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Author:

Kyle Pankey

Sales & Growth Leader
Carelon Subrogation

Kyle Pankey has over two decades of experience working within the healthcare and payer operations, with over 10 years specifically tied in to the payment integrity space.   Kyle lives in Chattanooga, TN and has served as Carelon Subrogation’s growth leader since mid-2022.

Kyle Pankey

Sales & Growth Leader
Carelon Subrogation

Kyle Pankey has over two decades of experience working within the healthcare and payer operations, with over 10 years specifically tied in to the payment integrity space.   Kyle lives in Chattanooga, TN and has served as Carelon Subrogation’s growth leader since mid-2022.

Author:

Aaron Browder

President
Carelon Subrogation

Aaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.

Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.

 

Aaron Browder

President
Carelon Subrogation

Aaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.

Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.

 

Author:

Matt Monyhan

Executive Director, Operations and Strategy
Carelon Subrogation

Matt Monyhan

Executive Director, Operations and Strategy
Carelon Subrogation

Author:

Creighton Long

Staff VP, Commercial Aligned Incentives Solutions
Anthem

Creighton Long

Staff VP, Commercial Aligned Incentives Solutions
Anthem

Delicia Clarke, Legal Consultant, Regeneron Pharmaceuticals

Great event delivering valuable insight from all aspects of the pharma sector! Definitely the go to IP litigation conference this year!

Adrian Spillman, Director IP, Valneva Group

Interesting presentations and many good discussions that are both informative and thought provoking 

Description: CEU Eligibility: COC, CPC, CPC-P, CPB, CPPM

Over the last few years, there have been many cases of hospitals receiving inappropriate reimbursement for medical procedures.  This session will focus on the procedures associated with these cases, including diagnostic and therapeutic procedures for access sites of dialysis patients, peripheral vascular patients and a variety of surgical procedures. We will explore these cases and discuss the characteristics and scenarios that lead to inappropriate reimbursement.

Learning Objectives:

Through the case study approach, examine specific types of hospital procedures that have been associated with inappropriate reimbursement

Explore methods for preventing, detecting and correcting errors leading to inappropriate reimbursement for these procedures.

Author:

CJ Wolf

Professor and Asst. Program Director
Brigham Young University-Idaho

CJ Wolf

Professor and Asst. Program Director
Brigham Young University-Idaho

AI is rapidly gaining traction across the healthcare space, driven by growing interest in generative AI, which can create content like text, images, and code. AI adoption, which hovered around 50 percent over the past six years, has surged to 72 percent this year. Within payment integrity, AI can help health plans escape from decades of legacy applications and outsourced high contingency fee vendors that have no incentive to automate/innovate.

 

Listen to industry experts discuss how to start implementing AI today and to create a balanced approach to AI adoption, one that embraces innovation while carefully managing risks.


Learning Objectives:

- Initiating AI Implementation in Healthcare: Understand the practical steps and strategies for beginning AI implementation within payment integrity, moving away from outdated systems and reliance on vendors with limited incentives for innovation.

- Leveraging AI for Payment Integrity: Learn what payment integrity use cases are ready for AI deployment helping reduce dependency on legacy applications, ultimately improving efficiency and reducing costs for health plans.
- Balancing AI Innovation with Risk Management: Explore how to adopt AI in a way that maximizes innovation while carefully managing potential risks.

Author:

Prasanna Ganesan

CEO
Machinify

Prasanna Ganesan

CEO
Machinify

Author:

Brandon Shelton

Senior Director, Advanced Analytics Lab
L.A. Care

Brandon Shelton is the Senior Director of the Advanced Analytics Lab at L.A. Care, the country's largest public-option health plan, where he leads teams of Data Scientists and Data Analysts to support the health plan's various enterprise domains with machine learning solutions, program impact assessments, and business intelligence deliverables. The team's contributions towards Payment Integrity savings consistently exceeds $20M per year.

Brandon Shelton

Senior Director, Advanced Analytics Lab
L.A. Care

Brandon Shelton is the Senior Director of the Advanced Analytics Lab at L.A. Care, the country's largest public-option health plan, where he leads teams of Data Scientists and Data Analysts to support the health plan's various enterprise domains with machine learning solutions, program impact assessments, and business intelligence deliverables. The team's contributions towards Payment Integrity savings consistently exceeds $20M per year.