- Explanation of factors contributing to underpayment, such as contractual discrepancies, coding errors, complex reimbursement rules, and more
- Ensuring collaboration between revenue cycle teams, coding professionals, and payer relations departments to address underpayment issues
- Adopting proactive monitoring, automated workflows and targeted follow-ups on identified discrepancies
- Coordinating the efforts of credentialing/enrollment, audits, investigations (SIUs), provider sanctions, and policy
- Very few insurance payers have all those groups working together in a coordinated effort to reduce fraud, increase revenue, and render excellent customer service to enrolled health care providers.

Dale Carr
Dale Carr currently serves as Director of the Missouri Medicaid Audit & Compliance (MMAC) unit, which
has overall responsibility for Medicaid program integrity efforts. Dale has worked for the State of
Missouri since 2011. Director Carr was previously a Police Officer in Fallon, NV; an Investigator for the
U.S. Office of Special Counsel; and a Supervisory Special Agent with the Coast Guard Investigative
Service. Dale holds a Bachelor’s degree in Administration of Criminal Justice and is a graduate of the
158th Session of the FBI National Academy.
- Empowering payers to proactively detect and prevent fraudulent activities

Karen Weintraub
With 25 years of data and 20 years of healthcare experience, Ms. Weintraub is currently responsible for the design and development of the company’s healthcare fraud detection software products and services. She provides subject matter expertise on system design and workflow, business rule development, data mining and fraud outlier algorithms as well as SIU policies and procedures. Prior to joining Healthcare Fraud Shield, managed SIUs on various healthcare investigations for all commercial, Medicaid and Medicare business and claims of fraudulent activity. Ms. Weintraub received a BA in Criminal Justice from the University of Delaware and an MA in Criminal Justice from Rutgers University. Ms. Weintraub is a Certified Professional Coder for Payers (CPC-P), a Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders, a Certified Dental Coder (CDC) from the American Dental Association, and the founder of the Hamilton, NJ AAPC chapter. She is also an Accredited Healthcare Fraud Investigator (AHFI) from the National Healthcare Anti-Fraud Association (NHCAA). Ms. Weintraub Taught CPT Coding, Fraud & Audits, and Medical Billing, Laws and Ethics and the local community college.

Lori Jensen
- 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

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