medical Student Documentation Cannot Be Billed
This episode focuses on a compliance issue that keeps tripping up practices: incident to billing, split shared visits, and the limits of what medical students can document. Sean M Weiss and Terry walk through where the rules apply, where they do not, and why using student documentation to support…
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Season 10 - Episode 434 - #TerryTuesday - Staying Ahead of Regulatory Updates: A Guide for Healthcare Practices
In this episode of The Compliance Guy, Terry Fletcher and Sean dive into the importance of proactive compliance and staying updated with federal and state healthcare regulations. This discussion is vital for healthcare providers who want to safeguard their practice from compliance risks and…
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Season 10 - Episode 433 - Dr. Ron Elfenbein - The Untold Story of a COVID Hero and the Fight for Medical Truth
Summary Dr. Ron Elfenbein shares his extraordinary journey through the COVID pandemic, his pioneering efforts with monoclonal antibodies, and the unjust legal challenges he faced after speaking out. This episode highlights the importance of scientific integrity, whistleblower protection, and the...
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Season 10 - Episode 432 - #TerryTuesday - This is The Stuff That Frustrates Us!
Summary In this episode, Terry Fletcher and Sean Weiss discuss the frustrations faced by healthcare staff with compliance issues, telehealth documentation, and billing practices. They explore real-world challenges, legal considerations, and practical advice for staff trying to navigate complex...
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Season 10 - Episode 431 - Why Written Policies Are Critical in Healthcare Compliance
Summary In this episode, Terry Fletcher and Sean Weiss discuss the importance of having up-to-date, written compliance policies in healthcare practices, the risks of relying on memory or outdated policies, and how to effectively implement and audit compliance programs to avoid legal and financial...
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Season 9 - Episode 430 - Christina Panos - Walters Kluwer - All Things Compliance & MediRegs
Summary In this episode, Sean Weiss interviews Christina Panos from Wolters Kluwer to discuss the importance of regulatory compliance in healthcare, the capabilities of MediRegs, and how organizations can stay ahead in fraud, waste, and abuse prevention. Key Topics Healthcare fraud, waste, and...
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Season 9 - Episode 429 - #TerryTuesday - The Ethical and Moral Dilemma of Telehealth In Critical Care
Summary This episode explores the ethical, legal, and practical implications of virtual critical care in healthcare, highlighting recent cases and regulatory challenges. Hosts Sean and Terry discuss the boundaries of telehealth, the moral dilemmas faced by providers, and the importance of...
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Season 9 - Episode 428 - #TerryTuesday - OIG Findings
Summary This episode features a detailed discussion on recent healthcare compliance issues, focusing on Medicare Advantage overpayments, the importance of proactive audits, and the evolving role of data analytics in fraud detection. Experts Terry Fletcher and Sean Weiss share insights on…
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Season 9 - Episode 427 - #TerryTuesday - Navigating Medical Necessity
Summary In this episode of The Compliance Guy, Sean Weiss and Terry Fletcher discuss various compliance issues related to audits, medical necessity, and the importance of thorough documentation in healthcare. They engage in a role play to illustrate common pitfalls in audits, emphasizing the need...
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Season 9 - Episode 426 - Sonda Kunzi - Behavioral Health
Summary Join Sean Weiss as he discusses behavioral health coding, billing, and the current challenges faced by providers with expert Sonda Kunzi. Explore topics like reimbursement issues, telehealth, and regulatory complexities in behavioral health care. Key Topics Behavioral health reimbursement...
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Season 9 - Episode 425 - Daily Dose - Mastering Virtual Supervision Under Medicare: A Practical Guide
Summary This episode explores the complexities of virtual supervision under Medicare, emphasizing compliance, operational best practices, and the potential benefits when implemented correctly. Key Takeaways Virtual supervision is a payment, workflow, and compliance rule, not just a convenience....
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Season 9 - Episode 424 - Hidden Dangers of Healthcare Billing - #TerryTuesday
Summary In this episode, Terry Fletcher discusses common compliance pitfalls in healthcare, billing errors, fraud risks, and the importance of accurate documentation and risk management. He emphasizes the need for healthcare providers to stay informed and vigilant against fraud and billing...
