STP 172 | Why Waiting on Compliance Could Put Your Practice at Risk w. Dr. Natasha Guess
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[00:00:05] Natasha Guess: I saw this incredible healthcare system that had the resources, has the frameworks and the technology to actually protect people. However, over the years, I also saw small and mid-size practices completely drowning in regulations in their obligations, and no one was helping them to actually figure out how to build out a system with the right structure.
[00:00:35] So that's why I started guess compliance,
[00:00:41] James Marland: Before we jump into today's conversation, I wanna let you know about two workshops coming up. First, on July 31st, I'm hosting a Launch a Paid Workshop in 30 Days. This workshop is for therapists, coaches, consultants, and other people in the helping profession who have [00:01:00] knowledge sitting in their head, maybe in their notes, or they've had conversations about it, but they're not sure how to turn it into a workshop that people will sign up and pay for.
[00:01:12] This workshop is for people who have an idea, but they don't know where to start. You don't need fancy tech. You don't need a large audience. You just need a simple idea, and I'll help you with a plan so that you can get your workshop out the door in 30 days.
[00:01:27] Then in September, today's guest, Dr. Natasha Guest, will be leading a workshop on compliance, after this conversation today, you'll understand why this matters. Also, you'll, you'll hear her heart in this episode on why it's really important to her to help therapy practices get in compliance and stay in compliance.
[00:01:47] compliance is not just paperwork. It protects you, it protects your staff, it protects your practice, and it protects all the work you've built on. If you're a subscriber to the newsletters, you're gonna get the [00:02:00] details first, including the dates, links, and how to sign up. So make sure you're subscribed at coursecreationstudio.com. Now onto the show
[00:02:13] Hello, and welcome back to the scaling therapist podcast. I'm your host, James Marland. If this is your first time here and if it's not your first time, welcome back. This is the show where I help you take your clinical wisdom and turn it into income. And I also bring on guests who help your business scale and they help you focus on things that will remove bottlenecks in your practices so that you can grow in scale. And today we're going to talk about something that when I was doing the virtual assistant company I needed a lot of help doing and it's a policy and compliance And so today we have on our show natasha guest and she's from guest compliance and consulting llc And she is the ceo and founder and she loves You Law and policy.
[00:02:59] So [00:03:00] welcome to the show.
[00:03:01] Natasha Guess: Thank you so much for having me on. It's a pleasure.
[00:03:04] James Marland: let's, let's first start out with why, why are you even like when people go to college and they're like thinking about a career, many people thinking, Oh, I want to study the, I want to study the ins and outs and intricacies of the law. And I want to know policy. And. I, I wanted, that's what I want my whole career to be. So you are a special person who, who has devoted your career to this. got you interested in it and what do you love about it?
[00:03:36] Natasha Guess: So I know I am a weird person, but there are a few of us that loves law and policy. So yeah. But for me much of my story started way before I, ever thought about being a compliance professional. I grew up in a third row country and I saw a lot of people, they got sick and died because.[00:04:00]
[00:04:00] One, there was not a structure in place and all of these illnesses and deaths, they were all preventable. And it wasn't because the medicine did not exist in the country. It was because there was no healthcare structure and, there was no system there, there was no accountability whatsoever and no governance.
[00:04:23] When I think back on that, I, I watched all of this play out in real life with real people. People within my family people that I met at the hospital while visiting family and, if there was something in place, a better structure, a better system. A compliance system, a regulation, it would've been better.
[00:04:46] So that has never left me. And when I migrated here to the us, I saw this incredible healthcare system that had the resources, has the frameworks and the technology [00:05:00] to actually protect people. However, over the years, I also saw small and mid-size practices completely drowning in regulations in their obligations, and no one was helping them to actually figure out how to build out a system with the right structure.
[00:05:22] So that's why I started guess compliance, I know from lived experience what it looks like when a person or a healthcare system has nothing holding it together. I've seen the debts and the illnesses to prove it. So yes, my, my love for laws and regulations, it comes from that, from living in a third world country where none of this existed and it, it was just a normal fit for me.
[00:05:49] Move into compliance.
[00:05:51] James Marland: I'm, I'm actually surprised, like your, your story is anchored in some personal pain,
[00:05:58] like it's anchored [00:06:00] in the, we could do better, the things
[00:06:02] could do better. We have the ability to do better. And then on the other side, I heard you say the small and midsize companies just drowning
[00:06:11] Natasha Guess: yes. I.
