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Oliver Hardcastle, Independent Consultant, HBSL Consulting

Just come along to one of these events and you’ll be hooked and definitely want to visit more of them – especially once you have a chance to meet everybody here and engage with the industry!

German Graff, Director of Business Development & Marketing, Clinglobal

“The event has been great, we’ve had the opportunity to meet a few people that we wouldn’t usually meet, and also to meet again with colleagues and clients we’ve been working with before, so it’s a great opportunity to be exposed as an organisation, but also to network and collaborate with different industries and different clients from within the industry. I think it’s been fantastic!”

2023 Innovation Showcase Finalists
Interview - Snorre Welling
Interview - Daniel Gysel
Interview - Matthias Greiller

In the dynamic landscape of healthcare, Payment Integrity is evolving beyond its traditional role of avoiding or recovering overpayments. This presentation explores how Payment Integrity can become the foundational driver of business intelligence within Payer organizations. Instead of perpetually avoiding or recovering overpayments, we propose harnessing the vast expertise of Payment Integrity audit professionals to identify, aggregate, and quantify key areas of continued overpayment. By working collaboratively with various stakeholders, these professionals can provide a roadmap, specific details, and root cause analysis to fix system edit issues, negotiate improved contract reimbursements, and align reimbursement and medical policies with industry benchmarks. This paradigm shift not only can significantly reduce the medical cost of care, optimizes financial performance but also, this approach and expanded role can foster a culture of continuous improvement and cost-effective healthcare.

Author:

Dave Cardelle

Chief Strategy Officer
AMS

Dave Cardelle

Chief Strategy Officer
AMS
 

Kay Larsen

Revenue Integrity Specialist
Adventist Health

Kay Larsen

Revenue Integrity Specialist
Adventist Health

Kay Larsen

Revenue Integrity Specialist
Adventist Health
Innovation Showcase Starter Pack