2019 Revenue Integrity Symposium

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2019 Revenue Integrity Symposium

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2019 Revenue Integrity Symposium


October 15-16, 2019 | Orlando, FL

The Revenue Integrity Symposium is the can’t-miss event for revenue integrity, revenue cycle, and Medicare compliance education and high-level networking for acute and long-term care professionals. Learn from trusted experts with cutting-edge regulatory insight that will arm you with the tools you need to take 2020 by storm. By popular demand, this year’s event kicks off with a motivational keynote session and introduces a track focused on professional development to help you navigate your career and ensure your team is positioned for success.

Benefits of the 2019 Revenue Integrity Symposium:

  • Learn strategies for designing a revenue integrity program, defining leadership, and setting and meeting revenue integrity goals
  • Gauge the financial and operational impact of the 2020 OPPS and MPFS proposed rules and the 2020 IPPS final rule
  • Discover best practices for maintaining an up-to-date and compliant charge description master (CDM) and learn to identify charge capture strategies
  • Get the latest information on external auditors and learn new strategies for dealing with claim denials and appeals
  • Develop strategies for enhancing your denials management program, using analytics to strengthen internal audits and defend against external audits
  • Gain insight into billing and coding hot topics that may impact your facility’s financial performance, including injections and infusions, claim edits, and patient status
  • Return to your facility armed with the tools to enhance revenue integrity and develop strategies for accurately documenting, coding, and billing patient encounters and stays
  • Discuss strategies for executing the new PDPM case-mix payment model
  • Analyze the role of diagnosis coding with the MDS in the post-acute care setting


2019 Highlights:

  • An overview of the 2020 OPPS and MPFS proposed rules and the 2020 IPPS final rule
  • Strategies for effective chargemaster maintenance, charge capture, and charge reconciliation
  • Revenue integrity program design and management
  • Properly addressing National Correct Coding Initiative edits and Medically Unlikely Edits
  • Current payer audit targets and strategies to protect revenue
  • Best practices for reducing payer denials using targeted data analytics
  • Understanding the impact of patient status and navigating payer regulations
  • Reimbursement, documentation, and coding strategies for laboratory tests and drug administration
  • Impact of value-based reimbursement models on revenue
  • The impact of the new PDPM case-mix payment model on billing and reimbursement
  • The link between ICD-10 coding and the MDS


NAHRI is hosting a live, paper-and-pencil CHRI exam at the Revenue Integrity Symposium on October 16, 2019 from 3:00-5:30 p.m. at the Renaissance Orlando at SeaWorld in Orlando, Florida. If you wish to sit for the paper-and-pencil CHRI exam, please note this exam location selection in field 7 of the CHRI exam application. Click here for more information and to apply for the exam.

Photography Disclaimer

From time to time, NAHRI or its contractors record, photograph, and/or stream the various aspects and activities of the Revenue Integrity Symposium for both archival and promotional purposes. By attending the conference, attendees give NAHRI and its contractors permission to use any attendee’s voice and image in any such archival or promotional recording, photograph, or streaming activity without any compensation or credit to the attendee.



Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.

Pre-Conference and Post-Conferences


Florida: Leader As Coach: Leadership Development Master Class

Pre-Conference: October 13–14, 2019 | Renaissance Orlando

This engaging, highly experiential course is designed for managers, leaders, and influencers who understand the necessity of superior coaching in today’s business ecosystem where leadership development has become everyone’s responsibility. The curriculum equips participants with immediately-usable skills they can use to cultivate collaborative talent development partnerships; engage in potent, performance-enhancing conversations; and create extraordinary engagement, alignment, productivity and innovation in their teams. For more information, click here.  


Medicare Boot Camp® — Utilization Review

Pre-Conference: October 13–14, 2019 | Renaissance Orlando

Medicare Boot Camp®—Utilization Review Version is an intensive two-day course focusing on the Medicare regulatory requirements for patient status and the role of the utilization review (UR) committee. For more information, click here.


Medicare Boot Camp® — Audits, Appeals, and Denials Version

Post-Conference: October 17–18, 2019 | Renaissance Orlando

Get expert guidance on preventing denials and focusing appeals efforts for success. The evolution of reimbursement models and uncertainty regarding healthcare laws mean that to keep the doors open, organizations can’t afford write off appealable denials. Organizations need sound, practical information on overturning denials. Medicare Boot Camp®—Audits, Appeals, and Denials Version is your key to proven strategies for success and will answer all of your questions on denials management and appeals processes. For more information, click here.


Medicare Boot Camp® — Provider-Based Departments Version

Post-Conference: October 17–18, 2019 | Renaissance Orlando

The Medicare Boot Camp—Provider-Based Departments Version provides education on attestations, on- and off-campus determinations, enrollment, billing, and reimbursement. This Boot Camp will provide brand new insight for understanding hospital outpatient department billing and reimbursement in an ever-changing regulatory landscape. For more information, click here.



Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.

Agenda


Tracks
Acute Care Regulatory Changes and Hot Topics 

Using Your Performance Data to Maximize Revenue  
Acute Care Coding and Documentation 
Chargemaster and Charge Capture Strategies 
Denials, Audits, and Appeals 
Patient Status and Utilization Review Strategies 
Professional Development 
Long-Term Care — Brought to you by AMBR


Day 1—Tuesday, October 15, 2019

Registration and Continental Breakfast (Provided – Exhibit Hall Open)
7:00 a.m. – 8:00 a.m.

General Session 1
8:00 a.m. – 9:00 a.m.
Great Balls of Fire!  How To Stay Motivated No Matter What
Denise Ryan
One of the greatest challenges we all face is keeping ourselves motivated. This is particularly difficult and extremely important with our fast-paced high responsibility jobs.  It’s easy to lose enthusiasm and get burned out, stressed out, and finally – checked out. This high-energy session will give you six steps for keeping your fire burning both professionally and personally. It’s not just a motivational speech; it’s a method you can apply long after the conference is over.

Breakout Session 1
9:10 a.m. – 10:10 a.m.

Round the Rule Merry-Go-Round: IPPS, OPPS, and MPFS
Jugna Shah, MPH, and
Valerie A. Rinkle, MPA, CHRI
Learn the major policy changes for both hospital and professional services that were promulgated in 2019 and are finalized or expected for 2020, including key aspects of the 2020 IPPS final rule and major provisions of the 2020 OPPS and MPFS proposed rules. Highlights of related regulations and rules, such as drug pricing and price transparency, will also be covered.
  PEPPER: An Integral Tool for Revenue Integrity
William L. Malm, ND, DNP, CRCR, CMAS
With ongoing audits, and reimbursement tied more closely to patient outcomes, creating a benchmark for audit measures can help you focus on internal audits and proactively address areas that might come under scrutiny in payer audits. PEPPER will show you how your facility measures up against your peers and where you can take action to prevent continued revenue leakage. This session explains how to utilize PEPPER proactively and provide a plan of action to take back to your facility. It demonstrates how to use the report to audit, monitor, and support revenue integrity functions. 
  Revenue Integrity: A Team Approach to Compliant Revenue Retention
Tracey Tomak, RHIA PMP and Dawn Crump, CHC, SSBB, MA
Are you ready to centralize your appeal efforts around audit and denial activity but don't know where to start? This session will begin with the basics of building the team by selecting the right mix of staffing and expertise. We will then discuss tools to put in place for operational efficiency as well as how to create an effective data analytics platform. From there we will discuss real-world potential process improvement that can lend itself toward an effective denial prevention program.
  PDPM Implications for Senior Management
Stefanie Corbett, DHA
Providers don’t want to miss this session on PDPM, which will be in full swing after October This session will discuss how to optimize revenue under the new model’s clinical categories and how to operationalize PDPM requirements with a thorough prescreening process, effective resident goal setting, accurate coding, IDT involvement, astute therapy contract negotiation, and more.


Networking Refreshment Break (Exhibit Hall Open)
10:10 a.m. – 10:40 a.m.

Breakout Session 2
10:40 a.m. – 11:40 a.m.