[00:06:12] James Marland: drowning.
[00:06:12] Like, how do I, How do I even understand what I need to do? I want to, I want to do what's right. I want to follow regulations. I just
[00:06:21] Natasha Guess: Yeah.
[00:06:21] James Marland: the ability to keep track of everything. And that I was talking to you in the beginning when I was working for the virtual assistant company for mental health providers, we, we did lots of work on HIPAA when I started. was like, okay, do HIPAA, make sure you're following him. I'm like okay, where do I even begin? And, and it, it, it felt overwhelming. It felt
[00:06:45] Natasha Guess: Yes.
[00:06:46] James Marland: a burden.
[00:06:48] Natasha Guess: Yeah, I can see how it feels like a burden, especially if you're not in the compliance space or you're not in the law or policy space, then, for a [00:07:00] practice or a practice manager or even their staff. They have 10 different things, 10 different hats they're wearing. So to sit down and actually understand all of these requirements, it'll take a lot.
[00:07:14] James Marland: yeah, that, that was a thing you, you hit, you hit it. Right on. Like I had other, I had hiring responsibilities, training
[00:07:21] responsibilities, budget responsibilities, the payroll. I wore a lot of hats,
[00:07:26] Natasha Guess: yes.
[00:07:27] James Marland: and then to throw on the compliance hat and the policy hat, and then the training of the compliance and the policy, was a very big it was something that I really needed help with it was something that yeah, I, I did, I did actually buy some support and training to get it done because I just couldn't. couldn't figure it out on my own. So
[00:07:49] Natasha Guess: yes.
[00:07:49] James Marland: Shift just a little bit and talk about the necessity of compliance and the necessity of having good policy. [00:08:00] What is the problems that this would solve? When you get this right, how does your business run better?
[00:08:06] Natasha Guess: when it comes to regulations and compliance, and this is honestly one of the biggest. Challenges that I have when I speak with a practice manager, and that's getting them to actually understand or truly believe that compliance is not something that they can put off until they're large and in getting, yes.
[00:08:28] A lot of providers are practices that I've spoken to. They're like we are a small company. We're never getting audited. And I'm like, no, it's not a never. It's a when It may, may not be right now, you may not be on the radar, but it will happen eventually. and before I say that, the assumption about compliance not being relevant for the small companies, it is so widespread, especially in this space [00:09:00] and.
[00:09:01] Yes. Like I said before, small practices, they'll go under the radar for however long, until there's a complaint, until there's a billing issue, until you're submitting claims that doesn't match your documentation and it is a dangerous thing, not having your compliance structure. So when I talk.
[00:09:24] James Marland: going to be wondering, just, you're going to be wondering, oh, when am I going to get found out?
[00:09:28] Natasha Guess: Yes,
[00:09:30] James Marland: What a mental burden to carry for months and years and decades, probably sometimes Oh, I
[00:09:35] Natasha Guess: yes,
[00:09:36] James Marland: this billing issue doesn't get found out. Or I know I, I'm not exactly sure if I'm doing this right, but Oh, it doesn't matter.
[00:09:42] And then you just carry that weight with you every time you submit, or every time a problem comes
[00:09:48] Natasha Guess: yes.
[00:09:48] James Marland: every time an envelope comes and that you're like, Oh, it's from this
[00:09:52] Natasha Guess: For, yes. And I get that all the time. And that's what I tell practice owners and managers. You do [00:10:00] not wanna wait for that letter or that notice because you are, you are gonna be scrambling at that point. And scrambling will not ensure that you're giving them what is needed. You will not be able to explain your oversight processes or even the policies and procedures you currently have in your practice.
[00:10:21] Yes,
[00:10:21] James Marland: no recovery.
[00:10:23] Natasha Guess: none at all. And then, another thing I get is we're a small company. Oh. We don't have to do this, and we don't have to do that. And I'm telling them, regulators, they're not looking for expectations or they do not scale expectations based on your headcount. Whether you're a five person practice, a hundred person, clinician group, it's the same.
[00:10:52] You have the same obligations for your compliance structure, for your fundamental HIPAA [00:11:00] standards. It is the same. What HIPAA says is according to the size and complexity of the organization, but it does not mean that you don't still have that regulatory requirement. You have to do what is required of you.
