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Track 1

Author:

Lawrence M. Simon, MD, MBA, FACS

Interim Senior Medical Director
Blue Cross and Blue Shield of Louisiana (BCBSLA)

Dr. Larry Simon is the Interim Senior Medical Director and Managing Medical Director for Medical Policy and Medical Appeals for Blue Cross and Blue Shield of Louisiana (BCBSLA), where he also serves as the Medical Director for Coding and Reimbursement and Chair of the Credentialing and Medical Quality Management Committees.  He is a member of the AMA CPT Editorial Panel, serving on the Executive Committee and as Co-Chair of the Molecular Pathology Advisory Group and Genomic Sequencing Procedures Workgroup.  He also chairs the Medical Director’s Forum for both the Louisiana Association of Health Plans and the National Anti-Fraud Advisory Board of the Blue Cross and Blue Shield Association.  Prior to joining BCBSLA, Dr. Simon served in numerous leadership roles for the American Academy of Otolaryngology, the American Medical Association, the American College of Surgeons, and the Louisiana State Medical Society. 

Dr. Simon is an alumnus of Louisiana State University, Baylor College of Medicine, Rady Children’s Hospital, and the BI Moody College of Business Administration at the University of Louisiana.  A diplomate of the American Board of Otolaryngology and a Fellow of the American College of Surgeons, Dr. Simon has over 15 years of experience in Health Policy and Healthcare Reform, and he has presented over 170 lectures and seminars on these topics. 

A Rotarian, an animal rescuer, a member of multiple civic boards, and a patron of the arts, Dr. Simon enjoys spending his time outside of work serving his community, helping the animal shelters and abandoned dogs of Louisiana, and travelling and enjoying life with his wife and their family and friends.

Lawrence M. Simon, MD, MBA, FACS

Interim Senior Medical Director
Blue Cross and Blue Shield of Louisiana (BCBSLA)

Dr. Larry Simon is the Interim Senior Medical Director and Managing Medical Director for Medical Policy and Medical Appeals for Blue Cross and Blue Shield of Louisiana (BCBSLA), where he also serves as the Medical Director for Coding and Reimbursement and Chair of the Credentialing and Medical Quality Management Committees.  He is a member of the AMA CPT Editorial Panel, serving on the Executive Committee and as Co-Chair of the Molecular Pathology Advisory Group and Genomic Sequencing Procedures Workgroup.  He also chairs the Medical Director’s Forum for both the Louisiana Association of Health Plans and the National Anti-Fraud Advisory Board of the Blue Cross and Blue Shield Association.  Prior to joining BCBSLA, Dr. Simon served in numerous leadership roles for the American Academy of Otolaryngology, the American Medical Association, the American College of Surgeons, and the Louisiana State Medical Society. 

Dr. Simon is an alumnus of Louisiana State University, Baylor College of Medicine, Rady Children’s Hospital, and the BI Moody College of Business Administration at the University of Louisiana.  A diplomate of the American Board of Otolaryngology and a Fellow of the American College of Surgeons, Dr. Simon has over 15 years of experience in Health Policy and Healthcare Reform, and he has presented over 170 lectures and seminars on these topics. 

A Rotarian, an animal rescuer, a member of multiple civic boards, and a patron of the arts, Dr. Simon enjoys spending his time outside of work serving his community, helping the animal shelters and abandoned dogs of Louisiana, and travelling and enjoying life with his wife and their family and friends.

 

Lawrence M. Simon, MD, MBA, FACS

Interim Senior Medical Director
Blue Cross and Blue Shield of Louisiana (BCBSLA)

Dr.

Lawrence M. Simon, MD, MBA, FACS

Interim Senior Medical Director
Blue Cross and Blue Shield of Louisiana (BCBSLA)

Lawrence M. Simon, MD, MBA, FACS

Interim Senior Medical Director
Blue Cross and Blue Shield of Louisiana (BCBSLA)

Dr. Larry Simon is the Interim Senior Medical Director and Managing Medical Director for Medical Policy and Medical Appeals for Blue Cross and Blue Shield of Louisiana (BCBSLA), where he also serves as the Medical Director for Coding and Reimbursement and Chair of the Credentialing and Medical Quality Management Committees.  He is a member of the AMA CPT Editorial Panel, serving on the Executive Committee and as Co-Chair of the Molecular Pathology Advisory Group and Genomic Sequencing Procedures Workgroup.  He also chairs the Medical Director’s Forum for both the Louisiana Association of Health Plans and the National Anti-Fraud Advisory Board of the Blue Cross and Blue Shield Association.  Prior to joining BCBSLA, Dr. Simon served in numerous leadership roles for the American Academy of Otolaryngology, the American Medical Association, the American College of Surgeons, and the Louisiana State Medical Society. 

Dr. Simon is an alumnus of Louisiana State University, Baylor College of Medicine, Rady Children’s Hospital, and the BI Moody College of Business Administration at the University of Louisiana.  A diplomate of the American Board of Otolaryngology and a Fellow of the American College of Surgeons, Dr. Simon has over 15 years of experience in Health Policy and Healthcare Reform, and he has presented over 170 lectures and seminars on these topics. 

A Rotarian, an animal rescuer, a member of multiple civic boards, and a patron of the arts, Dr. Simon enjoys spending his time outside of work serving his community, helping the animal shelters and abandoned dogs of Louisiana, and travelling and enjoying life with his wife and their family and friends.