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Season 9 - Episode 423 - Monday Roundtable - Navigating CMS and LCD Challenges
Summary This episode features a comprehensive discussion on healthcare compliance, audits, and payment integrity, with insights from industry experts on recent trends, challenges, and legal considerations in healthcare billing and review processes. Key Topics Prepayment reviews and quality…
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Season 9 - Episode 422 - #TerryTuesday - The Truth About G2211
Summary In this episode, Sean Weiss and Terry Fletcher discuss the complexities and pitfalls of billing add-on code G2211 for E&M services, emphasizing the importance of medical necessity, proper documentation, and understanding payer policies. Key Topics G2211 coding and billing Medical…
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Season 9 - Episode 421 - AI: Separate Fact From Fiction - Frank Cohen
Summary In this episode, Sean Weiss and Frank Cohen explore the realities of AI, its limitations, and its implications for healthcare and legal fields. They discuss how AI models work, the importance of human oversight, and the risks of overestimating AI capabilities. Key Topics How AI tokenizes...
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Season 9 - Episode 420 - #TerryTuesday - The Hidden Risks of Over-Familiarity in Healthcare Compliance
Summary In this episode of The Compliance Guy, hosts Sean Weiss and Terry Fletcher explore the importance of internal audits, provider documentation, and maintaining objectivity in healthcare compliance. They discuss common pitfalls like over-familiarity with providers, the impact of personality…
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Season 9 - Episode 419 - Monday Compliance Roundtable
Summary This episode features a lively panel discussion on critical issues in healthcare compliance, including the use of cell phones for medical communication, prepayment reviews, and critical care documentation. Experts Joe Rivet, ESQ, Scott Kraft, Jordan Johnson, Stephanie Allard, and David...
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Season 9 -Episode 418 - Navigating Healthcare Regulations: FTC, FDA, and OCR - Susan Walberg, JD
Summary In this episode of the Compliance Guy podcast, host Sean Weiss interviews healthcare compliance expert Susan Wahlberg. They discuss the evolving landscape of healthcare regulation, focusing on the roles of the FTC, FDA, and OCR, and explore how compliance professionals can stay ahead in a...
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Season 9 - Episode 417 - Decoding Medical Necessity in Labs: Legal Insights From Dean Viskovich, ESQ
Summary In this episode, healthcare attorney and expert Dean Viskovich discusses the complexities of telehealth, medical necessity, and laboratory compliance, providing practical guidance for labs and billing companies navigating CMS and payer requirements. Key Topics Medical necessity and legal...
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Season 9 - Episode 416 - #TerryTuesday - How Payers Are Influencing Medical Coding
Summary In this episode, Sean and Terry Fletcher discuss the latest issues in healthcare compliance, focusing on problematic billing practices, the risks of retrospective diagnosis coding, and the influence of third-party payers like Optum. They explore how these practices threaten provider...
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Season 9 - Episode 415 - The End of The Fax Machine? #TerryTuesday
Summary In this engaging discussion, Sean Weiss and Terry Fletcher explore the recent CMS final rule that bans fax machines and snail mail in healthcare transactions. They analyze the implications for revenue cycle management, the move towards digital documentation, and the broader impact on...
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Season 9 - Episode 414 - Decoding Audits: RadV. AI, and Medical Necessity Uncovered
Summary This episode features a comprehensive discussion on current issues in healthcare compliance, including RadV audits, auto down coding, medical necessity, and the impact of AI in billing practices. Experts share insights on regulatory challenges, provider strategies, and the future of...
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Season 9 - Episode 413 - #TerryTuesday - Unmasking Insurance Down Coding: How Payers Undermine Providers
Summary This episode features Sean Weiss and Terry Fletcher discussing recent issues with insurance payers, down coding policies, and the impact on healthcare providers. They analyze the implications of AI-driven denials, the importance of proper documentation, and advocate for provider advocacy...
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Season 9 - Episode 412 - #TerryTuesday The Hidden Risks of Documentation Cloning
Summary In this episode, Sean Weiss and Terry Fletcher explore the complexities of healthcare compliance, focusing on workflows, documentation, and audits in medical practices. They discuss real-world scenarios involving frequency audits, documentation cloning, and the importance of proactive...
