2024 Revenue Integrity Symposium

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2024 Revenue Integrity Symposium

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2024 Revenue Integrity Symposium

September 12 – 13, 2024  |  Chicago, IL

he 2024 Revenue Integrity Symposium is more dynamic and bigger than ever! Join us September 12–13, 2024, in Oak Brook (Chicago), Illinois, for two days of empowering education and networking for your revenue cycle team.

The Revenue Integrity Symposium is unlike any other event around. It creates a space for attendees to engage personally and professionally with like-minded individuals across the healthcare spectrum. We’re offering unmatched educational opportunities—including a new, third track dedicated solely to denials management—and the chance to build meaningful connections with your peers and industry experts through extensive networking.

So, bring your curiosity, dedication to your career, and drive to learn—and help us make 2024 the best year yet!

Highlights for 2024

  • The 2024 conference brings you top-notch speakers across three tracks, providing opportunities for all in revenue cycle, revenue integrity, and compliance, and clinical documentation integrity
  • You’ll gain expert insight and tips on:
    • Avoiding and managing payer denials
    • Maintaining your chargemaster
    • Addressing charging and charge capture issues
    • Data analytics and KPIs
    • Creating effective workflow and program structures
    • Ensuring compliance with the latest billing, coding, and reimbursement rules
    • Responding to payer audits
  • You’ll also get access to an app that includes all session materials, a session planner, and networking with your peers
  • As always, the Revenue Integrity Symposium provides continental breakfast, lunch, and networking breaks with snacks and beverages, plus a networking reception—all included with registration

Event Learning Outcomes:

  • Discuss the financial and operational impact of regulatory and payer changes
  • Identify strategies to manage and reduce denials
  • Define methods to maintain and up-to-date and compliant chargemaster
  • Describe tools and strategies to improve compliance and revenue cycle performance
  • Recognize ways to accurately document, code, and bill patient encounters
  • State strategies for designing a revenue integrity program, defining leadership, and setting revenue integrity goals

2024 Revenue Integrity Symposium

Who Should Attend

  • Revenue integrity professionals
  • Revenue cycle directors and staff
  • Compliance officers
  • CFOs, CMOs, CNOs, and VPMAs
  • Case managers
  • HIM directors, managers, and staff
  • Utilization review and utilization management coordinators, committee members, and physician advisors
  • Recovery audit coordinators and other auditing professionals
  • Reimbursement managers, billers, and other finance staff
  • Chargemaster coordinators
  • Business office managers and staff
  • Risk management professionals
  • Patient financial services managers
  • Clinical documentation integrity directors, managers, and specialists
  • Coders and coding managers

2024 Revenue Integrity Symposium

Pre-Conference

Medicare Boot Camp®—Denials and Appeals Version

Get expert guidance on preventing denials and focusing appeal efforts for success. Reimbursement models continue to evolve, and uncertainty persists regarding healthcare laws and CMS policy. Both of these factors mean that organizations cannot afford to write off appealable denials that are winnable, lest they face insolvency or be forced to close their doors. Organizations need sound, practical information on overturning denials. Medicare Boot Camp®—Denials and Appeals Version is your key to proven strategies for success and will answer your questions on denials management and appeal processes.

This Boot Camp teaches you about the latest claim audit and appeal issues based on official guidance and regulations. You’ll leave the class armed with a thorough understanding of the audit and appeal process and ready to put your new knowledge into action for tangible results.

You will leave this program knowing how to:

  • Prepare for CMS audits
  • Navigate the appeal process through and beyond the Administrative Law Judge level
  • Research denials and upcoming audit focus areas
  • Implement policies to support efficient appeals and identify appropriate denials to appeal

You will leave this Boot Camp with an understanding of:

  • Navigating regulations and CMS policies in order to comply and increase CMS reimbursement from the get-go
  • The different types of audits and how you can prepare your organization for them
  • The audit, denial, and appeal process and what to look out for
  • How you should respond to audits
  • How to increase your organization’s favorable appeal decisions

More information here.

Location/Dates

September 10 – 11, 2024
8:00AM – 5:00PM each day

Hilton Chicago/Oak Brook Hills Resort & Conference Center
3500 Midwest Road
Oak Brook, IL 60523
630-850-5555
Hotel website

Room Rate: $205/night
Room Rate Cut-Off: August 19, 2024

Pricing

$1,149.00

Register for the pre-con boot camp and the Revenue Integrity Symposium and SAVE 15%! *Discount appears in cart.
To register multiple attendees, please call 800-650-6787.

