Specialty Credits for: Core B- CPPMs
Revenue Cycle Management
Becky Peters
Executive Director, Patient Access Services
Banner Health
Charlotte Garnitsch
Partner
Taylor Wessing
Selma Ünlü
Senior Partner
NSN Law
Peter Thomsen
President
EPI
Stacy Calvaruso
Vice President of Sales and Client Delivery
ASP-RCM Solutions
- Learn to solve one of the most costly RCM Challenges - An open discussion regarding practical tools and insights to minimize costly errors and boost revenue.
- Discover technology enablers - How to determine if the value is attainable when choosing technology.
- Learn how to leverage all resources - The solution must include both your team and your technology.
Stacy Calvaruso
Vice President of Sales and Client Delivery
ASP-RCM Solutions
- Key takeaways:
- Discover how cost arbitrage and staffing continuity make offshore services a viable option for many organizations. At the same time, understand the key challenges of security and quality concerns, along with actionable strategies to mitigate these risks effectively.
- Learn about market dynamics and service penetration across regions and categories
- Understand the pros and cons of various pricing models, critical questions to ask during negotiations, and common risks or pitfalls to avoid in contracting.
Revenue Cycle Management
Wess Pass
Chief Revenue Officer
Data Marshall
Kimberly Collins Skinner, MBA, CHFP, CRCR
VP, Client Services
Data Marshall
Data Marshall Inc.
Website: https://datamarshall.com/
Data Marshall is a tech enabled Revenue Cycle platform headquartered in Franklin, TN with a global presence. We have been operating successfully for 20 years, specializing uniquely in both payer and provider services to give us a 360-degree understanding of the claim life cycle. Data Marshall has launched a 2.0 version of our organization, making significant strategic investments in talent and technology, and taking the most aggressive pricing approach in the industry. We are taking full revenue risk against our SLAs. Simply put, we perform or we don’t get paid. We prioritize our clients’ goals as our own, whether it is increased enterprise valuation, cost reduction, or operational continuity. We are confident that we are the best partner possible for provider platforms.
Edward Marx
Chief Executive Officer
Marx Advisory
The youngest child of Holocaust survivors, Ed moved to the United States at age 10. At 16, he served as a medical clinic janitor where he discovered his healthcare calling. Ed took successive positions as combat medic, anesthesia tech, strategic planner and technology manager. He quickly learned how the convergence of clinical, business and digital saved lives. His passion ignited, he jumped feet first into technology and operations in the C-Suite of Cleveland Clinic, NYC Health & Hospitals, Texas Health Resources and University Hospitals.
Intermixed, Ed served the supplier side as well. He was CEO for consulting firm Divurgent, global CDO for Tech Mahindra Health & Life Sciences and CIO of the Advisory Board. Concurrently, he served 15 years as an Army combat engineer officer and combat medic. Today, Ed is focused on his own advisory practice.
Ed does a fair amount of speaking, writing and podcasting. He authored healthcare bestsellers including “Voices of Innovation” and “Healthcare Digital Transformation”. He is currently writing a book for Mayo Clinic on “Patient Experience” and “Voices of Innovation - Payers”. His podcast “DGTL Voices” is “Top 3%” globally. His Blog, CEO Unplugged, surpassed 1M views. Ed recently started a YouTube channel to expand his audience.
Most importantly, Ed is husband to Simran who holds a Doctor of Nursing (DNP). They love to dance and climb mountains. They have 5 grown children and 4 grandchildren. To stay fit, he is captain of TeamUSA Triathlon.
For more career information you can find me:
Twitter https://twitter.com/marxtango
LinkedIn https://www.linkedin.com/in/edwardmarx/
Website https://www.marxadvisory.com/
- Gain insights into the current state of the RCM industry and understand the key challenges healthcare organizations face.
- Identify strategic priorities for enhancing financial performance and optimizing the revenue cycle.
- Explore the impact of adopting cutting-edge technologies and tools to streamline revenue cycle management processes, reduce costs, and improve overall profitability.
Revenue Cycle Management
Edward Marx
Chief Executive Officer
Marx Advisory
The youngest child of Holocaust survivors, Ed moved to the United States at age 10. At 16, he served as a medical clinic janitor where he discovered his healthcare calling. Ed took successive positions as combat medic, anesthesia tech, strategic planner and technology manager. He quickly learned how the convergence of clinical, business and digital saved lives. His passion ignited, he jumped feet first into technology and operations in the C-Suite of Cleveland Clinic, NYC Health & Hospitals, Texas Health Resources and University Hospitals.