Background and History of the 2 Midnight Rule and the Importance of Patient Status Issues
Marc Hartstein, MA
Hear former CMS Senior Executive Marc Hartstein speak on the history and background on the 2-midnight rule. Hartstein was responsible for drafting and leadership of CMS' 2 midnight rule through the agency, the Department of Health and Human Services, and the White House.
 

The CDM: Tales from a CFO, Coordinator, and Consultant
Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, Kay Larsen, CRCR, and Linda J. McCray, CPA, MBA
Get an inside look at best practice strategies for maintaining an up-to-date and accurate chargemaster and promoting collaboration amongst CDM professionals, financial leadership, and consulting experts. This session will use case studies and real-life examples to explain the role of the CDM coordinator, CFO, and outside consultants in maintaining an up-to-date chargemaster and addressing common CDM and charge capture issues. Attendees will take away key tips for promoting revenue integrity in the facility setting.

  The ABCs of HCCs
Rose T. Dunn, MBA, RHIA, CPA, CHPS, FACHE, FHFMA
The use of the Hierarchical Condition Category (HCC) methodology is expanding among governmental and commercial payers. Understanding the initiatives of this program will be important for the attendee to ensure that the practices at their organization are compliant and supportive of receiving entitled reimbursement through this reimbursement methodology. The session will provide foundational information about HCCs and discuss where there is potential risk for misrepresenting HCCs for reimbursement purposes and compliance pitfalls revenue integrity leaders must avoid.
  Tracking and Analyzing Therapy Utilization To Minimize Claim and Denial Risk
Reginald Hislop
Even though therapy minutes no longer drive reimbursement under PDPM, these services and the way they are documented still impact revenue integrity. During this session you’ll learn how to avoid scrutiny from CMS and how to analyze therapy utilization in order to minimize risk for claim audits and denials. Hislop will also review tracking therapy utilization patterns using PEPPER reports, how to maintain your current business model for therapy staffing and contract therapy services while optimizing reimbursement and quality, and effective collaboration strategies for billing and therapy personnel to maximize reimbursement.


Networking Lunch (Provided – Exhibit Hall Open)
11:40 a.m. – 12:40 p.m.

Sponsored Session
12:40 p.m. – 1:10 p.m.

Breakout Session 3
1:20 p.m. – 2:20 p.m.

Seeing Through Pricing Transparency
Caroline Rader Znaniec, MBA, MS-HCA
This session will provide a review and discussion of pricing transparency requirements. In addition, the session will provide discussion and review of strategies utilized nationally, and pros and cons to the various approaches. At the completion of the session, attendees will be better versed and prepared for pricing transparency discussions at their individual organizations.
  Drug Administration Review and Refresher: Testing Your Knowledge Through an Interactive Dialogue
Jugna Shah, MPA
This session will help participants challenge their coding, billing, documentation, and reimbursement knowledge related to facility reporting of drug administration (injection/infusion) services, including hydration, therapeutic, and chemotherapy services. We will also review any new codes and/or reporting requirements for CY 2020 and cover more detailed issues, such as the financial implications of series billing, as well as reviewing the most frequently asked questions from 2019. This will be an interactive session, so come ready to participate!
  Evolution of Utilization Review and the Role of Physician Advisors
Kurt Hopfensperger, MD, JD, and Kimberly AH Baker, JD, CPC
This session will explore the challenges involved in elevating the effectiveness of utilization review (UR). Attendees will learn how to rethink UR processes and leverage artificial intelligence to apply expertise at the most appropriate points in the UR process, achieving appropriate reimbursement and avoiding clinical denials
  Implementing Revenue Cycle Management for SNFs
Kim Cusson, CCS, CPC
Revenue cycle management (RCM) has traditionally been a term used in the acute-care world; however with PDPM’s new requirements, this process is catching on in long-term care. This session will explain what RCM is and how the accounting model’s best practices can be utilized to optimize revenue under the new payment model.

 
Networking Refreshment Break (Exhibit Hall Open)
2:20 p.m. – 2:50 p.m.

Breakout Session 4
2:50 p.m. – 3:50 p.m.

Success and Leadership: Panel Conversation with Four Women Leaders
Kim Garriott; Stacey McCreery, MBA; Angela Walker, MBA; Tiffany Walls
Join us for a panel discussion featuring tenured women leadership in healthcare. They will share best practices, successes, opportunities, and challenges. During this event, the panelists will draw upon their personal career experiences and offer insights on leading and how they pushed past the barriers. It will be an invigorating panel with open discussion and questions from the audience. Prepared to be inspired.
  Value-Based Care: A Comprehensive Look at MIPS, Bundles, and Recent Changes
William L. Malm, ND, DNP, CRCR, CMAS

The decrease in fee-for-service reimbursement has changed the landscape to evidenced-based care and cost management. Beginning with an overview of CMS’ major value-based care programs, this session will define bundles and explore risks associated with value-based care.



  Let’s Own Our Revenue Integrity: Using Revenue Cycle Principles to Maximize Reimbursement 
Sheldon A. Pink, MBA, FHFMA
A revenue integrity program resonates at the core of revenue cycle and financial outcomes to ensure that clinical and financial expectations are met from a payer and provider perspective. This session will demonstrate how to take charge of revenue integrity by identifying areas of opportunity for charge capture, developing practices to ensure departments charge appropriately, implementing daily charge reconciliation procedures, measuring the value of incorporating revenue cycle principles, and sustaining a revenue integrity program through transition.
  Using Your Performance Date to Maximize Revenue
Reginald M. Hislop III, PhD 
LTC facilities have recently been introduced to various reimbursement and incentive programs. To thrive under this new environment, providers must understand how their quality data metrics are determined and how they can be translated into various revenue optimization strategies. This session includes cases and examples for Value-Based Purchasing, bundled payment programs, narrow provider networks, accountable care organizations, Medicare Advantage negotiation, and hybrid risk-sharing models, as well as marketing strategies that center on attracting the most rewarding patients under PDPM.

 
Breakout Session 5
4:00 p.m. – 5:00 p.m.

Pricing Hospital Services: Anything but Transparent
Valerie A.Rinkle, MPA, CHRI,
Dapo Akanbi, MBA, and John D. Settlemyer, MBA, MHA, CPC
Review the do’s and don’ts for pricing hospital services and the rationale behind the guidelines as well as recent requirements to post prices online. We will review any new updates related to pricing transparency requirements.

  Today’s World Of Audits And Reviews: A Look at Cms’ Audit Programs, Their Contractors, and Other Federal Oversight
Diane Weiss, CPC, CPB, CCP
In today's healthcare industry, we can no longer operate under a strategy of "IF we get audited." We must now work with a daily assumption of "WHEN we get audited." Knowing who can request documentation, and why, for audits and reviews is an area that deserves everyone's attention throughout the entire revenue cycle process and is a necessary component of any successful revenue integrity program. This session will provide an overview of the audit related contractor types that are utilized within Medicare's Program Integrity scope of work.
  Strategies to Implement the Self-Denial Process and Bill Successfully with Condition Code W2
Kimberly AH Baker, JD, CPC
Condition code W2 is not just for “failed condition code 44” cases. Self-denials and billing correctly with condition code W2 is an important strategy to ensure payment for all patients admitted to the facility. Learn the UR and billing requirements to make this process work effectively and receive helpful handouts to get you started or improve your processes, including a letter to patients and a form to document UR decisions. 
  Consolidated Billing: Impacts on Reimbursement Under PDPM 
Stefanie Corbett, DHA
Under PDPM, SNFs can expect to receive greater reimbursement for residents with greater clinical complexity, higher acuity, and multiple comorbidities. This session will explain the role of consolidated billing requirements in properly anticipating the projected revenue and costs of care with the advent of this new model, including how to properly assigned reimbursement rates through preadmission screenings and MDS assessment accuracy.


Adjourn
5:00 p.m.

Networking Reception
5:00 p.m. – 6:00 p.m.

 

Day 2—Wednesday, October 16, 2019


Continental Breakfast (Provided – Exhibit Hall Open)
7:00 a.m. – 8:00 a.m.

Breakout Session 6
8:00 a.m. – 9:00 a.m.

