Track 1: Payment Integrity
Track 2: Revenue Cycle Management & Revenue Integrity
Progressing Value-Based Care Partnerships – sharing different strategies to help payers engage providers when moving to a value-based payment method and achieve a partnership.
The transition to Value Based care is a challenging one. Strong partnerships between payers and providers is crucial for success. Join us as we discuss how to meet your provider partners where they are at and help them transition into value based care. Participants will
- Recognize the importance of assessing where providers are on their path to VBC
- Understand what support systems should be considered for their provider networks
- Learn best practices for removing barriers to success.
Track 1
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.
Moderator
David V. Cardelle, R.Ph.
Chief Strategy Officer, SVP, Health Plan Strategy & Partnerships
Advanced Medical Strategies
Panelists
Dr. Ahmad Kilani MD, MBA, MLS, MSIT, CHCQM-PHYADV, FACP, FACHE
Medical Director
Cleveland Clinic
Kelly Springmann
Provider Enablement & Product Development
Florida Blue
Jenny Raulerson, BSN, MSHI
Sr Clinical Consultant
Florida Blue
During this presentation, Dr Archer and Dr Goyal will:
- Share the idea of clinically integrated revenue cycle key components
- Examine the roles of the clinicians and the revenue cycle staff at each step in the revenue cycle
- Analyze the effects of the clinically integrated revenue cycle in change management in its impact on clinical outcomes, experience and cost of care.
Track 2
Dr Deepak Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC
Executive Medical Director Revenue Cycle and Supply Chain
Monument Health
Dr Brad Archer
Chief Medical Officer
Monument Health
Vendor management strategies for payment integrity are essential to ensure that your organization optimizes financial processes and ensures the recovery of overpayment. Here are some strategies that we will discuss:
- Vendor Selection and Due Diligence
- Stacking Vendors and multi-vendor approach
- Vendor Performance Metrics
- Data Sharing Protocols
- Payment integrity program options
Track 1
Novelette Wallace, MPH, PMP, CSSBB
Head of Payment Integrity
Johns Hopkins Healthcare
Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.
Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.
With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve
Track 2: Revenue Cycle Management & Revenue Integrity