2024 Revenue Integrity Symposium

Agenda

Thursday, September 12, 2024

7:00 a.m. – 7:45 a.m.
Registration & Buffet Breakfast (Exhibit Hall)

8:00 a.m. – 8:30 a.m.
Opening Remarks From NAHRI

8:30 a.m. – 9:30 a.m.
Keynote Session: TBD
TBD
TBD

9:45 a.m. – 10:45 a.m.
Breakout Sessions

Holding Medicare Advantage Plans Accountable for Coverage Decisions
Kimberly A. Hoy, JD, CPC
Whether you’re struggling to understand how Medicare rules and requirements apply to Medicare Advantage (MA) plans or are looking for ways to ensure MA plans follow the new rules, this session is for you! The session will cover the regulations that constrain MA plan coverage decisions, internal coverage policies, prior authorizations, and denials after payment or authorization. You’ll come away equipped with a thorough understanding of the regulatory requirements so you can hold MA plans accountable for providing and paying for the benefits they are required to provide to your patients. The session will also discuss MA plan coverage and payment for clinical trials, including under Coverage with Evidence Development and Investigational Device Exemption studies.

Creating the Clinically Integrated Revenue Cycle
Deepak Manmohan Goyal, MD, MBBS, MBA, and Ronald Hirsch, MD, FACP, CHCQM, CHRI
Hospitals are faced with tremendous financial pressures from every side. In most hospitals and health systems, the revenue cycle team works as hard as, but separate from, the clinical team. This divide leads to less-than-optimal performance for both. To achieve optimal performance, there are three goals that must be achieved: getting paid, getting paid enough, and controlling the cost of care. In this session, Drs. Goyal and Hirsch will guide you to creating the single integrated revenue cycle team that can optimally achieve all three goals with clinician and revenue members actively participating at every step in the process.

Innovating a Successful Denials Management Program: Predict, Prioritize and Prevent
Heather Dunn, MBA, CHFP, CRCR, and Diana Ortiz, JD, RN, CCDS
Typical health systems operate with a 2% operating margin, and 15% of insured revenue is at risk of denial. Preventing denials is one way to protect against a significant revenue loss for healthcare providers. How can you effectively prevent and manage your denials? In this session, learn how to innovate a successful denials program with a payment intelligence platform. We’ll discuss how to predict denials and payment lags by using advanced technology and combining clinical and payment data, as well as share tips on how to prioritize CDI worklists to target high-risk claims that could benefit from interventions and proactively prevent denials.

10:45 a.m. – 11:30 a.m.
Networking & Refreshment Break (Exhibit Hall)

11:30 a.m. – 12:30 p.m.
Breakout Sessions

Becoming Strategic with Automation: RCM Leaders Speak Up!
Garland Goins, MBA, and Sheldon Pink, MBA, FHFMA, LSSBB
Too often, we are inundated with challenges that require technology-focused solutions. This session will discuss recent industry challenges that require an innovative, cost-effective technology solution. The session will give attendees the tools to differentiate between types of automation available in the healthcare industry. It will take a deep dive into the main drivers causing roadblocks and resistance to adoption of new tech in the healthcare industry, how to accurately identify the appropriate automation for your organization, and the advantages of moving forward. The speakers will present case studies of successful and unsuccessful technological transformations at health systems and analyze what worked and what didn’t. Furthermore, it will answer one of the healthcare industry’s most important questions: How do you measure ROI for technology and automation? Finally, the speakers will demonstrate how to assess organizational readiness before beginning these projects.

How a Physician Advisor Can Help a Hospital's Bottom Line
Catherine Pesek Bird, DO, MBA, CHCQM
Physician advisors can be extremely helpful to a hospital's reimbursement in three key areas: utilization management, clinical documentation integrity, and quality. In this session we will review these areas in detail and provide practical examples of how physician advisors can help your hospital including how to manage patient criteria by payer, improving the query process, and metrics that physicians advisors can positively effect.

Having Real Impact on Denials
Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CCS
In the realm of revenue cycle denials management, technological innovations, particularly AI-driven analytics and machine learning, are pivotal in proactively predicting and preventing claim denials. Effective strategies encompassing meticulous documentation, timely submissions, and adept communication with payers stand as vital pillars for successful denial appeals and resolutions. Addressing the mounting impact of patient financial responsibility on billing issues requires refined patient communication, tailored financial counseling, and improved billing processes to mitigate denials, marking a critical focus within the revenue cycle. In this session, attendees will get practical, actionable information on leveraging advanced technology, best practices for optimizing appeals, data analysis tips, and more.