[00:11:16] In doing so, you are protecting your patients. You are protecting your practice. You are protecting what you've worked so hard to build. Because as we know for these small and mid-sized practices, one fine or one cap can shut them down. They don't have all the same resources like the large corporations, that is why compliance is important. You want to protect your patients. They are first and foremost, you have to protect your staff members and you have to protect your reputation. And any of these things can be harmed. Yes,
[00:11:54] James Marland: That's interesting because if you're not doing it, not protecting. if [00:12:00] something bad happens, the staff who are depending on you might not have a job,
[00:12:04] Natasha Guess: yes.
[00:12:05] James Marland: be shut down. The people who depend on you for their services might not get their services.
[00:12:12] And, the family members that depend on your income,
[00:12:16] Natasha Guess: Oh
[00:12:16] James Marland: you're found, and there's a big fine or. Something catastrophic happens, money gets taken back or whatever.
[00:12:25] Natasha Guess: all of the time I.
[00:12:27] James Marland: you're not protecting people. So compliance is a, it makes it sound more important than Oh, I'm just doing what the government wants.
[00:12:39] And the government's just trying to, make
[00:12:43] Natasha Guess: Tell me what,
[00:12:44] James Marland: guy
[00:12:46] Natasha Guess: And that is not true. I do know there's so many regulations. Every day we might get changes to regulation. There's always something going on. But if you look at it from your patient's point of [00:13:00] view. Everything that you do in relation to compliance helps your patient as well as yourself and your staff members.
[00:13:10] Because for instance, you get a breach, something happens, you get a hacker, you know you have this breach. Then your patient's information, their PHI information, it's all out there. That can harm your patients. Now if you follow hipaa security standards, then you are covered. Everything is covered. And even if something happens, you have that oversight already in place.
[00:13:39] I,
[00:13:39] James Marland: you're following HIPAA and some, somebody does something, are you liable for? Is that like somebody, I don't know, you're following everything and something bad happens and you, you lose some of the data. Does that mean people can sue you still?
[00:13:58] Natasha Guess: When it comes [00:14:00] to your patients there's always that possibility that you might have a patient that wants to see you.
[00:14:05] James Marland: at any time.
[00:14:06] Natasha Guess: Yes.
[00:14:07] James Marland: company, oh, okay,
[00:14:09] Natasha Guess: Yes, but if you are following the all of the standards and you have active oversight and monitoring of your vendors, of your EHR system, of your staff, then when that investigation occurs.
[00:14:24] You have that evidence to show OCR or OIG, that this is what was in place. This is what we are following, and it's less for you. The all of that is considered during an investigation. Now, when it comes to members, like I said, or your patients, they can always choose to sue you for something. But having that in place that is better for everyone.
[00:14:54] James Marland: Yeah. And yeah, and I guess that's, that's a for some people, this might be a mental shift, it's [00:15:00] not just a policy to do. It's, it's better for everyone that we follow these things.
[00:15:06] Natasha Guess: It is.
[00:15:06] James Marland: to, I want to talk about the, the, the person, the smaller, medium sized business that says this will be easier to do when we're bigger, cause we'll have more resources.
[00:15:18] What do you say about that?
[00:15:20] Natasha Guess: That's when I say that is not true because like I said, HIP does says that you should have these standards in place according to your size and complexity. And one of the things that I have found when speaking to a lot of practices, and this is so often that. That's the first question I ask when I have a discovery call.
[00:15:48] And it's three gaps. Three gaps. Because providers or practices say, okay, we're gonna wait until it's larger, until we've grown [00:16:00] to that point where we can actually have the resources to do it. And the first one is always informal access. But you have a five person team and then you decide, okay, it's time for growth.
[00:16:14] You are gonna expand. And as growth happens, you have system permissions with access where all of your team member, for example, all of them, they have access to all of your information.
[00:16:31] James Marland: Every client, every
[00:16:32] Natasha Guess: Ev
[00:16:32] James Marland: everything. Yeah.
[00:16:34] Natasha Guess: Your billing coordinator, your front desk, your clinical team, and that is not right. HIPAA requires role-based access and that's one of the first things I find when they come, when providers or practices tell me, oh, we'll wait until we're large enough, so we have the resources, and that's when I have to explain to them that.
[00:16:59] Your [00:17:00] therapist access versus your billing coordinator. Access should look differently. And then once a month, I have to explain this every time, once a month, take that time, review those access permissions. You may have a staff that was that left or moved to a different position and they still have that same access, God forbid.