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Season 9 - Episode 411 - The Hidden Dangers of Medical Documentation Alterations, Metadata and Its Role in Healthcare Fraud Detection
Summary This episode features a lively panel discussion on healthcare documentation, compliance risks, and best practices. The experts share insights on managing documentation delays, metadata analysis, contract oversight, and the impact of AI in healthcare record-keeping. key topics Risks of...
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Season 9 - Episode 410 - #TerryTuesday - The Hidden Risk of Diagnostic Coding
Summary This episode features a lively discussion on Olympic hockey, healthcare compliance, and the pitfalls of diagnostic coding. The hosts share insights on how practices often manipulate diagnoses for payment, the importance of proper documentation, and the impact of payer policies on clinical...
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Season 9 - Episode 409 - HIPAA 2026 - #TerryTuesday - What Healthcare Providers Must Know
Summary This episode features a deep discussion on HIPAA compliance, recent enforcement updates, and the implications of AI and third-party tools on patient data security. Experts Terry Fletcher and Sean Weiss explore how healthcare providers can stay compliant amidst evolving regulations and...
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Season 9 - Episode 408 - #TerryTuesday - What's Driving The Issues with EMRs?
Here is the latest episode of The Compliance Guy! Summary In this episode of The Compliance Guy, Sean M Weiss and Terry Fletcher discuss various topics related to compliance, telehealth, and revenue cycle management. They emphasize the importance of accurate documentation in medical records, the...
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Season 9 - Episode 407 - Monday Compliance Roundtable
Summary The 2026 Compliance Roundtable discusses critical issues in healthcare compliance, focusing on prior authorizations, telehealth, clinical laboratories, and incident two billing provisions. Experts (Joe Rivet, Terry Fletcher, Scott Kraft, Stephanie Allard, Jordan Johnson, and David…
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Season 9 - Episode 406 - The Rise of AI Scribes: What Patients Need to Know
Summary In this episode, Sean M Weiss and Terry Fletcher discuss the implications of AI in healthcare, particularly focusing on AI scribes and the importance of patient consent. They explore the challenges and responsibilities healthcare providers face in ensuring patient privacy and compliance...
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Season 9 - Episode 405 - Policy Reformer - Veteran White House Policy Advisor
Summary In this episode, Sean M Weiss interviews Katy Talento, CEO of All Better Health, discussing her journey in healthcare policy reform, the challenges of navigating the healthcare system, and the importance of price transparency. Katy shares insights from her time in the White House, her...
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Season 9 - Episode 404 - Joe Rivet, ESQ - The Complexities of Regulatory Compliance
Summary In this episode of The Compliance Guy, Sean Weiss interviews Joe Rivet, a healthcare attorney with extensive experience in federal matters, including prior authorization processes and the No Surprises Act. They discuss the potential changes in legislation regarding prior authorizations…
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Season 9 - Episode 403 - From Prosecutor to Defense Counsel
Summary In this episode of The Compliance Guy Podcast, host Sean Weiss speaks with Evan Gottlob, a former federal prosecutor turned defense attorney, about the complexities of regulatory compliance in healthcare law. They discuss the decision-making process behind prosecutions, the impact of...
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Season 9 - Episode 402 - #TerryTuesday - Is Your EMR Crap?
Summary In this episode, Sean Weiss and Terry Fletcher discuss the critical importance of complete and accurate medical documentation in healthcare. They explore the consequences of incomplete records, the role of electronic medical records (EMRs), and the need for accountability among healthcare...
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Episode 401 - Season 9 - Understanding How to Use Medical Student and Ancillary Staff - #TerryTuesday
Summary In this episode, Sean Weiss and Terry Fletcher discuss the new year and the importance of compliance in healthcare. They highlight the upcoming legislative changes affecting telehealth, the roles of medical students, and the challenges of documentation and accountability in healthcare...
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Episode 399 - Ancillary Staff v. Reimbursable Providers - Daily Dose
Summary In this episode, Sean Weiss discusses the complexities surrounding ancillary providers and their billing practices, particularly focusing on CMS and commercial payer rules. He explains the definitions and roles of ancillary staff, the intricacies of incident to billing, and the compliance...
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Episode 398 - AI Compliance - Richa Kaul
Summary In this episode, Sean M Weiss engages with Richa Kaul, CEO of Compliance with a Y, discussing the critical role of governance, risk, and compliance (GRC) in today's data-driven world. They explore the mission behind the organization, the importance of risk assessments, and the challenges...