12:30 p.m. – 1:15 p.m.
Networking Lunch—provided (Exhibit Hall)

1:15 p.m. – 1:45 p.m.
Sponsored Session

2:00 p.m. – 3:00 p.m.
Breakout Sessions

The Real Work of Revenue Integrity is NOT Producing Widgets
Stephanie Ellis, RN, BSN, COC, CHRI, and Suzanne Lestina
This session will help attendees learn the value of developing common and aligned goals that will create transparency, drive accountability and open communication within their teams and the organization. This session will also explore a way to leverage goals as the basis for everything their team does, making progress clear at all times. The speakers will share their journey of how they built leader confidence and buy-in and created a centralized view of goals and metrics through cross-functional teamwork at UChicago Medicine.

Addressing Payer Policies—One PIT Stop at a Time
Tresa Binek, PharmD, MS, MBA, CRCR, and Victoria Sina
Are payer policies speeding right by you? How can you stay in the race and keep up with payers’ ever-changing policies? We will discuss the concept of our Payer Integrity Team (PIT) and how we collaborated with our revenue and clinical operations to assess and address payer policies. We hope to see you at our PIT stop.

Denials: A Spotlight on Documentation Gaps and Differing Diagnostic Standards
Elizabeth Aguirre, MD, CCDS, and Jared Brock, MBA
This session will review how Baylor Scott & White Health buckets denials to identify physician documentation gaps and work towards denial prevention. The speakers will identify how differing diagnostic standards lead to denials and impact appeal potential and explain how to leverage data to pinpoint changes in denial trends. They will also share tips on how to present data to executive leadership and gain their support for your efforts. Finally, attendees will learn how denial management can do double duty as an audit tool.

3:00 p.m. – 3:30 p.m.
Networking & Refreshment Break (Exhibit Hall)

3:30 p.m. – 4:30 p.m.
Breakout Sessions

Compliant Charge Capture from Authorizations to Z-Codes
Sarah Goodman, MBA, CHCAF, COC, CHRI, CCP, FCS, and Kay Larsen, CHRI
In an “A to Z” approach, this session will describe the role of a chargemaster coordinator and common reimbursement methodologies in the facility setting, address proven strategies for maintaining the chargemaster to ensure successful charge capture across a sampling of ancillary departments, expound upon other factors affecting charge capture such as authorizations, National Correct Coding Initiative edits and modifiers, MolDx Z-code identifiers, and much more!

Revenue Integrity Evolution
Salisha Hamid, MBA, CPA, CRCR, Kelli Howard, MBA, and Howard Kung, CPA, MBA, FHFMA, FACHE, CPC, CRCR
During this session, revenue integrity leaders from Mayo Clinic will discuss how they transformed their revenue integrity team. The speakers will identify key considerations for establishing roles and responsibilities in a complex environment, discuss creation of a mission statement and future state for the department, and explain the importance of defining core vs. supportive functions.

TBD
Amy Inch, COTA, CPC, CPMA
TBD

4:45 p.m. – 5:15 p.m.
Bonus Session

Taking Your Career to the Next Level: Q&A on the CHRI Certification
TBD
Learn how obtaining your CHRI certification can help you stand out in the revenue integrity profession and highlight the depth and breadth of your knowledge in this Q&A session. Members of NAHRI’s Credential Committee will discuss what the credential represents and what’s covered during the exam. They’ll also share tips for studying for the exam, what it’s like to take the exam, and more.

5:15 p.m. - 6:30 p.m.
Networking Reception (Exhibit Hall)

Friday, September 13, 2024

7:00 a.m. – 7:45 a.m
Buffet Breakfast (Exhibit Hall)

8:00 a.m. – 9:00 a.m.
General Session: Where Growth Takes Root: Foundations and Future States of Revenue Integrity
Caroline Znaniec, MBA, MS-HCA, CRIP, CRCR
Is your revenue integrity program primed for growth and hardy enough to weather changes in the environment? Gain insight into national revenue integrity trends and best practices and how to plan for the future with revenue integrity industry leaders and NAHRI Advisory Board members. This session will dig into data on revenue integrity goals, priorities, and more collected by NAHRI from healthcare organizations nationwide.

