Every payment integrity recovery, denial, and appeal eventually comes back to one place: the clinical documentation in the medical record. For payer PI teams that are still building out or scaling up, understanding how documentation is created, queried, and finalised before it ever reaches a claim is the single most useful foundation you can lay. RCX works on both sides of that fence, supporting hospital CDI programs and payer DRG validation reviews, and this panel brings together payer PI leaders and clinical documentation experts who have spent their careers inside the chart. The goal: help attendees build review programs that recover real dollars, hold up under appeal, and don't burn out their provider relationships in the process.
- How clinical documentation actually gets created, queried, and finalised on the provider side, and the DRG families where new PI programs should focus first
- What "defensible" looks like in a DRG validation or documentation-driven review, and how to design reviews that recover dollars without destroying provider relationships
- Where AI fits for a team just starting out, and what data and governance you need before turning it on
In partnership with RevCycle Xperts
Justice Croffie
Dr. Croffie is a veteran health information management professional with 46 years of experience
in International Classification of Diseases (ICD) coding, prospective payment systems (DRG),
clinical documentation integrity (CDI), and clinical documentation compliance, and education.
Before joining RCX, Justice worked for 17 years as an independent consultant and served as
Associate Administrator for Clinical Information, where he oversaw the development of EHR
systems, mid-revenue cycle operations and reimbursement optimization for a leading New
York-based provider. His recent past 12 years have been focused on in provider claim integrity
and payor payment integrity auditing.
Justice brings extensive experience from his work on both the provider and the payer sides of
healthcare delivery claims and payment services to RevCycle Xperts, Inc.
Barbara Shaw
Stephanie Samuels
A nationally recognized leader with 20 years of experience in Clinical Documentation Integrity (CDI), ICD-coding Quality, DRG methodology, and Payment Integrity Audits, Stephanie leads the: continued-education, training, quality oversight, and overall development of RCX’s consulting team in conducting payment integrity audits.
With subject matter expertise on both Payer-side claim audits and Provider-side integrity reviews, Stephanie offers a rare end-to-end perspective on clinical documentation compliance and payment accuracy.
She continues to build high-performance RCX review team by teaching audit strategies that foster collaboration between providers and payers while supporting accurate reimbursement and data integrity.
Her expansive experience includes serving as Senior Director of Clinical Documentation and Coding Quality at the nation’s largest public healthcare system, where she led enterprise-wide documentation and coding quality initiatives.
Erin Moss
A seasoned healthcare executive with 40 years of experience across clinical practice, health information management, and revenue cycle operations. Erin’s track record is from an entry-level clerical position in Medical Records to leadership role in the industry affords her with a complete understanding of the foundational structure of all units of the healthcare revenue cycle process.
She has led strategic transformation initiatives in Clinical Documentation Integrity (CDI), coding, DRG validation, and financial recovery programs at leading healthcare organizations, including NYC Health and Hospitals, NYU Langone, and NewYork Presbyterian, MetroPlus Health insurance Plan, and NYCHSRO.
Known for designing, implementing and optimizing compliance programs, she brings to RevCycle Xperts, a disciplined, results-driven approach grounded in deep operational expertise.
Erin continues to be a dedicated mentor and industry advocate, and a thought leader, guiding healthcare organizations successfully navigate through the complex regulatory requirements and operational challenges.
Rhonda Ruiz
An accomplished Health Information Management executive with 45 years of progressive leadership experience in revenue cycle operations.
Dedicated most of her career to clinical documentation integrity (CDI), healthcare quality and outcomes, case management, and patient access. She is recognized for advancing operational excellence, strengthening regulatory compliance, improving financial performance, and leading strategic transformation initiatives across health systems.
Prior to joining RevCycle Xperts, Inc., she served in leadership positions in New York, including, Interim Director of Health Information Management at Brookdale University Hospital, Associate Director of Revenue Cycle Operations for Montefiore New Rochelle and Mount Vernon Hospitals, and Assistant Vice President of Operations and Revenue Cycle at Sound Shore Health System.