- Coupling compliance and revenue cycle to ensure revenue integrity
- Effectively designing comprehensive compliance audits and developing action plans that incorporate feedback based on audit results

Lori Jensen

Lori Jensen

Carl Reinhardt
- Implementing a streamlined claims process to prevent missing information and incorrect coding, and tracking patterns claim denials to mitigate future issues
- Highlighting causal factors such as front-end errors related to benefit information, coverage details, and missing or invalid claims data
- Discussing the value of automated denial management systems as a means to reduce administrative burden
- Payment Integrity Begins at the Top
- The SIU’s Greatest Need-Data
- Recent Schemes & Trends
- Internet Based Providers
- Behavioral Health Providers
- Telehealth Providers

Carl Reinhardt
- Using an AI-first approach to enhance transparency and accuracy throughout the payment continuum

Mike Spellman
Lyric
Website: www.lyric.ai
Lyric is the trusted leader in healthcare decision intelligence. Built on more than 35 years of proven results, Lyric combines responsible AI with clinical, payment, regulatory, and policy expertise to deliver transparent, auditable insights in milliseconds across real-time claims workflows. Lyric augments human decision-making so health plans can make faster, more accurate payments while maintaining full control. Today, Lyric supports 200 million lives, with nine of the top 10 U.S. health plans relying on its platform to reduce waste, improve efficiency, and support accurate payments. To learn more, visit lyric.ai.
In healthcare to optimize skills used to improve the value of products, it is essential to remove clinical and financial silos. Collaborating and aligning revenue teams with value analysis teams provide a platform to tell the entire business story in healthcare, decrease cost, and increase revenue.
Relationships in this arena generate opportunities to find billing and charging errors, and implement best practices into workflow, procedures, and buying trends. Collaboration benefits the teams by offering vital evidence that helps providers make judicious choices about the products they may want to bring into facilities. A revenue cycle analyst can aid in the discovery of problems with processes or old ways of how and where procedures are performed. Using dashboards, reports, and charging and reimbursement data can be seamlessly be integrated into existing value analysis processes making it easy to collaborate on the best ways to achieve your revenue targets.

Lori Jensen
- Developing a Payment Integrity Program from the ground up for a brand new Medicare Advantage Health Plan
- Covering both the opportunities and the challenges of building and effectively managing PI programs that prevent, avoid, or recover billing errors, payment errors and other party liability errors
- Listing of suggestions/ advice from our success, and lessons learned