9:15 a.m. – 10:15 a.m.
Breakout Sessions

Using NCDs, LCDs, and NCCI Edits to Ensure Compliant Coding and Billing
Kristen Hunter, RHIA, CHRI, CCS, CPC, CPMA, CRC, CANPC, CEDC, CEMC, CRCR
Understanding how to interpret national coverage determinations (NCD), local coverage determinations (LCD), and National Correct Coding Initiative (NCCI) edits is an important part of denials prevention. Too often reimbursement is lost or delayed due to a lack of understanding of how these resources should be utilized to ensure compliant documentation and billing requirements. Knowing how to appropriately apply these guidelines is an important part of fixing and preventing denials. Join this session to take a deep dive into how to use these tools to protect revenue and ensure compliance.

Program Integrity: Impacts of Fraud, Waste, Abuse Audits on Revenue Cycle
Amy Inch, COTA, CPC, CPMA
This session will identify the major CMS program integrity entities and their roles, the definitions of fraud, waste, abuse, and billing errors, as well as the laws governing their activities and actions. We will address the impacts a program integrity audit can have on revenue and provide resources and case examples to incorporate into compliance programs throughout the revenue cycle.

What Level of Denial Are You In?
Gopi Astik, MD, MS, Kristine Green, MSN, RN, and David Sowers, BSN, MS, RN, CCDS
In this session, the speakers will describe their organization’s process of evaluating denials and writing appeals using a multidisciplinary process involving CDI nurses, physician advisors, and front-line clinical champions. The session will describe how to leverage the denial/appeals process to educate the CDI team via case-based feedback and how denials can be used to improve future documentation practices for clinicians. The speakers will use examples of how they used denials data to improve documentation and how they use metrics to evaluate the program and its performance, as well as share tips for starting similar programs at your own organization.

10:15 a.m. – 10:45 a.m.
Networking & Refreshment Break (Exhibit Hall)

10:45 a.m. – 11:45 a.m.
Breakout Sessions

Working with External Auditors
Sandy Giangreco Brown, MHA, BS, CHRI, RHIT, CCS, CCS-P, CHC, COC, CPC, CPC-I, COBGC, PCS, and Diane Weiss, CPC, CPB, CHRI
This session will discuss multiple perspectives of how to respond, react and be proactive regarding audits!

Streamlining Medicare Short Stay Review Processes for Efficient Reimbursement
Anjani Mahabashya, M.D., CHCQM-PHYADV
In this session, learn how Geisinger leverages physician advisors and a revenue management team as part of a short stay review process aimed at ensuring Medicare compliance and optimizing reimbursement. Attendees will get a glimpse into how the workflow functions, including automatic routing to work queues, how advanced algorithms are applied to identify cases for review, and more. The speaker will share how the approach not only saves time but ensures meticulous compliance with CMS guidelines, ultimately contributing to the financial well-being of the healthcare system.

Denials Management through CDI and Coding Collaboration
Tammy Combs, RN, MSN, CDIP, CCS, CNE, and Robin Tripp, MAS, RHIA, CPC, CRC
This session will explore the process of managing claim denials from a clinical documentation integrity (CDI) and coding perspective. Claim denials may be avoided when the health record includes high-quality clinical documentation and accurate ICD-10-CM/PCS code assignment. The collaboration between CDI and coding teams is essential to the denials management process. This session will provide insightful ways in which these two teams can successfully work together to reduce the denial rate, related to clinical documentation and ICD-10-CM/PCS coding. In addition to the knowledge that attendees will gain, scenarios will be included to guide the audience in applying the information into their daily practice.

11:45 a.m. – 12:50 p.m.
Networking Lunch—provided (Exhibit Hall)

12:50 p.m. – 1:50 p.m.
Breakout Sessions

Developing a Charge Audit Program
Andrew Wade
Learn how Children’s Colorado uncovered more than $10 million in missing revenue by developing a charge audit program. This session will explore how the program was created and operates, essential steps of successful charge audits, and more!

Telehealth: Post PHE and Beyond
Yvette DeVay, BS, MHA
This session will present an in-depth look at Medicare’s telehealth benefit as we transition from the post-PHE period. The session will focus on eligible telehealth services, appropriate coding, compliant billing, status of federal waivers, and permanent telehealth billing requirements.

Building Resilience: CDI Strategies for Proactive Denials Prevention
Penny Jefferson, MSN, RN, CCDS, CCDS-O, CDIP, CCS, CRC, CHDA, CPHQ, CRCR, and Tami McMasters Gomez, CCS, CCS-P, CDIP, CCDS
This session offers an in-depth exploration of strategies and best practices to reduce denial risks before they occur. The session focuses on the critical role of CDI professionals in ensuring accurate and complete clinical documentation, aligned with coding guidelines and payer requirements. Attendees will gain insights into common root causes of prospective denials and learn practical approaches to prevent them through collaboration with medical staff, utilization of technology, continuous monitoring, and data analytics.