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Episode 397 - Daily Dose - The Compliance Officer "The Guardian of Integrity "
Summary In this episode, Sean M Weiss discusses the critical role of compliance officers in healthcare organizations, emphasizing their responsibilities, best practices, and the importance of regulatory compliance. He highlights the need for a proactive approach to risk assessment, the do's and...
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Episode 396 - Daily Dose - Building a Culture of Compliance
Summary In this episode of the Compliance Guy podcast, Sean M Weiss reflects on the challenges and lessons learned in 2025 regarding compliance in healthcare. He emphasizes the importance of building a robust culture of compliance to prepare for the upcoming year, 2026, which is expected to bring...
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Episode 395 - #TerryTuesday - Understanding Revenue Cycle Management
Summary In this episode, Sean M Weiss and Terry Fletcher discuss the complexities of compliance in healthcare, particularly as the year comes to a close. They explore the importance of understanding revenue cycle management, the disconnect between clinical and payer policies, and the necessity of...
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Episode 394 - USA v Raj - The Trial That Changed Everything
Summary In this episode of the Compliance Guy podcast, Sean M Weiss interviews Dr. Raj Bothra, who shares his harrowing experience of being wrongfully accused of Medicare fraud and excessive narcotics distribution. Dr. Bothra discusses the complexities of the case, the role of the DOJ and FBI…
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Episode 393 - Medicare Advantage and Your Obligation to Comply - #TerryTuesday
Summary In this episode, Sean M Weiss and Terry Fletcher discuss the complexities surrounding Additional Documentation Requests (ADRs) from Medicare Advantage plans. They emphasize the importance of compliance, the legal obligations of providers, and the potential consequences of ignoring these...
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Episode 392 - The Real Role of The Compliance Officer - Daily Dose
Summary In this episode, Sean M Weiss discusses the critical role of compliance officers in healthcare organizations, emphasizing their responsibilities, best practices, and the importance of maintaining objectivity and independence. He outlines the do's and don'ts of compliance, highlights...
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Episode 391 - #TerryTuesday - Getting It Right
Summary In this conversation, Terry Fletcher and Sean M Weiss discuss the recent announcement by ChatGPT regarding its decision to cease providing health and legal advice due to a significant error rate. They explore the implications of this decision, the ongoing debate about the accuracy of AI...
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Episode -390 - Summer McKeivier - The Complexities of Healthcare Law
Summary In this episode of The Compliance Guy podcast, Sean M Weiss engages in a detailed conversation with attorney Summer McKeivier about the complexities of healthcare law, particularly focusing on incident two billing, healthcare fraud prosecutions, and the challenges faced by providers in...
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Episode 388 - Don Self - Complexities of Medical Billing
Summary In this episode of the Compliance Guy podcast, Sean M Weiss welcomes Don Self, a veteran in the medical billing industry, to discuss his extensive experience and insights. They explore Don's two recent books, touching on topics such as medical office management, evaluation and management...
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ABOUT THIS SHOW
Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals.
The show features interviews of industry leaders, government officials, and others helping to shape the healthcare landscape.
Sean M. Weiss (AKA – The Compliance Guy) has been an industry respected name for more than 25-years. A physician and health system advocate, Sean engages with clients to ensure a “level-playing-field” and due process when allegations and/or accusations of impropriety are leveled by a payor or government investigation agency.
When Sean is not engaging in administrative, civil and criminal matters on behalf of more than 30 nationally recognized law firms and clients, he is serving as a third-party compliance officer for a dozen organization across the country ranging in size and specialty to ensure a “Cul
HOSTED BY
Sean M. Weiss
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Frequently Asked Questions
How many episodes does The Compliance Guy have?
The Compliance Guy currently has 417 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is The Compliance Guy about?
Sean is the host of “The Compliance Guy” a live production dedicated to the intersection of regulatory compliance and the business of medicine. The show provides timely, accurate, and easy to digest information to healthcare professionals. The show features interviews of industry leaders,...
How often does The Compliance Guy release new episodes?
The Compliance Guy publishes regularly with 417 episodes available. Check the episode list for the typical release schedule.
Where can I listen to The Compliance Guy?
You can listen to The Compliance Guy on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts The Compliance Guy?
The Compliance Guy is created and hosted by Sean M. Weiss.
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