Intermixed, Ed served the supplier side as well. He was CEO for consulting firm Divurgent, global CDO for Tech Mahindra Health & Life Sciences and CIO of the Advisory Board. Concurrently, he served 15 years as an Army combat engineer officer and combat medic. Today, Ed is focused on his own advisory practice.
Ed does a fair amount of speaking, writing and podcasting. He authored healthcare bestsellers including “Voices of Innovation” and “Healthcare Digital Transformation”. He is currently writing a book for Mayo Clinic on “Patient Experience” and “Voices of Innovation - Payers”. His podcast “DGTL Voices” is “Top 3%” globally. His Blog, CEO Unplugged, surpassed 1M views. Ed recently started a YouTube channel to expand his audience.
Most importantly, Ed is husband to Simran who holds a Doctor of Nursing (DNP). They love to dance and climb mountains. They have 5 grown children and 4 grandchildren. To stay fit, he is captain of TeamUSA Triathlon.
For more career information you can find me:
Twitter https://twitter.com/marxtango
LinkedIn https://www.linkedin.com/in/edwardmarx/
Website https://www.marxadvisory.com/
Lisa Meredith
AVP, Revenue Cycle Management
LifePoint Health
Medical implants and biologics are a critical part of modern healthcare, but the FDA approval process for these devices is flawed creating provider and payor policy coverage confusion. Many implants are approved through the 510(k) pathway, which allows new devices to be cleared based on similarity to existing products and real world evidence data, rather than requiring clinical trials to demonstrate safety and efficacy.
This presentation will provide an in-depth look at the issues with the current FDA approval framework for implantable devices. We will examine case studies of problematic implants that have led to patient complications, and discuss the lack of reliable evidence required for many products. Attendees will learn about the criteria for reliable evidence that health plans should utilize to create coverage policies.
The session will address considerations for payors to protect members and ensure appropriate care, highlighting the role of payment integrity teams in identifying and validating implant charges.
By the end of this session, attendees will have a comprehensive understanding of the systemic issues with medical implant and biologics regulation, and practical approaches their organizations can implement to ensure appropriate utilization.
Learning Objectives/Key Takeaways of the Session (max 50 words, 2-3 bullet points):
- Understand the disconnect between the real world evidence required by the FDA versus reliable evidence necessary for approval.
- Explore the role of payment integrity in identifying overpayment related to these issues.
- Develop strategies to enhance payer policies and review processes to mitigate risks and manage biologics and implant coverage effectively
Payment Integrity
Ellen Catania
Sr. Director of Review Operations
MedReview
Ellen is a registered nurse with extensive experience spanning clinical care and the health insurance industry, making her an expert in payment integrity and claims review. She has served as a clinical leader and consultant for payors and payment integrity companies. She excels in auditing high-value claims for third-party administrators and stop-loss carriers, while also providing clinical support to clients and addressing claim-related inquiries.
At MedReview, Ellen oversees the planning and development of Medicare and Medicaid hospital bill and DRG validation reviews and is also responsible for the oversight of the foreign and domestic nurse auditor teams conducting those reviews. An authority on Medicare and Medicaid policies, Ellen’s expertise also includes quality assurance oversight, peer review programs, and health plan contract interpretation.
MedReview
Website: https://www.medreview.us/
MedReview sets itself apart with over 50 years of experience delivering physician-approved pre-pay and post-pay payment integrity services that prioritize billing and payment quality, accuracy, and precision. Every claim reassigned by MedReview is reviewed, approved, and documented by a team of physicians, resulting in the industry’s lowest appeal overturn rate.
Utilizing proprietary technology combined with extensive subject matter clinical and administrative expertise, we achieve a 40% or greater reassignment rate focused on our clients’ specific needs. MedReview provides the full spectrum of payment integrity solutions including DRG and clinical reviews, cost outlier audits, re-admission reviews, data mining and itemized bill reviews.
Partnered with clients across the country, MedReview offers a flexible approach, supporting both complete outsourcing and supplemental enhancements to existing programs. By optimizing recoveries, preventing overpayments, and improving the provider experience, MedReview empowers payors to navigate the complexities of payment integrity with confidence and measurable success.