Understanding and Applying New Lab Date of Service Requirements
Marc Hartstein, MA
Hear former CMS Senior Executive Marc Hartstein speak on the laboratory date of service rule. This session will provide an overview of the reason for the policy and changes made in recent years. 
  Reduce MUE and NCCI Edits by Being Proactive
Denise Williams, COC
The National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUEs) can be difficult and time consuming to resolve. It is often unclear who is responsible for conducting research to resolve an edit, costing a facility valuable time in the appeals process. Without processes in place to effectively resolve edits across departments, hospitals risk duplicating efforts or losing edits, which can result in lost revenue. This session will address all of these concerns and provide real life examples and strategies to mitigate these edits on the front end, helping to decrease re-work.
  Safety Net for Revenue Capture
Suzanne Tschetter, CPA, Karen Giacomo, BA, CPC, CHA, and Jim Carlson
Want to increase revenue and build relationships between clinical and financial staff? Want to capture missing charges? Come learn how the Cleveland Clinic and RevInt implemented tools and strategies to improve charge capture.
  Avoiding Common Cost Report Mistakes: Implications for Compliance and Reimbursement
Kim Cusson, CCS, CPC
Learn how cost reports impact reimbursement in your SNF and how to avoid common mistakes that could lead to Medicare noncompliance or fraud. This session will include an overview of cost report elements and submission timelines, case studies, and guidance for using cost report data to help facilities improve their accounting process.


Breakout Session 7
9:10 a.m. – 10:10 a.m.

Target Probe and Extrapolate: A Concerning CMS Initiative 
Alicia Kutzer, Esq., LL.M., MHA
Learn about the most serious and costly method CMS uses to calculate an overpayment for recoupment: the extrapolation method. Extrapolations have not been on the radar of most large facilities until now. This session is designed to teach participants how to shield their facilities from the potentially devastating consequences arising from the interplay between the target probe and educate initiative and the extrapolation process.
  Securing and Retaining the Best Talent: A Panel Discussion on Creating a Strategy and Culture to Attract and Retain Staff
Marijane Armbruster, RHIA; Nicole Harper, PhD; Stacey McCreery, MBA; Patti Medvescek
This panel discussion will address how to secure the best talent and share strategies on creating a winning culture to attract and retain staff. Panelists will share best practices, successes, opportunities, and challenges of retaining star employees and reducing turnover costs. It will be a passionate panel with a focus on how people are the most important asset. Lean in and join us.
  Understanding Part A Hospital Benefits: Help Me Count the Days
Judith L. Kares, JD
Define the inpatient hospital Part A benefit, including both the 90 regular covered inpatient days that renew each time a new benefit period begins and the 60 lifetime reserve days (LRD) that do not. This session will cover the rules related to the beneficiary’s right to elect not to use LRDs and the consequences of that election to both the beneficiary and the hospital. It will also review the limitations that apply to the number of covered days available for inpatient psychiatric care, as well as limitations on availability of Medicare coverage when inpatient psychiatric care is provided by state or local government facilities.
  PDPM Crash Course for the Business Office
Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA
What do billers need to know about the new payment model? As under RUG-IV, members of the business office will still be the last line of defense against claim audits and denials before sending out claims. This session will help billers understand what new information they should look out for to ensure clinical documentation and what’s represented on the claim align, as well as reinforce traditional best practices to avoid denials and returns to provider.


Networking Refreshment Break (Exhibit Hall Open)
10:10 a.m. – 10:40 a.m.

Breakout Session 8
10:40 a.m. – 11:40 a.m.

Organizational Interdependence Strategies for Improved Revenue Integrity
Caroline Rader Znaniec, MBA, MS-HCA, and Stacie Smith, EMBA, RHIA
This session will describe how the various stakeholders within the revenue cycle, and their functions, are interdependent on the others to maintain organizational revenue integrity. The audience will be engaged in open discussion to share their approaches and experiences. Attendees will also walk away with a troubleshooting guide, including an interdependence chart and guide to revenue cycle key performance indicators and common root causes.
 

Managing Denials Processes: An Analytical Approach
Becky W. Cook, CPA, MHA, and Scott Everitt, MBA
Resolving denials is a task completed by some of the most highly trained staff. This session will help you learn how to increase the team's effectiveness with analytical techniques and reporting. Learn how to track statistics and KPIs for each step in the denials management process. Attendees will come away understanding how to prioritize improvements to registration and claims processes and appeals and report on the outcome by measuring resolution, including recovery of funds, outstanding balances, and potential unrecoverable balances.

  Observation: Commonly Used, Poorly Understood, Frequently Billed Incorrectly
Ronald Hirsch, MD, FACP, CHCQM
The 2-midnight rule, RAC audits, and more aggressive insurer admission reviews have resulted in an increased use of observation services. But in many cases observation is being incorrectly ordered by physicians and improperly billed by hospitals, attracting the attention of the Medicare Administrative Contractors and the OIG. Understanding the proper use of observation, and what can and cannot be billed, is crucial to maintaining compliance and revenue integrity.
  Tracking Payer Correspondence to Prevent Lost Claims
John Larscheid
Understanding the flow of claim messaging between payers can have a bigger impact than denials on accounts receivable days in your SNF. This session will walk attendees through how to manage the different mediums through which providers and payers communicate and best practices for tracking and capturing correspondence when juggling multiple payer types to help the business office stay ahead of each billing cycle.


Networking Lunch (Provided – Exhibit Hall Open)
11:40 a.m. – 12:40 p.m.

Sponsored Session
12:40 p.m. – 1:10 p.m.

Breakout Session 9
1:20 p.m. – 2:20 p.m.

Leveling the Field: An Analytic Approach to Creating Individual Payer Strategies
Joseph Zebrowitz, MD, and Jay Ahlmer, CFA
Traditionally, revenue cycle and utilization review (UR) are siloed from each other. The disconnect between these functions offers payers an enormous opportunity to reduce payments. Join this session to understand the impact of UR on the revenue cycle, learn how Medicare Advantage and commercial payers have created strategies that leverage UR and coding metrics to undermine hospital revenue. Zebrowitz and Ahlmer will demonstrate how to create a unified set of financial performance goals for both revenue cycle and UR to achieve and how to use an approach similar to payers based on revenue and cost drivers. After participating in this session, you will have the skills to bridge the divide between revenue cycle and UR and take the lead in driving meaningful, measurable change.
  Appropriate Use Criteria for Advanced Diagnostic Imaging: Understanding the Requirements and Impact on Operations
Denise Williams, COC, and Angela Lynne Simmons, CPA
Appropriate Use Criteria is a new concept under the Medicare program. While CMS issued guidance in the Medicare Physician Fee Schedule, this applies to hospital providers and independent testing facilities. Providers will have to consult established criteria to support the ordering of advanced diagnostic imaging services, and provide this information with the order for the service. The providers who furnish the service will have to report this information on their claims – this includes hospitals and independent testing facilities, as well as the furnishing physician/clinician. While there are a few exclusions, most services will require this. This session will cover the basis for the establishment of these criteria, how to access them, what will be required from a process standpoint and some strategies for insuring that all information is available and reported on the claim.
  DRG Optimization: Why Current DRG Optimization Efforts May Be Coming Up Short
Laura Legg, RHIA, RHIT, CCS, CDIP
Solving diagnosis-related group (DRG) optimization continues to be a challenge for revenue cycle leaders. This session will look at the top revenue cycle management challenges facing hospitals, the disconnect between current solutions and achieving DRG optimization, key areas of vulnerability for lost or decreased revenue, and strategies to solve these problems. Attendees will leave with a comprehensive plan for improvement and an understanding of the key role revenue integrity plays in realizing it.
  Reinventing Your Triple Check and Medicare Meeting Processes for PDPM Success
Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA
The triple check process verifies claims for accuracy and compliance with Medicare regulations before billing. Learn how to shift the discussion during your Medicare and triple check meetings from rehab minutes to components under Section GG, return to provider codes, diagnosis coding specificity, and matching MDS documentation to the claim. This session will review ways to involve the entire interdisciplinary team to ensure maximum effectiveness.