[00:17:27] You get a breach because a staff member that left still has access to your client information. And we've seen this in enforcement. This has happened, and not having that structure in place for role-based access, that is one of the biggest issues that OCR talks about. And then another thing that I find is informal communication, and I talk about this one a lot just because sometimes [00:18:00] you have a team member that needs to get a problem solved quickly because we know teams are built for speed, and they decided instead of going that extra step and signing into the secure system to send a message, they'll use their cell phone.
[00:18:18] And send a text message because it's just easier and they have to move quickly. Now, they'll walk away from that after it's done, not think about it. And months later, for instance, there's a complaint or a member asks, oh, they wanna see their access, everyone that had access to their information. Now you have a team member that sent an informal text.
[00:18:45] With access to your pain patient information that had no type of reason for that, and I don't understand why practices they do this. I do [00:19:00] understand. Let me rephrase that. I do understand because they're so busy, but these are the type of things.
[00:19:07] James Marland: that's not a good excuse,
[00:19:09] Natasha Guess: It is not. It is.
[00:19:10] James Marland: Oh, I was
[00:19:10] Natasha Guess: It is. Definitely it is not. And that's where you have a lot of red flags and that's, those are the cracks that, you know, within a practice that exposure lives in.
[00:19:25] James Marland: I think the, the problems that you solve there, it's a variety of problems,
[00:19:30] but it boils down to protection and it's the right thing for your, your clients and your business.
[00:19:37] Natasha Guess: yes. It's.
[00:19:40] James Marland: I was if somebody was considering. Hiring some sort of service like you, how do you, how do you help?
[00:19:46] Let's say I'm a practice and I, I know a little bit of compliance, but I also want to offload some of the, the mental capacity, to, to try to learn everything and stay on top of it. [00:20:00] What, what can somebody like you and your business do to help a business grow, grow and scale?
[00:20:06] Natasha Guess: practically speaking, I do work, like I said earlier, with small and mid-size teams. So what I do with that is I come into a practice. And I give them first and foremost, a diagnostic compliance check, and that means I am looking at your staff members, your documentation. I'm looking at where, which areas you are doing the right things correctly, and if there are any gaps, then we'll sit and talk about those gaps and we'll work to get everything implemented.
[00:20:44] So for me. When I come into that practice, I am looking at HIPAA standards. I am looking at requirements for the seven elements of a compliance program. Even though small and mid-sized teams, they don't have a [00:21:00] full compliance department or a program, I still look at those requirements to ensure that when you are growing and when you're scaling, that you are following every one of those standards.
[00:21:12] And for behavioral health practices, I know a lot of times it is not just HIPAA standards, it's Medicaid, it's Medicare, it's the 42 CFR part two. There's so many different regulations for behavioral health. I look at all of those standards. You're a telehealth framework, your EHR system. Every one of those things I look at to ensure that you are in the accurate place when it comes to regulations.
[00:21:42] And if you don't wanna think about that, then hiring someone is the best thing to do. Whether it's myself or another compliance consultant, we are there to ensure that you are doing the right things and keeping yourself out of the [00:22:00] line of fire when it comes to regulations.
[00:22:03] James Marland: One of, one of the things that when I was thinking about hiring somebody was I just don't know what I don't know. I want to do the right thing. It's just such a, for me, it was such a large area that was not sure I was doing the right thing. And you, you, you mentioned the role based role based permissions. And then even like reporting things,
[00:22:29] Natasha Guess: Yes,
[00:22:30] James Marland: just, what is reportable? What, what isn't, what what do you got to do if you make a report? Just all those little details, we wanted to do the right thing
[00:22:42] Natasha Guess: I.
[00:22:43] James Marland: it just took, it took a lot of time to figure out our process that probably somebody you, you, you say things about the things you're saying, roll off the top of your head, that it would take me four or five Google searches to figure out what you're talking about,
[00:22:59] Natasha Guess: [00:23:00] I know that, and that's because I live and breathe compliance. That's why I am sure what you are doing. If I try, I'll get frustrated and be like, okay, I'm gonna hire someone. Yeah.
[00:23:13] James Marland: So that's, that's how you help you. Does every, does everything start out with an assessment? You do an assessment, then figure out the gaps, then work towards closing the gaps. Is
[00:23:23] that how it works?
[00:23:24] Natasha Guess: yes. Everything starts with an assessment because you can't fix what you don't know about. So every single thing,
[00:23:32] James Marland: Yeah. You can't fix what you don't know about. That sounds, that's very true. So do
[00:23:36] Natasha Guess: yes.
[00:23:37] James Marland: Like one time service or ongoing code, compliance services? What, what, what is the, what is it that you offer?
