Panels and Presentations Addressing Key Challenges of Revenue Cycle Management
Revenue Cycle Management
Panels and Presentations Addressing Key Challenges of Payment Integrity
Payment Integrity
Michael Devine
Director Special Investigations Unit
L.A Care
Medical Cost Containment
Panels and Presentations Addressing Key Challenges of Revenue Cycle Management
Revenue Cycle Management
Stephanie Sjogren
Director, Coding and Provider Reimbursement
EmblemHealth/Connecticare
Stephanie Sjogren is a director of coding and provider reimbursement, working with payment integrity to ensure proper claims adjudication and to prevent fraud, waste, and abuse. Prior to joining ConnectiCare/EmblemHealth, she performed provider audits and education at a women’s healthcare group. Sjogren has also worked with physicians and staff to integrate and use electronic health record systems effectively and to stay in compliance with the Centers for Medicare & Medicaid Services’ rules and regulations. Her areas of specialty are payment integrity, auditing, and clinical documentation improvement.
Christine Hall
Adjunct Instructor
Florida Atlantic University
Panels and Presentations Addressing Key Challenges of Payment Integrity
Payment Integrity
Moderator:
Natalie Clayton
Head of Market Intelligence
Kisaco Research
Panelists:
Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE
VP Payment Integrity
Blue Cross NC
Dr. Priscilla Alfaro is a seasoned healthcare professional with extensive experience in executive medical management, fraud prevention, and healthcare analytics. A certified medical coder, fraud examiner, and auditor, she has a proven track record of improving healthcare efficiency and preventing fraud, waste, and abuse across various roles and affiliations, including the Texas HHS and Anthem.
Monique Pierce
Payment Solutions & Operations
Cohere Health
Monique started her Payment Integrity career in COB at Oxford HealthPlans. After the merger with UnitedHealthcare, she led multiple teams and was responsible for creating innovative programs. Monique joined SCIO Health Analytics in 2014 and was responsible for system and process improvements before being promoted to VP of client engagement and business optimization In 2020, Monique joined start-up Devoted Health and created a full suite of programs from the ground up. Based on a passion for metrics and measuring performance, she centralized and standardized all programs reducing implementation time and maximizing savings. Today, Monique is driving opportunities to improve claim payment by designing and developing new prior auth and claim reconciliation products at Cohere Health.
Curated meetings based on your RCM/PI painpoints and investments -30 minutes each -3 meetings per registered individual -All those not scheduled to take meetings will be encouraged to take part in interactive sessions, competitions and activities in the exhibition room.
Medical Cost Containment
Take a break to grab a drink, enjoy a snack, and connect with presenters after their sessions. Don’t miss the interactive sessions and competitions happening in the exhibition room during this time!
Medical Cost Containment
Panels and Presentations Addressing Key Challenges of Payment Integrity and Revenue Cycle Management.
Medical Cost Containment
AMS Intelligent Analytics
Website: http://www.amspredict.com/
Advanced Medical Strategies (AMS) is the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.
Medical Cost Containment
Mark Buehrer
PE Founder & CEO
heartfoods