Adjourn
2:20 p.m

NAHRI’s Certification in Healthcare Revenue Integrity Credentialing Exam
3:00 p.m. – 5:30 p.m.
View the CHRI Exam Candidate Handbook at nahri.org/certification to learn about prerequisites and apply today.


*Agenda and speakers subject to change



Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.

Long-Term Care Track


AMBR members take an additional $100 off registration!

The Revenue Integrity Symposium is the can’t-miss event for revenue integrity, revenue cycle, and PDPM education and high-level networking for long-term care professionals. Learn from trusted experts with cutting-edge regulatory insight that will arm you with the tools you need to take 2020 by storm.

Benefits of the 2019 Revenue Integrity Symposium LTC Track:

  • Discuss strategies for executing the new PDPM case-mix payment model
  • Analyze the role of diagnosis coding with the MDS in the post-acute care setting
  • Analyze therapy utilization in order to minimize risk for claim audits and denials
  • Learn practices to maintain your current business model for therapy staffing and contract therapy services while optimizing reimbursement and quality
  • Discuss how to use revenue cycle management’s best practices to optimize revenue under the new payment model
  • Understand how quality data metrics are determined and how they can be translated into various revenue optimization strategies
  • Explain the role of consolidated billing requirements in properly anticipating the projected revenue and costs of care with the advent of this new mode
  • Understand the link between ICD-10 coding and the MDS


Members of the
Association for Medicare Billing and Reimbursement (AMBR) for Long-Term Care get free admission to a special members-only networking reception on October 14, the night before RIS officially kicks off. AMBR members attending this reception should RSVP online as soon as possible to reserve their space. Not a member? Join today and save $100 off your RIS registration costs.

Professionals wishing to earn support from program administrators to attend RIS may adapt our justification letter proposal.

 

Agenda

PDPM Implications for Senior Management

Stefanie Corbett, DHA

Ensure accurate revenue under PDPM’s clinical categories. Operationalize PDPM requirements with a thorough prescreening process, effective resident goal setting, accurate coding, interdisciplinary team involvement, astute therapy contract negotiation, and more.


Tracking and Analyzing Therapy Utilization to Minimize Claim and Denial Risk

Reginald M. Hislop III, PhD

Even though therapy minutes no longer drive reimbursement under PDPM, these services and the way they are documented still impact revenue integrity. During this session, you’ll learn how to avoid scrutiny from CMS and how to analyze therapy utilization in order to minimize risk for claim audits and denials. Hislop will also review tracking therapy utilization patterns using PEPPER reports, how to maintain your current business model for therapy staffing and contract therapy services while optimizing reimbursement and quality, and effective collaboration strategies for billing and therapy personnel to maximize reimbursement.


Implementing Revenue Cycle Management for SNFs

Kim Cusson, CCS, CPC

Revenue cycle management (RCM) has traditionally been a term used in the acute-care world; however with PDPM’s new requirements, this process is catching on in long-term care. This session will explain what RCM is and how the accounting model’s best practices can be utilized to optimize revenue under the new payment model.


Using Your Performance Date to Maximize Revenue

Reginald M. Hislop III, PhD

LTC facilities have recently been introduced to various reimbursement and incentive programs. To thrive under this new environment, providers must understand how their quality data metrics are determined and how they can be translated into various revenue optimization strategies. This session includes cases and examples for Value-Based Purchasing, bundled payment programs, narrow provider networks, accountable care organizations, Medicare Advantage negotiation, and hybrid risk-sharing models, as well as marketing strategies that center on attracting the most rewarding patients under PDPM.


Consolidated Billing: Impacts on Reimbursement Under PDPM

Stefanie Corbett, DHA

Under PDPM, SNFs can expect to receive increased reimbursement for residents with greater clinical complexity, higher acuity, and multiple comorbidities. This session will explain the role of consolidated billing requirements in properly anticipating the projected revenue and costs of care with the advent of this new model, including how to properly assign reimbursement rates through preadmission screenings and MDS assessment accuracy.


Avoiding Common Cost Report Mistakes: Implications for Compliance and Reimbursement

Kim Cusson, CCS, CPC

Learn how cost reports impact reimbursement in your SNF and how to avoid common mistakes that could lead to Medicare noncompliance or fraud. This session will include an overview of cost report elements and submission timelines, case studies, and guidance for using cost report data to help facilities improve their accounting process.


PDPM Crash Course for the Business Office

Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA

What do billers need to know about the new payment model? As under RUG-IV, members of the business office will still be the last line of defense against claim audits and denials before sending out claims. This session will help billers understand what new information they should look out for to ensure clinical documentation and what’s represented on the claim align, as well as reinforce traditional best practices to avoid denials and returns to provider.


Tracking Payer Correspondence to Prevent Lost Claims

John Larscheid

Understanding the flow of claim messaging between payers can have a bigger impact than denials on accounts receivable days in your SNF. This session will walk attendees through how to manage the different mediums through which providers and payers communicate and best practices for tracking and capturing correspondence when juggling multiple payer types to help the business office stay ahead of each billing cycle.


Reinventing Your Triple Check and Medicare Meeting Processes for PDPM Success

Maureen McCarthy, BS, RN, RAC-MT, QCP-MT, DNS-MT, RAC-MTA

The triple check process verifies claims for accuracy and compliance with Medicare regulations before billing. Learn how to shift the discussion during your Medicare and triple check meetings from rehab minutes to components under Section GG, return to provider codes, diagnosis coding specificity, and matching MDS documentation to the claim. This session will review ways to involve the entire interdisciplinary team to ensure maximum effectiveness.

Keynote Speaker


Denise RyanDenise Ryan

Raleigh, North Carolina based professional speaker Denise Ryan is a motivational pyromaniac. Her infectious energy and enthusiasm will set a room ablaze.

A magna cum laude graduate of the University of South Carolina with a master’s degree in business, what she really specializes in is lighting fires.

After earning millions for clients in the corporate world, Denise realized she had a talent for firing people up. She parlayed this gift into FireStar, a company specializing in enthusiasm. Eleven years later, Denise motivates and energizes large corporations and small businesses across America at conferences, board retreats and annual meetings. Her no nonsense, direct delivery coupled with her astute business savvy and irreverent wit leave audiences not only laughing, but with actionable tips.

Not your typical “motivational speaker,” Denise is genuine and real. But also highly skilled – she holds the title of Certified Speaking Professional (CSP), a designation awarded to fewer than 10 percent of professional speakers. Denise is an author, keynote speaker and most notably, a fire starter extraordinaire. FireStar’s unique programs are relevant, uplifting and informative. Denise’s trademark interactive programs address myriad workplace issues such as dealing with change, getting along with others, staying motivated and the secrets of successful selling. She also offers customized training sessions. Denise’s infectious enthusiasm motivates the unmotivated and challenges the challenged. Consider yourself warned: FireStar programs are five-alarm scorchers.


Your Presenters


Jay Ahlmer, CFA

Jay Ahlmer, CFA, is senior vice president of strategic accounts at Versalus Health. He has more than 15 years of experience in healthcare consulting, mergers and acquisitions, revenue cycle, and analytics. In his current role, Ahlmer collaborates with hospital management teams to improve operational and financial performance through data analytics and process optimization. Before joining Versalus, Ahlmer was a senior associate at TripleTree where he managed various sell-side merger and acquisition transactions within the healthcare market. While at TripleTree, he assisted executives in strategic planning, market sizing and analysis, and financial projections. Prior to TripleTree, Ahlmer was director of finance at Executive Health Resources where he supported multiple private equity recaps, and a business divestiture, among other projects. Ahlmer has his bachelor’s degree from the Wharton School at the University of Pennsylvania. He is also a CFA Charterholder. 

   
Dapo Akanbi, MBA

Dapo Akanbi, MBA, is implementation manager, net patient revenue, with Craneware. He has extensive experience in the healthcare pricing arena. Prior to joining Craneware, he worked as a pricing consultant guiding customers through numerous pricing engagements and contributing to the enhancement of other market net revenue solutions. He earned his undergraduate and graduate degrees in business administration from Georgia State University.

