About Comprehensive Compliance Concepts
Our team of experts realizes that it does not benefit any organization to be 100% compliant and not be able to perform their respective day-to-day functions.
To reduce any negative impact on operations, Comprehensive Compliance Concepts approaches each engagement as a team effort. We believe this concept is paramount to the success of any project.
We believe that an effective Compliance Program can improve the quality of care and positively impact revenue by identifying unrealized reimbursement due to incorrect coding and/or documentation.
Why not allow your compliance efforts to work for you?
Jeff has over 20 years in the compliance field. As a former Deputy United States Marshal and Special Agent, he has conducted healthcare investigations regarding a myriad of providers and payors. Jeff has testified in federal courts and state superior courts as well as numerous regulatory proceedings. Jeff possesses a great deal of experience in the design and implementation of compliance and HIPAA programs.
In the private sector, Jeff has been the Chief Compliance Officer and Privacy Officer for publicly traded companies, HMOs, large healthcare systems, skilled nursing facilities, home health agencies and physician practices. Several of these organizations employed over 50,000 employees and had annual revenues exceeding $10 billion.
Jeff in his role as Privacy Officer has investigated HIPAA matters concerning major celebrities in the entertainment industry as well as senior executives at large public/private corporations. Jeff has conducted in-depth HIPAA risk assessments and designed and implemented corrective action programs.
Jeff has Chaired Compliance Committee meetings and has been a member of several Independent Review Boards (IRBs). In addition, he has performed due diligence reviews both nationally and internationally for organizations concerning acquisitions, IPOs, mergers and venture capital funding.
Presently, Jeff serves as an Independent Review Organization (IRO) for several organizations.
Todd has over 20 years providing actuary services. As the chief actuary for HMOs, large physician practices, MSOs and IPAs, he was responsible for managing provider settlements for numerous organizations. Todd brings a unique perspective concerning provider contracts due to his many years negotiating and modeling these types of arrangements. In his current role as a financial recovery expert he strives to promote fairness in the administration of payor/provider contracts.
Todd has been reviewing and contesting claims and other revenue adjustments for risk and incentive based providers and payors, for over 20 years. He has identified and recovered millions of dollars from a myriad of payor sources and provider types.
Ms. Burrus’ entire career has been in the representation of health providers. For many years, she had a large medical malpractice defense practice in conjunction with providing counseling in risk management, peer review, contract review and payer issues in Virginia. In 1999, she successfully completed her LLM in Health Law at the University of Houston Health Law & Policy Institute. The same year, Ms. Burrus and Dr. Kroger started the firm.
Since that time, she has continued to defend providers in malpractice matters while continuing to increase her practice in health law. She counsels providers in the areas of risk management, peer review actions, regulatory representation involving billing, and fraud and abuse, representation of practitioners before licensing boards, general counsel issues for practitioners in issues associated with contract and employer issues, creation of business practices, and evaluating proposed business deals for regulatory compliance.
Kim Lancaster has over 20 years of experience in healthcare administration and Medicaid regulation. She served in multiple leadership positions including Health Department Bureau Chief administrating the statewide children’s behavioral health system. She also served as Medicaid Operations and Compliance Officer, overseeing contract compliance and policy development. Kim participated as a writer in the development of the State’s first integrated, physical and behavioral health, Medicaid contract. She was involved in the scoring and selection processes for the State’s Acute and Children’s Rehabilitation Services contractors. She managed the implementation of selected Acute and Children’s Rehabilitation Services contractors assessing for readiness to ensure continuity of care for the State’s Medicaid members. Additionally, Kim served as Compliance and Privacy Officer for a Health Plan serving 500,000 enrolled members. In this role she was responsible for leading internal processes for promoting and ensuring compliance with laws, regulations, company policies, and contracts. Kim operated as the liaison with legal counsel, representing the Plan in hearings. She chaired the Plan’s Compliance Committee overseeing Risk Management and internal ethics and complaint reporting programs. She was responsible for formulating and implementing policies and procedures, including training and enforcement.
Josephine has over 20 years of experience in the healthcare industry with an emphasis on federal and state government billing guidelines. Due to her experience in both the medical billing and government contractor ends of the healthcare industry spectrum, Josephine has developed an extensive understanding of the medical billing revenue cycle. She provides coding, billing, auditing, denial management, and education support to physicians, including expertise in training providers about complex Medicare topics, such as Teaching Physician guidelines, Incident-to, and Split/Shared billing. She offers a vast range of knowledge from working in a variety of professional medical settings, including large academic medical facilities in both Florida and New York.