Healthcare GRC Archives

Denials, Denials, Denials – Strategies for Addressing Medicare Advantage Denials, Downgrades, and Disputes

Medicare Advantage plans continue to present challenges with frequent denials, downgrades, and disputes—the "3 D's." It’s time to shift from a reactive stance to a proactive approach by mastering the regulations and turning denials into actionable strategies. Join Day Egusquiza, President of AR Systems Inc., as she shares her expertise on effectively responding to Medicare Advantage denials by leveraging regulations to confidently reject unjust claims ...

By SAI360|2025-05-06T19:42:58+00:00September 26th, 2024|Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Watch The Modern Compliance Office: Tackling Present-Day Challenges and Refreshing Practices

It’s undeniable that the work environment and how we work has been fundamentally changed by the Covid pandemic. As we adapt to these changes, industries across the board, including healthcare, are tasked with modernizing their practices to stay relevant and effective. This webinar delves into the evolving landscape of Compliance Offices, examining the current challenges and exploring strategies to overcome them. Designed for compliance professionals ...

By SAI360|2025-05-06T20:27:15+00:00September 20th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Watch The Modern Compliance Office: Tackling Present-Day Challenges and Refreshing Practices (Video)

This webinar delves into the evolving landscape of Compliance Offices, examining the current challenges and exploring strategies to overcome them. Hear from compliance industry experts, Strategic Management CEO Richard Kusserow and COO Jillian Concepcion.

By SAI360|2024-09-18T15:35:14+00:00September 18th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

A Chief Compliance Officer’s Blueprint for Patient-Centric Compliance

Happy National Compliance Officer Day 2024! To bridge the compliance-care divide, chief compliance officers must foster collaboration between academic and seasoned professionals, blending theoretical knowledge with practical experience from the start. By tailoring compliance programs to the unique risks of each healthcare environment and strategically leveraging technology, they ensure effective risk assessments and compassionate patient care. Prioritizing education, open communication, and innovation drives continuous improvement ...

By SAI360|2025-04-28T02:45:22+00:00August 27th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC|

Can Your Compliance Program Adapt to Changing Times?

How well-equipped is your compliance program to handle the unpredictable shifts in the healthcare landscape? To help answer this pressing question, Richard Kusserow, CEO of Strategic Management Services, and former DHHS Inspector General recently shared results of a 2024 benchmark survey about the current state of healthcare compliance programs. This annual survey provides valuable insights into the challenges and trends shaping the compliance landscape. Challenges Facing ...

By SAI360|2025-04-28T02:45:25+00:00August 5th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC|

The Modern Compliance Office: Tackling Present-Day Challenges and Refreshing Practices

Live webinar: Thursday, September 19th Time: 1:00PM ET | 12:00PM CT | 10:00AM PT It’s undeniable that the work environment and how we work has been fundamentally changed by the Covid pandemic. As we adapt to these changes, industries across the board, including healthcare, are tasked with modernizing their practices to stay relevant and effective. This webinar delves into the evolving landscape of Compliance Offices, ...

By SAI360|2025-04-23T20:37:23+00:00July 23rd, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Watch Mid-Year Check-In: Adapting the GCPG to your Existing Compliance Program

Compliance officers and compliance professionals have had six months to digest and begin applying the General Compliance Program Guidance (GCPG) published by the Office of Inspector General (OIG) in November 2023. The OIG reiterated several practices from previous guidance materials and outlined new ones that health care organizations should consider implementing in their compliance programs. Among these practices include, but are not limited to, increased ...

By SAI360|2025-04-10T08:41:49+00:00July 12th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Watch Mid-Year Check-In: Adapting the GCPG to your Existing Compliance Program (Video)

Compliance officers and compliance professionals have had six months to digest and begin applying the General Compliance Program Guidance (GCPG) published by the Office of Inspector General (OIG) in November 2023. For some compliance officers, there are real challenges associated with finding the right resources in implementing the best practices promulgated by the OIG in its various guidance materials, with getting leadership support as a ...

By SAI360|2024-07-11T15:32:03+00:00July 11th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Mid-Year Check-In: Adapting the GCPG to your Existing Compliance Program

Live webinar: Thursday, July, 11th Time: 1:00 PM ET | 12:00 PM CT | 10:00 AM PT Compliance officers and compliance professionals have had six months to digest and begin applying the General Compliance Program Guidance (GCPG) published by the Office of Inspector General (OIG) in November 2023. The OIG reiterated several practices from previous guidance materials and outlined new ones that health care organizations should ...

By SAI360|2024-06-07T13:31:43+00:00June 7th, 2024|Compliance, Governance, Risk & Compliance: GRC, Healthcare GRC, Healthcare Revenue Integrity|

Ensuring Compliance with Open Payments: Innovative Solutions from SAI360

Open Payments, mandated by the Affordable Care Act, require certain industries to report payments and other transfers of value to healthcare providers. Open Payments remain a key focal point now for ethics, governance, risk management, and compliance leaders. Namely, the expansion of the Open Payments Data to include other healthcare providers—in addition to physicians—has significantly enhanced the transparency available to your organization and the public. This ...

By SAI360|2025-04-28T02:39:58+00:00June 1st, 2024|Governance, Risk & Compliance: GRC, Healthcare GRC|

Healthcare GRC News

Denials, Denials, Denials – Strategies for Addressing Medicare Advantage Denials, Downgrades, and Disputes

Watch The Modern Compliance Office: Tackling Present-Day Challenges and Refreshing Practices

Watch The Modern Compliance Office: Tackling Present-Day Challenges and Refreshing Practices (Video)

A Chief Compliance Officer’s Blueprint for Patient-Centric Compliance

Can Your Compliance Program Adapt to Changing Times?

The Modern Compliance Office: Tackling Present-Day Challenges and Refreshing Practices

Watch Mid-Year Check-In: Adapting the GCPG to your Existing Compliance Program

Watch Mid-Year Check-In: Adapting the GCPG to your Existing Compliance Program (Video)

Mid-Year Check-In: Adapting the GCPG to your Existing Compliance Program

Ensuring Compliance with Open Payments: Innovative Solutions from SAI360

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