   
Kimberly Anderwood Hoy Baker, JD, CPC

Kimberly Anderwood Hoy Baker, JD, CPC, is the director of Medicare and compliance for HCPro. She is a lead regulatory specialist and lead instructor for HCPro's Medicare Boot Camp®—Hospital Version and Medicare Boot Camp®—Utilization Review Version. She is also an instructor for HCPro’s Medicare Boot Camp®—Critical Access Hospital Version. Baker is a former hospital compliance officer and in-house legal counsel, and has 10 years of experience teaching, speaking, and writing about Medicare coverage, payment and coding regulations and requirements.

   
Marijane Armbruster, RHIA

Marijane Armbruster, RHIA, has been serving at IU Health in Indianapolis for over 26 years. She started her IU Health career as a coding manager and now serves as a VP of revenue cycle services overseeing the middle functions of revenue cycle which include: coding, HIM, clinical documentation integrity, utilization management, charge management, and the RCS physician advisor team. Armbruster has a BS from Indiana University in health information management and received her RHIA credential. She also serves on the IU Health Pension Board. Her greatest accomplishment to date is winning her battle with ovarian cancer and surviving two strokes in 2018.

   
Jim Carlson

Jim Carlson is currently the vice president of charge capture services for Revint Solutions. He has more than 25 years of experience in management consulting, technology, and start-up company operations.   His recent focus has been building the leading revenue integrity charge capture solution with Acustream, now Revint Solutions. He specializes in optimizing value within revenue cycle to help clients recover revenue, create savings through root cause analysis, and process improvements across interdepartmental workflows.  

   
Becky W. Cook, CPA, MHA

Becky W. Cook, CPA, MHA, isa former CFO for a large multispecialty group who was responsible for revenue cycle outcomes.  Since changing careers, she has consulted on using analytics to improve performance of revenue cycle processes.

   
Stefanie Corbett, DHA

Stefanie Corbett, DHA, is HCPro’s post-acute regulatory specialist, as well as a health policy educator, consultant, researcher, and author. She has a special affinity for seniors and enjoys leveraging her experience, education, and passion to healthcare professionals for the advancement of healthcare services rendered to the older adult population. Her professional experience also includes owning and operating a private healthcare consulting firm, Corbett Healthcare Solutions, LLC, in South Carolina, and serving as the deputy director of health regulation for the state of South Carolina. She was licensed as a nursing home administrator in several states and has also worked as an assistant professor of healthcare administration.

   
Dawn Crump, CHC, SSBB, MA

Dawn Crump, CHC, SSBB, MA, isenior consultant revenue cycle solutions with MRO Solutions in Norristown, Pennsylvania. Crump has worked within the hospital environment within quality, compliance, or revenue integrity for the last 20 years. In addition, she managed internal coding compliance and the government audit and denial team and for a large health system. Drawing on her strong analytical and relationship-building skills and more than 20 years of urban and rural healthcare experience, she has guided providers to successfully analyze their critical financial information, identify potential opportunities for improvement, and develop innovative cost effective solutions enhancing revenue retention and customer satisfaction opportunities. She obtained her Six Sigma Black Belt/Lean certification more than 10 years ago.

   

Kim Cusson, CCS, CPC

Kim Cusson, CCS, CPC, is the healthcare risk CBA manager in Crowe Horwath’s healthcare division.Cusson has more than 30 years of healthcare experience including more than 20 years of experience in auditing, hospital postacute care consulting, and physician coding and billing. She has also held positions as billing director, healthcare compliance manager, and outpatient coding manager. Cusson has served as board member of a local professional association.

 

   
Rose T. Dunn, MBA, RHIA, CPA, CHPS, FACHE, FHFMA

Rose T. Dunn, MBA, RHIA, CPA, CHPS, FACHE, FHFMA, is chief operating officer of St. Louis-based First Class Solutions, Inc., a national health information management consulting firm providing coding compliance, skilled nursing facility (SNF), and health information management (HIM) operational consulting services. She is a prolific author and has spoken on a variety of HIM and compliance subjects. Dunn is the author of NAHRI’s Revenue Integrity Manager’s Handbook. She has held faculty appointments with St. Louis University, Stephens College, and the University of Minnesota. Her firm assists healthcare providers and organizations with their HIM and coding operational concerns, coding and coding compliance requirements, HIPAA privacy and security readiness, and IRB activities. Dunn is a past president of AHIMA and chair of the AHIMA Foundation and recipient of AHIMA’s 1997 Distinguished Member and 2008 Legacy Awards. In 2011, she served as the Interim CEO of AHIMA. In addition to AHIMA, she is active with HFMA, AICPA, and ACHE.  

   
Scott Everitt, MBA

Scott Everitt, MBA, has worked for more than 20 years in healthcare, holding key leadership roles in finance, clinical operations, IT, and HR. He is currently the vice president of analytic solutions with Practical Data Solutions (PDS) where he assists clients with transforming their data into useful information and creating strategic solutions for performance improvement. Prior to his role with PDS, he held key leadership roles with the University of Utah Medical Group and Intermountain Healthcare in Utah.

   
Kim Garriot

Kim Garriot is a principal consultant, healthcare strategies with Logicalis. With a strong background in clinical imaging, data management and workflow process improvement, Garriott has more than two decades of business and IT leadership experience helping healthcare organizations optimize the use of technology investments. Garriot works directly with healthcare clients to develop and implement clinically focused IT strategies that center on leveraging business value and an optimized user experience. She is an international speaker, has been named by Health and IT Imaging Magazine as “100 People You Need to Know” and was named by CRN Magazine as one of the Top 30 Women IT Executives in 2017.

   
Karen Giacomo, BA, CPC, CHA

Karen Giacomo, BA, CPC, CHA, has 29 years of experience in various aspects revenue cycle with a primary focus in revenue integrity, charge master and charge capture/reconciliation. She is currently the revenue assurance manager for the Cleveland Clinic and focuses on missed charge opportunities. Giacomo has performed revenue integrity audits at various healthcare systems that she has worked for, from first patient contact through to bill drop with a focus on leaning processes, a full charge master review, a charge accuracy audit, and the roll out of charge reconciliation. Giacomo has also been responsible for the build and/or maintenance of IT systems for scheduling, registration, and payer contracts. Giacomo reviews and disperses CMS and payer information to the revenue cycle management department. She has managed various teams within the revenue cycle, and she has assisted with the charge description master (CDM) build and charge reconciliation implementation in Epic for Cleveland Clinic Akron General.

   
Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS

Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, is president/CEO and principal consultant for SLG, Inc., in Raleigh, North Carolina. She is a nationally known speaker and author on the charge description master (CDM), outpatient facility coding, and billing compliance, and has more than 30 years’ experience in the healthcare industry. Goodman has been actively involved and held leadership roles in a number of professional organizations on the local, state, and national levels, including the National Association for Healthcare Revenue Integrity (NAHRI). Goodman serves as an advisory board member for NAHRI.

   
Nicole Harper, PhD

Nicole Harper, PhD, director, revenue cycle improvement at Eskenazi Health in Indianapolis, can be described as a transformational leader who drives results through motivating and inspiring others. Her focus and passion centers around strategic alignment, employee empowerment, professional development and revenue cycle operations. In her current role as director of revenue cycle improvement, she assists in problem solving and analyzing issues in an effort to elevate outcomes, develop on-going business/clinical relationships, support growth, and optimize appropriate reimbursement. Through her work, she is able to impact healthcare daily through generating and maintaining physician partnerships, improving patient experiences, and initiating change.

Harper thrives on opportunities to endorse adult education, collaboration, building vision, and creating synergies that will optimize the future of healthcare. She is a knowledgeable revenue cycle finance and coding professional with a Doctor of Philosophy (PhD) focused in organizational leadership and change from Walden University.