Track 1

Author:

Ram Davaloor

Founder and COO
Claimshark

Ram Davaloor

Founder and COO
Claimshark

Author:

Colleen Gianatasio

Director, Clinical Documentation Integrity and Coding Compliance
CDPHP

Colleen is a strategic clinical documentation, coding and compliance, and risk adjustment expert with 10+ years of experience driving increases in provider engagement. She has thoughtfully built clinical documentation improvement programs from scratch to target accurate risk scores, increases in provider satisfaction, and cost-savings.

Beyond her role at CDPHP, Colleen is also currently the president of the AAPC National Advisory Board.

Colleen Gianatasio

Director, Clinical Documentation Integrity and Coding Compliance
CDPHP

Colleen is a strategic clinical documentation, coding and compliance, and risk adjustment expert with 10+ years of experience driving increases in provider engagement. She has thoughtfully built clinical documentation improvement programs from scratch to target accurate risk scores, increases in provider satisfaction, and cost-savings.

Beyond her role at CDPHP, Colleen is also currently the president of the AAPC National Advisory Board.

Author:

Tina Azar

Vice President, Market Leader
EXL Health

As EXL’s Vice President of Market Leadership, Tina Azar works to ensure EXL’s products and services drive to the greatest opportunities while servicing the needs of customers. Using strategic planning and thought leadership, her primary focus is to analyze insights and trends of the US Healthcare and then design and execute  comprehensive programs. She is a trusted client partner with over 22 years’ experience in claims, finance, program management, implementation and has lead operational, account management, and sales teams for Payment Integrity for over 12 years. With 12 years of experience in leading Sales and Account Management, she achieved top-in-class recognition while delivering customer and organization cost containment goals while serving as a cultural ambassador, corporate trainer, and mentor. Prior to EXL, she has worked for Change Healthcare, Emdeon and Viant.

Tina Azar

Vice President, Market Leader
EXL Health

As EXL’s Vice President of Market Leadership, Tina Azar works to ensure EXL’s products and services drive to the greatest opportunities while servicing the needs of customers. Using strategic planning and thought leadership, her primary focus is to analyze insights and trends of the US Healthcare and then design and execute  comprehensive programs. She is a trusted client partner with over 22 years’ experience in claims, finance, program management, implementation and has lead operational, account management, and sales teams for Payment Integrity for over 12 years. With 12 years of experience in leading Sales and Account Management, she achieved top-in-class recognition while delivering customer and organization cost containment goals while serving as a cultural ambassador, corporate trainer, and mentor. Prior to EXL, she has worked for Change Healthcare, Emdeon and Viant.

 

Alan Coulter

VP of Business Development
Performant

Alan Coulter

VP of Business Development
Performant

Alan Coulter

VP of Business Development
Performant
 

Debra Hamer

Director, FWA Analytics
CERIS

Debra Hamer

Director, FWA Analytics
CERIS

Debra Hamer

Director, FWA Analytics
CERIS

Author:

Harold Davis

VP, Product Growth
Rialtic

Harold Davis

VP, Product Growth
Rialtic

Author:

Kelly Bennett, JD, CFE, AHFI

Medicaid Program Integrity Chief
Agency for Health Care Administration

Kelly Bennett graduated from the University of Tampa and Florida State University College of Law.  She has been a member of the Florida Bar since 1997 and is a Certified Fraud Examiner and an Accredited Health Care Fraud Investigator.  She has worked at the Florida Agency for Health Care Administration since 2001 and has served in several roles, including as a Senior Attorney within the Medicaid Division of the Office of the General Counsel, the Assistant Bureau Chief for the Bureau of Medicaid Program Integrity, the Agency’s Medicaid
Fraud Liaison, and is currently the Chief of Medicaid Program Integrity, where she has served since July of 2014.  She is currently the President for the National Association for Medicaid Program Integrity and is an active participant in training and collaboration initiatives with the National Health Care Antifraud Association.

Kelly Bennett, JD, CFE, AHFI

Medicaid Program Integrity Chief
Agency for Health Care Administration

Kelly Bennett graduated from the University of Tampa and Florida State University College of Law.  She has been a member of the Florida Bar since 1997 and is a Certified Fraud Examiner and an Accredited Health Care Fraud Investigator.  She has worked at the Florida Agency for Health Care Administration since 2001 and has served in several roles, including as a Senior Attorney within the Medicaid Division of the Office of the General Counsel, the Assistant Bureau Chief for the Bureau of Medicaid Program Integrity, the Agency’s Medicaid
Fraud Liaison, and is currently the Chief of Medicaid Program Integrity, where she has served since July of 2014.  She is currently the President for the National Association for Medicaid Program Integrity and is an active participant in training and collaboration initiatives with the National Health Care Antifraud Association.

2024 is critical for Health Plan Payment Integrity Leadership.  With new and legacy pressures being placed on Internal PI Teams what are the opportunities and challenges in 2024 and beyond.  Explore how to leverage your internal resources, leading edge technologies, and HPRI relationships to drive success in the coming year.  

Author:

John-Michael Loke

SVP, Health Plan Strategy & Partnerships
AMS

John-Michael Loke

SVP, Health Plan Strategy & Partnerships
AMS