2:00 p.m. – 3:00 p.m.
Breakout Sessions

Revenue Integrity: No Two Are Alike
Michele Bear, DBA, MBA, CHRI, CRCR, CHC, CPC, and Frank Cantrell, CHRI
This interactive session will look at the structure, program, and effectiveness of revenue integrity in the healthcare landscape. The speakers will discuss KPIs for revenue integrity, including productivity and quality standards, and how those are measured within revenue integrity. They’ll discuss how to manage resources and resource struggles and how to measure and prove ROI to build and support revenue integrity initiatives. Attendees will also gain insights into the use of AI tools, automation, and third-party tools to support revenue integrity.

Embracing the New Revenue Integrity: Becoming Bigger Than the Charge Description Master
Prashant Karamchandani, PMP, FHMFA, CRCR, and LaTonya O’Neal, RHIA
With the rapidly changing healthcare revenue cycle landscape and financial challenges leaders face, there has never been more of a need to have tight revenue integrity teams. While ensuring charge description masters stay current and compliant, the industry has required teams function in a more proactive, process-oriented capacity to identify and eliminate bottlenecks that impact revenue cycle performance.

MaineHealth's Journey to a Successful CDI Program With a Denials Management Process
Lori Jayne and Robin Matthews, RN, BSN, CCDS
Explore the inspiring journey of MaineHealth in establishing a successful CDI program seamlessly integrated with an effective denials management process. This session will delve into the strategic steps, challenges faced, and lessons learned as MaineHealth navigated the path to optimizing clinical documentation and streamlining denials management. Gain valuable insights into the strategies employed, key milestones achieved, and the overall impact on revenue cycle efficiency.

3:00 p.m.
Conference concludes

— Agenda subject to change —

2024 Revenue Integrity Symposium

Speakers

Elizabeth M. Aguirre, MD, CCDS, is inpatient clinical documentation physician lead at Baylor Scott & White Health in Temple, Texas. She is a board-certified internal medicine physician with 10 years of hospital medicine experience and seven years of CDI experience. She started her CDI journey with concurrent chart reviews and now primarily works with denial reviews and developing CDI physician education.

Gopi Astik, MD, MS, is a hospitalist, medical director, and assistant professor of medicine at Northwestern Memorial Hospital (NMH). She completed her medical training at the University of Missouri-Kansas City School of Medicine and a masters in healthcare quality and patient safety at Northwestern University. She currently serves as the lead medical director of clinical documentation and has spoken nationally about methodology and tactics used by the clinical documentation department at NMH. Dr. Astik is also the director of professional development for the division of hospital medicine. Here she works to design and implement programs to help faculty grow in their careers as academic hospitalists. Her research interests are in quality improvement with special focus in diagnostic errors. She completed a fellowship in diagnostic excellence through the Society to Improve Diagnosis in Medicine and continues to present her work nationally in this field. She is also interested in hospital operations and optimizing workload in healthcare settings.

Michele Bear, DBA, MBA, CHRI, CRCR, CHC, CPC, has more than 30 years’ experience in healthcare revenue cycle, compliance, and operations. She holds a bachelor’s, master’s and doctorate degree in business administration with a concentration in healthcare administration. Bear is a member of the NAHRI Leadership Council. She currently leads the revenue integrity, chargemaster, quality assurance, reporting, and data analytics and team member engagement departments for the revenue cycle at Baptist Health in Jacksonville, Florida.

Tresa Binek, PharmD, MS, MBA, CRCR, is a pharmacist by training, now a passionate leader in revenue integrity. She serves as the director of revenue practice at Intermountain Health, where she oversees the revenue practice teams for multiple service lines including OR, ED, CV/IR, pharmacy, medical oncology, radiation oncology, and infusion. Her team’s mission is to partner with revenue cycle and clinical operations to ensure consistent and compliant charge capture practices, complementary to the clinical workflows. She is focused on smart automation and intentional work, ensuring her teams partner, design and work effectively to guard and protect the revenue for Intermountain Health.

Jared Brock, MBA, is the system director of CDI analytics at Baylor Scott & White Health in Temple, Texas. He oversees the collection, aggregation, and reporting of all data related to the inpatient and outpatient CDI programs.