   
Marc Hartstein, MA

Marc Hartstein, MA, came to Health Policy Alternatives (HPA) in Washington D.C. after 26 years with the Centers for Medicare and Medicaid Services (CMS). Hartstein held several management and staff positions during his time at CMS, most recently as the director of the Hospital and Ambulatory Policy Group. At CMS, Hartstein was central to the development of the Medicare Severity DRGs, the 2-midnight rule, Medicare policy for off-campus hospital outpatient departments, the misvalued code initiative, and regulations to implement Medicare’s new clinical laboratory fee schedule among other policies. Hartstein’s experience not only gives him detailed knowledge of the workings of the executive branch of government, he also has worked extensively with the legislative branch. He has assisted in the drafting of legislation, working with the Congressional Committees that have subject matter jurisdiction over Medicare. Hartstein has a master’s degree in public policy from the University of Minnesota’s Hubert H. Humphrey Institute of Public Affairs and a bachelor’s degree in political science and economics from the University of Vermont.

   
Reginald M. Hislop III, PhD

Reginald M. Hislop III, PhD, is managing partner and CEO of H2 Healthcare, LLC, with locations in Kansas, Wisconsin, Illinois, and Nevada. Hislop has more than 30 years of executive experience in the development, operations, and financing of all aspects of healthcare, with particular experience in postacute care. In addition to his work at H2, he serves as a consultant on health policy and reimbursement for the New York investment banking firm of DeMatteo Monness, provides policy and reimbursement guidance to the Transitional Healthcare Consortium and for clients of the Gerson Lehrman Group, and is a consulting member of the 10eqs knowledge network. Hislop holds a bachelor of science in business administration with a major in finance, a master of arts in applied mathematics and quantitative sciences, and a doctor of philosophy in macro‐economics.

   
Ronald L. Hirsch, MD, FACP, CHCQM

Ronald L. Hirsch, MD, FACP, CHCQM, is vice president of R1 RCMin Chicago. He is a general internist and HIV specialist. Hirsch was the medical director of case management at Sherman Hospital in Elgin, Illinois. He is certified in healthcare quality and management by the American Board of Quality Assurance and Utilization Review Physicians. In addition, he is a member of the American Case Management Association, a member of the American College of Physician Advisors, and a fellow of the American College of Physicians. Hirsch serves as an advisory board member for NAHRI. 

   
Kurt Hopfensperger

Kurt Hopfensperger, MD, JD, currently serves as vice president, compliance and physician education, at Optum Physician Advisor Solutions, a national organization that provides technology-enabled, expert physician advisor teams concentrating on managing Medicare and Medicaid regulatory compliance, minimizing inappropriate medical necessity denials, and achieving appropriate lengths of stay in acute care hospitals and health systems. Prior to joining Optum Physician Advisor Solutions, Hopfensperger developed an accomplished career as a neurologist, serving as the medical director of patient safety and chair of the employed physician group at Cheyenne Regional Medical Center, as well as in private practice with Wyoming Neurology, Cheyenne Medical Specialists, and Medical Arts Associates in Moline, Illinois. Previously, he also ran his own law practice in the Chicago area, in which he specialized in general medicolegal consultation, technical case review for malpractice and disability claims, and contract and payer cases. He remains actively licensed to practice law.

   
Judith Kares

Judith L. Kares, JD, is an expert in Medicare rules and regulations and is an instructor for HCPro's Medicare Boot Camp-Hospital Version®. She spent a number of years in private law practice, representing hospitals and other healthcare clients, and then as in-house legal counsel prior to beginning her current legal/consulting practice. She is also an adjunct faculty member at the University of Phoenix, where she teaches courses in business and healthcare law and ethics.

   
Alicia Kutzer Esq., LL.M., MHA

Alicia Kutzer Esq., LL.M., MHA, is an adjunct instructor for HCPro’s Medicare Boot Camp — Audits, Appeals, and Denials Version, Medicare Boot Camp – Hospital Version, Medicare Boot Camp – Utilization Review Version, and Medicare Boot Camp – Critical Access Hospital Version. Kutzer is a licensed attorney in the state of Pennsylvania and is a managing partner of Kutzer Law Firm, LLC, located in the Wilkes-Barre/Scranton area and founded in 2011. She served as an Administrative Law Judge in more than 1,000 Administrative Fair Hearings. Prior to that, Kutzer was a post-adjudication appeals officer, appeals officer, and subject matter expert for MAXIMUS, Inc., a Medicare Qualified Independent Contractor (QIC), from April 2012 through November 2015.

   
Kay Larsen, CRCR

Kay Larsen, CRCR, is a revenue integrity specialist at Glendale Adventist Medical Center (soon to be Adventist Health Glendale), Glendale, California. She has enjoyed 17 years working in healthcare, including many years as a CDM coordinator. Larsen’s favorite part of her job is working with departments maximizing revenue through education and charge review. In her years of work, she has experienced standardization projects, extensive price reviews, and conversion of financial systems and is still passionate about revenue integrity. Larsen serves as an advisory board member for NAHRI. 

   
Laura Legg, RHIA, RHIT, CCS, CDIP

Laura Legg, RHIA, RHIT, CCS, CDIP, is experienced as a leader, consultant, coding expert, speaker, trainer and auditor for acute care and critical access hospitals and major health systems. Legg is the director of revenue integrity solutions at BESLER where she lends her expertise to help clients improve operations, deliver education, and ensure compliant coding and billing. She is a member of HFMA, AHIMA, AAPC, and NAHRI. Legg speaks regularly at regional and national AHIMA events, and she is an advisory board member for Briefings for Coding Compliance and an AHIMA mentor.

   
William L Malm, ND, DNP, CRCR, CMAS

William L Malm, ND, DNP, CRCR, CMAS, is a managing director at Health Revenue Integrity Services. He is a nationally recognized author and speaker on topics such as healthcare compliance, chargemasters, and CMS recovery audits. Malm brings over 25 years of experience with a combination of clinical and financial healthcare knowledge that encompasses all aspects of revenue integrity. Previously, Malm played a key role in providing revenue integrity and data expertise for Craneware, Inc., the market leader in revenue integrity software solutions. He also serves as the secretary/treasurer for the Certification Council of Medical Auditors. He has extensive experience with all postpayment audits, having previously worked as a systems compliance officer at a large for-profit healthcare system.

   
Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT

Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, is the President of Celtic Consulting, LLC, in Torrington, Connecticut, and the CEO and founder of Care Transitions, LLP, a post discharge care management service provider. Recognized as an industry leader in clinical reimbursement for long-term care, Maureen has been a registered nurse for over 30 years with experience as an MDS coordinator, director of nursing, rehab director, and a Medicare biller. Maureen and her associates at Celtic Consulting regularly provide consultation focusing on 5-Star quality improvement programs, quality auditing, clinical care management, PDPM/PPS/MDS/CMI services, and compliance solutions including Medicare compliance auditing and custom education, to meet any organization’s needs.

   
Linda J. McCray, CPA MBA

Linda J. McCray, CPA MBA, started her accounting career in a small public accounting firm in north west Washington. She started her journey in healthcare as an internal auditor for Adventist Health. She worked in several positions during her career with Adventist Health, such as director of fiscal services, CFO, and regional CFO. Since retirement, she has consulted with hospitals working to improve charge capture in electronic medical records. She also volunteers as treasurer for a private Christian school and assistant treasurer for her local church. She enjoys spending time with her family and working in the yard.

   
Stacey McCreery

Stacey McCreery, MBA, established ROISG following her extensive tenure as executive director of Indiana University Health, the largest healthcare system in Indiana. The scope of her work was broad and included the mergers and acquisitions of several hospitals, system-wide corporate budgeting and training, as well as the financial integrations of several hospitals and physician groups. McCreery’s previous engagements include financial responsibility for three Indianapolis, Indiana hospitals: Methodist Hospital, University Hospital, and Riley’s Hospital for Children. She was with the transformation team from inception at the largest healthcare system in Indiana, saving $54M through lean efforts.

   
Patti Medvescek

Patti Medvescek started her career in the clinical laboratory at Methodist Hospital and continued to support laboratory medicine at Winona Memorial Hospital before moving on to Roche Diagnostics in positions within the Quality and Technical Support Departments. Her current role encompasses her passion for process improvement with her experience and clinical knowledge. In her various roles as supervisor, manager, and director, she was involved in employee selection, retention, and development for a diverse range of team members., including entry level lab techs up to her management teams. She is a frequent speaker at industry conferences including IBM Watson and Children’s Hospital Association.