[00:23:44] Natasha Guess: I actually offer both. I've done one time projects and I've had clients that wanted me to stay on, on a monthly ongoing adver advertise. Oh, I can't even say the word. An adv
[00:23:56] James Marland: maybe? Yeah.
[00:23:57] Natasha Guess: basis. Monthly. [00:24:00] Yes. That word kept me out. Yes. So I do have both types of clientele and it just depends. I find that some businesses, they have me come in and do their assessment, and with the assessment they get a roadmap, a 90 day roadmap on how they can fix everything.
[00:24:17] And I have some clients that. They start off that way and once they realize, okay, maybe this is not something that I can handle, or I need more help with this, then they bring me back in for their implementation. But I do have both sets of clients. Yes,
[00:24:32] James Marland: This is very needed. It's not just following the, the, the government who's trying to keep you down. It protects you. It
[00:24:39] Natasha Guess: I,
[00:24:39] James Marland: your clients and it gives you, I think, peace of mind is a big deal here.
[00:24:44] Natasha Guess: yes.
[00:24:46] James Marland: for people if, if somebody is looking to find out more about what you offer and the products and services that you have, where can they go online?
[00:24:56] Natasha Guess: So they can find me at guest compliance consulting, [00:25:00] LLC, and. llc.com. And you can also look me up on LinkedIn. You can find me on LinkedIn. But most people, they do find me on my website where they can book directly and speak with me. And I also offer free compliance strategy calls. And these are just where you'll tell me about your practice, we'll talk about, your pain points, and then we go from there.
[00:25:25] But these calls are free.
[00:25:28] James Marland: Great. And you can also you're also on the services directory, the scaling therapist services. com directory.
[00:25:35] Natasha Guess: Yes.
[00:25:35] James Marland: you have a profile in there. Yeah.
[00:25:37] Natasha Guess: I.
[00:25:37] James Marland: That's we're really happy to have you there. And Any final words for people who are, who are, let's, let's talk to the person who is like, Oh, I can do this later. What, what would you say to them as your final word?
[00:25:51] Natasha Guess: It would say, please do not wait until later. Later is when you have a an audit. It's [00:26:00] when you have a peer knocking on your door. It is when someone files a complaint and OCR is investigating you. And at that point, all of the opportunities that you had to fix things on your own, that will not be an option any longer.
[00:26:18] And at that point, you are risking your patients. You're risking your staff, you are risking your practice and your reputation. And a lot of providers, they've worked very hard to get where they're at. Do not take this for granted and then end up in that space where you're either in a hundred thousand dollars fine or more, or you're.
[00:26:44] The complaint is so big and you're spending time in prison for something, and that's very extreme, but that's how I like to look at things. Why not do the right thing today and get yourself the [00:27:00] oversight that's needed so that you can defend yourself if something happens?
[00:27:06] James Marland: Awesome. Natasha, thank you so much for being on the show. I really enjoyed our conversation and I wish you the best as you help people protect their practices and help their clients and their staff.
[00:27:18] Natasha Guess: Thank you so much for having me. It is such a pleasure. I really enjoyed this.
[00:27:24] James Marland: Okay, listeners, you have heard it here. It doesn't pay to wait. It doesn't pay to wait to get your compliance in order. doesn't give you peace of mind. It doesn't protect your reputation. It doesn't protect the business that you've spent so long to do. So it's now time to get compliant and put your mission in motion. We will see you next time.
[00:27:44]
[00:27:49] Speaker 2: before we end the show, I wanna thank our pro-level sponsors for sponsoring the show: Humor Speaks, RevKey, The Practice Co-Lab, Arc Integrated, TheraSaaS [00:28:00] CRM, Guest Compliance Consulting LLC, Private Practice Elevation, Freedom Business Solutions, Bosco LLC, Profit Comes First, River Street Studios, Wealth and Worth Within, TherapyFlow, and of course, coursecreationstudio.com.
[00:28:16] If you're looking for businesses that can help you break through your, your therapy practice business bottlenecks, go to scalingtherapistservices.com. Check out those proven businesses. Finally, I wanna remind you that the workshop is quickly coming up for creating your own-- launching your own workshop in 30 days.
[00:28:35] I'm gonna be putting that on. It's a half-day working workshop where you'll, you'll come with a, a fuzzy idea and leave with a plan for launching in 30 days. Check the show notes for the link to sign up. I will see you there
[00:28:48]