   
Sheldon A. Pink, MBA, FHFMA

Sheldon A. Pink, MBA, FHFMA, is the chief of revenue cycle management for American Academic in Philadelphia. He has more than 18 years of experience in managing the mission, vision and purpose of Revenue Cycle Management activities and processes for multi-integrated health networks in not for profit and for profit health systems. Sheldon’s contributions have been critical to a variety of revenue cycle initiatives that improved reimbursement by over 150 million dollars in several organizations. He constantly provided strong support in fulfilling the companies’ collection responsibilities for both hospital and physician operations, meeting strategic goals and exceeding company objectives. Sheldon has experience leading national operational teams in the areas of Hospital & Physician Billing, Patient Access, Accounts Receivable, Revenue Integrity, System Implementations, Payor Contracting, Vendor Management and Performance Improvement. His prior positions focused on communicating a compelling and inspired vision and sense of core purpose to stakeholders of the organization; he talks beyond today; talks about possibilities; is optimistic; creates mileposts and symbols to rally support behind the organizational vision. He has inspired and motivated Revenue Cycle cultures in organizations. Sheldon has a Bachelor’s of Science in Accounting & Finance; and a Masters of Business Administration (MBA) in Healthcare Administration. Both degrees were acquired at Wilmington University in Delaware. He is a Certified Healthcare Financial Professional (CHFP) and Fellow of the Healthcare Financial Management Association (FHFMA). Other memberships include the National Association of Healthcare Revenue Integrity (NAHRI), American College of Healthcare Executives (ACHE), American Association of Healthcare Administrative Management (AAHAM) and the National Association of Healthcare Access Management (NAHAM). Sheldon was co-chair of the HFMA Philadelphia Chapter Revenue Cycle committee before joining American Academic Health System. He has presented at various industry conferences and groups across the country for HFMA & ACHE discussing the economic challenges & solutions in our healthcare environment.

   
Caroline Rader Znaniec, MBA, MS-HCA

Caroline Rader Znaniec, MBA, MS-HCA, is the owner and consulting lead of Luna Healthcare Advisors LLC in Denton, Maryland. In the past, she held various positions both within consulting and the industry. Znaniec was the national revenue integrity lead for Grant Thornton LLP (Baltimore), associate director of charge integrity at Navigant Consulting (Baltimore), corporate compliance officer at Anne Arundel Health System (Annapolis, Maryland), senior consultant of the national CDM practice of KPMG LLP (Baltimore), clinical operations manager at Children’s National Medical Center (Washington, D.C.), business operations manager of Halpern Eye Care (Dover, Delaware), and physician billing representative at Peninsula Regional Medical Center (Salisbury, Maryland). She holds a Bachelor of Science in Corporate Health as well as a Master’s in Business Administration and Masters of Science Management in Healthcare Administration.

   
Megan Reavis, MBA, BS, COTA/L

Megan Reavis, MBA, BS, COTA/L, is a national educator and has worked primarily in the geriatric setting as a clinician and in management, including as rehab director and area director, for the past 23 years. She started MCR Seminars out of Lansdale, Pennsylvania, as a platform for educating therapists and has written and taught numerous continuing education courses for the long-term care setting. For the past 10 years, Reavis has been teaching and designing workshops to address the needs of occupational, physical, and speech therapists in various settings focusing on the changing trends of how therapy is being provided in their work and community. Reavis is the author of The Fabulous Book of Functional Activities.

   
Valerie A. Rinkle, MPA, CHRI

Valerie A. Rinkle, MPA, CHRI, is a lead regulatory specialist and instructor for HCPro's Revenue Integrity and Chargemaster Boot Camp as well as instructor for the Medicare Boot Camp®—Hospital Version, Medicare Boot Camp®—Utilization Review Version, and Medicare Boot Camp®—Critical Access Hospital Version. Rinkle is a former hospital revenue cycle director and has over 30 years of experience in the healthcare industry, including over 12 years of consulting experience in which she has spoken and advised on effective operational solutions for compliance with Medicare coverage, payment, and coding regulations.

   
Jugna Shah, MPH

Jugna Shah, MPH, is the president and founder of Nimitt Consulting, Inc., a firm specializing in case-mix payment system design, development, and implementation. She has 15 years of experience working with providers on the ongoing clinical, operational, financial, and compliance implications of Medicare’s OPPS based on APCs. Shah has educated and audited numerous hospitals on their drug administration coding and billing practices. She has contributed to several books and numerous OPPS/APC articles and is a contributing editor of HCPro’s Briefings on APCs. Shah serves as an advisory board member for NAHRI.

   
Angela Lynne Simmons, CPA

Angela Lynne Simmons, CPA, is the vice president of revenue and reimbursement at Vanderbilt University Medical Center. A Texas Certified Public Accountant, she brings more than 30 years of experience in healthcare operations and finance, and public accounting for healthcare entities. Simmons has expertise in healthcare policy, reimbursement principles from government programs (Medicare and Medicaid) as well as healthcare financial analysis and cost accounting. Much of her focus throughout her career has been on identifying revenue opportunities and pursuing those through improving hospital operations and by Medicare filings and appeals. Prior to relocating to Vanderbilt, she was the director of clinical revenue and reimbursement for U.T. M.D Anderson Cancer Center where she was responsible for Medicare and Medicaid reimbursement, cost accounting, revenue and rate-setting, financial analysis and clinical decision support reporting. Simmons serves as an advisory board member for NAHRI.

   
Stacie Smith, EMBA, RHIA

Stacie Smith, EMBA, RHIA, is the senior program manager of revenue integrity at Children’s National Medical Center in Washington, DC. Smith has over 30 years’ experience in HIM, revenue cycle and revenue integrity. Smith has a demonstrated history of working in hospitals, health organizations and other areas of the healthcare industry. She is skilled in healthcare consulting, software implementation, MC/MCD, healthcare operations, teaching, and team building among multiple other areas. She completed here undergrad work with an Associate of Science focused in Health Services/Allied Health/Health Sciences from Eastern Kentucky University, a Baccalaureate of Arts in Organization Management from Midway College, and graduate work in a Master of Business at Sullivan University. She is a member of AHIMA and assisted in the publication of articles in AHIMA and completed an audio seminar on revenue cycle with AHIMA.

   
Tracey A. Tomak, RHIA, PMP

Tracey A. Tomak, RHIA, PMP, is the director of project management and client engagement at Intersect Healthcare in Towson, Maryland. She has more than 20 years of experience in revenue cycle with a focus on hospital coding, charge capture, and denials management. In her current, Tomak is responsible for coordinating project implementation of Intersect Healthcare’s Veracity software. She works directly with clients to ensure that they are fully utilizing the Veracity software to effectively manage commercial and government audits and denials. Tomak is an active member of IHIMA, serving as the Nominating Committee Chair for the 2018–2019 year.

   
Suzanne Tschetter, CPA

Suzanne Tschetter, CPA, leads the Revenue Integrity department at the Cleveland Clinic. During her 27 years at the Cleveland Clinic, Tschetter obtained her MBA and actively engaged in a variety of roles from corporate finance to revenue cycle focusing on root cause analysis, process improvement and revenue verification. During her most recent 21 years in revenue cycle, she co-chaired the compliance committee giving her a deep appreciation for revenue integrity. The transition of the Revenue Assurance team under her leadership enhanced her involvement with the clinical departments to ensure optimal charge capture.

   
Angela Walker, MBA

Angela Walker, MBA, is an executive director in information services at IU Health, the largest health care system in Indiana. She leads teams through business development projects serving as an enterprise project management office for acquisitions, divestitures, joint ventures, and other partnership arrangements. She also leads the technology components of strategic design and construction capital projects accountable for multidisciplinary information technology teams. In addition, Walker is the executive director for information services business relationship management.

In the 26 years leading up to her current role, Walker worked in all facets of healthcare revenue cycle divisions, lending to the foundation of her career. Patient access, charge master, revenue management, and provider enrollment are the areas where she likes to dive in most. In October 2018, she joined the BRM Institute Executive Council enhancing the team as an advocate in healthcare for the BRM community.

Born and raised in Indiana, Walker lives with her husband of 26 years, nine-year-old son, and a cat named Dusty. She has a son attending the University of Northwestern Ohio for Agricultural and Diesel Technologies, and a daughter who entered the Purdue Global Learning program in August 2019 as well as working full time. One of Walker’s future goals is publishing a white paper and increasing the BRM Institute member roster while advancing the awareness and value of business relationship management.

   
Tiffany Walls

Tiffany Walls is vice president, business development, with Revint Solutions. Since 2004, Walls has dedicated her career exclusively to the healthcare industry. Beginning as a patient financial services director for a large orthopedic practice in Indianapolis, she eventually found her professional stride by partnering with healthcare providers to enhance business operations and financial performance. For the last 15 years, Walls has served in various leadership roles both in operations and business development as well as volunteering in industry trade organizations. Today, she is the vice president of business development for Revint Solutions, one of the fastest growing, industry leaders in revenue cycle, revenue integrity. and reimbursement. Walls is a graduate of Purdue University where she earned her bachelor’s degree in organizational leadership and supervision. Most importantly, she is a wife, a mother and a faithful fan of the Indianapolis Colts.

   
Diane Weiss, CPC, CPB, CCP

Diane Weiss, CPC, CPB, CCP, is the vice president, reimbursement, for RestorixHealth in Metairie, Louisiana. Weiss joined RestorixHealth in Metairie, Louisiana, in June 2011 which facilitated the formation of the New Orleans office revenue cycle team. Prior to joining RestorixHealth (formerly Wound Care Specialists), Weiss managed a general surgery practice for 10 years in the Greater New Orleans area where she served as practice manager and was also the surgeons in-office medical assistant. In 1995, her career moved to the payer side. She became the provider education representative for Pinnacle Medicare Services, providing CMS Medicare Part B provider education and denial management for providers throughout Louisiana and other states within the MAC jurisdiction. For those 12 years with Medicare, Weiss conducted provider education workshops, seminars, and spoke to a variety of specialty societies, coding groups and medical manager associations. She provided information and assistance with claims submission issues, denial management and effectively communicated CMS’ annual changes regarding reimbursement and coverage for Part B Providers. She also served as Ochsner Health System’s Internal Medicare Consultant for five years before joining RestorixHealth in a full-time capacity. Weiss serves as an advisory board member for NAHRI.

   
Denise Williams, COC

Denise Williams, COC, is senior vice president of the revenue integrity division and compliance auditor at Revant Solutions, Inc. She has more than 30 years of healthcare experience, including a background in multiple areas of nursing. For the past 25 years, Williams has been in the field of coding and reimbursement and has performed numerous E/M, OP surgical, ED, and observation coding chart reviews from the documentation, compliance, and reimbursement perspectives. She serves as a contributing author to articles published in HCPro’s Briefings on APCs and is a nationally recognized speaker on various coding and reimbursement topics. Williams serves as an advisory board member for NAHRI.

   
Joseph Zebrowitz, MD

Joseph Zebrowitz, MD, has focused his career on assisting hospitals in gaining a true picture of their compliance profiles through analysis and audit and advancing lasting solutions to provide enduring compliance and revenue integrity. Zebrowitz is FOUNDER AND CO-CHIEF EXECUTIVE OffiCER of Versalus Health where he has led the Versalus team in the development of an innovative approach to 2-midnight rule compliance and managed care performance. Before Versalus, Zebrowitz founded and was managing partner of Devon Hill Capital Partners. At DHCP, Zebrowitz identified and led investments in several successful healthcare startups. Before DHCP, Zebrowitz spent 12 years as executive vice president and senior medical director of Executive Health Resources (EHR), where he led the development of EHR’s compliance and revenue integrity products endorsed by the AHA as “Best in Class.” Zebrowitz regularly conducted educational sessions for EHR’s client and completed hundreds of regulatory assessment audits for EHR’s hospital clients. Prior to joining EHR, Zebrowitz was a founder and vice president of Strategic Alliances at eHealthContracts, now Concuity, Inc. Before Concuity, Zebrowitz was a practicing obstetrician/gynecologist at Abington Memorial Hospital in Pennsylvania.

Continuing Education


AAPC
This program has the prior approval of AAPC for 10 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Accreditation Council for Continuing Medical Education (ACCME)
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 10 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AHIMA
This program has been approved for 10 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).
 
American Nurses Credentialing Center (ANCC)
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 10 nursing contact hours is provided by HCPro. 
  
Association of Clinical Documentation Improvement Specialists (ACDIS)
This program has been approved for 10 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Improvement Specialists (ACDIS).
  
California Board of Registered Nursing (CA BRN)
HCPro is approved by the California Board of Registered Nursing to provide 12 nursing contact hours. California BRN Provider #CEP 14494.
 
National Association of Healthcare Revenue Integrity (NAHRI)
This program has been approved for 10 continuing education units towards fulfilling the requirements of the Certification in Healthcare Revenue Integrity (CHRI), offered as a service of the National Association of Healthcare Revenue Integrity (NAHRI).



Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.

Pricing


Main Conference: Tuesday, October 15 – Wednesday, October 16, 2019

Retail
Base Price: $1,199.00
Early Bird Price: $1,099.00 – Ends August 29, 2019!

NAHRI Members
Base Price: $1,099.00
Early Bird Price: $999.00 – Ends August 29, 2019! 

AMBR Members 
Base Price: $1,099.00
Early Bird Price: $999.00 Ends August 29, 2019!

Group Rate (5 at the price of 4)
Base Price: $4,800 ($960/person)
Your discount will automatically appear in your cart when you register your Team of Five.



Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.

Location/Details


Renaissance OrlandoWHERE: Renaissance Orlando
6677 Sea Harbor Drive

Orlando, FL 32381

Room rate: $219/night (includes nightly resort fee)
Hotel cut-off date: Friday, September 20, 2019
Toll-Free Reservation Center: 1-407-351-5555 and referring to Event code, HCPro Revenue Integrity Symposium
Reservations URL: https://book.passkey.com/e/49861368

Our resort is just minutes from Walt Disney World® and other attractions for you to discover. RIS 2019 attendees will receive special discounted rates to attend some of the following local attractions. To purchase discounted tickets to the Disney parks, click here or call 407-566-5600 by October 12, 2019. Stay tuned for additional details!

  • Magic Kingdom Park®
  • Disney's Hollywood Studios®
  • Disney's Animal Kingdom®
  • Epcot®
  • Disney Springs ®
  • Disney's Blizzard Beach ® and Disney's Typhoon Lagoon ®
  • Universal Studios Florida®
  • Universal's Islands of Adventure®
  • I-Drive 360
  • Orlando Premium Outlets Shopping Mall
  • Kennedy Space Center

*all prices are subject to change

CONVENTION TICKET INFORMATION FOR SEA WORLD & DISCOVERY COVE

For SeaWorld Tickets (Convention Group Rate) please click here.  Please note, rates change based on dates/availability.

UNIVERSAL STUDIOS

For current ticket pricing, information and to purchase attraction tickets, please call 407-248-7323 for assistance. Make sure to identify yourself as part of RIS at the Renaissance Sea World.

Disney Springs  Show Your Badge Program

http://www.wdwdvm.com/concepts/Disney_Springs_Show_Your_Badge_Offers.pdf

 

Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.

Sponsors/Exhibitors


Silver Sponsors



Hayes

 

 

 

 

Optum 360

 

 


Exhibitors


Apprev
ARMCO Partners
Besler
Change Healthcare
Claro Healthcare, LLC
Eide Bailly LLP
GeBBS
Intersect Healthcare
Kiwi-Tek
Practical Data Solutions
Revint Solutions
Streamline Health
UASI
Versalus Health
VitalWare
XSOLIS

Interested in becoming a 2019 RIS Sponsor?
For information on sponsorship and exhibition, please contact Carrie Dry at cdry@h3.group or 630-235-2745.



Thank you for your interest in the Revenue Integrity Symposium. Please continue to visit us for updates. We will be updating this page frequently as details are finalized.

Please note that the program materials will be available via download and the conference app only. A download link will be provided prior to the event, but a printed book of the presentations will not be available on-site.