Frank Cantrell, CHRI, is the corporate director of revenue integrity for the Pen Highlands Health System. Penn Highlands is a five-hospital, community-based, not-for-profit system in northwestern Pennsylvania servicing 13 counties. Prior to Penn Highlands, Cantrell served as the director of revenue integrity for the Huntsville Hospital Health System, a 2,100-bed health system in Huntsville, Alabama. With over 32 years of combined clinical and financial healthcare experience, he is responsible for various aspects of the revenue cycle, including developing and maintaining facility chargemasters, internal clinical audits, government audits, reducing charge and billing compliance risk, and enhancing revenue.

Yvette DeVay, BS, MHA, is a regulatory specialist for HCPro, Inc. She develops content for HCPro’s Medicare Boot Camp® - Physician Services, Appeals and Denials, and Federally Qualified Health Center and is an instructor for the Medicare Boot Camp® -Hospital Version and Critical Access Hospital and Rural Health Version. She has over 25 years’ experience with extensive experience as a professional/outpatient coding consultant. She has extensive knowledge of Medicare coding, billing, and compliance issues. She worked with a Medicare Program Safeguard Contractor where she filled the roles of data analyst, policy consultant, and data manager during her employment.

Heather Dunn, MBA, CHFP, CRCR, vice president of finance and chief revenue cycle officer for Vanderbilt University Medical Center, brings 20 years of proven excellence in digital transformation, revenue cycle automation technologies, and healthcare IT governance. As the vice president and chief revenue cycle officer, Dunn leads all phases of the integrated revenue cycle, including analytics, performance excellence, and digital transformation for the Vanderbilt Medical Group, hospitals, and ambulatory clinics. Before joining Vanderbilt, Dunn was the executive director of revenue operations and clinical coding at the University of Texas MD Anderson Cancer Center. She directed and led a centralized revenue integrity and coding office. Dunn earned a bachelor of science in healthcare administration and a master of business administration in healthcare informatics from New England College in Henniker, New Hampshire.

Stephanie Ellis, RN, BSN, COC, CHRI, is the director of revenue performance and audit management at UChicago Medical Center. She reports through the hospital revenue cycle with responsibility for revenue integrity, internal nurse audit, and coding for hospital outpatient clinic and community physicians. She is a registered nurse and has a number of years of experience in Chicagoland healthcare and revenue cycle areas with 15 years in leadership roles. Ellis is a member of the NAHRI Advisory Board and the NAHRI Leadership Council.

Sandy Giangreco Brown, MHA, BS, RHIT, CCS, CCS-P, CHC, CPC, COC, CPC-I, COBGC, PCS, is the director of coding and revenue integrity at CliftonLarsonAllen, LLP. She manages and develops relationships, audit services, and education for clients, coding staff, and providers. She has more than 35 years of experience in healthcare and medical records management, coding, auditing, and compliance in the hospital, outpatient, and physician settings. She loves presenting and sharing education, with her areas of specialty including OB-GYN, general surgery, cardiology, anesthesia, E/M, oncology, and radiology coding. She conducts regional and national presentations for groups such as AHIMA, WHIMA, CHIMA, NCHIMA, HCCA, AAPC, and MGMA, and teaches courses for the AAPC.

Garland F. Goins Jr., MBA, is the vice president of revenue cycle management for Alo/Avance Health System in Durham, North Carolina. Goins is responsible for organizational charge compliance, revenue preservation and enhancement, and value-based care integrity in this role. He has held progressive leadership roles in the revenue cycle for comprehensive primary care and academic medical centers for more than 17 years and is an active local and national member of HFMA, AAPC, NAHRI, and AHIMA. He has received considerable and notable honors for his work within these organizations and the communities they serve, from directing Six-Sigma quality initiatives leading to the prevention of $25 million in revenue loss and earning the highest UMMC leadership award, to managing Duke Health’s drives to end homelessness through executive engagement with the Durham Rescue Mission. Goins shares his advocacy for revenue cycle progression and innovation through thought-leadership engagements as a seasoned member and conference presenter for HFMA, Connex Partners Innovation Board, HealthLeaders Magazine, and NAHRI.

Sarah L. Goodman, MBA, CHCAF, COC, CHRI, 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 chargemaster, outpatient facility coding, and billing compliance and has more than 35 years’ experience in the healthcare industry. Goodman has held leadership roles in a number of professional organizations on the local, state, and national levels—including the NAHRI Advisory Board—and currently also serves as an alternate adjunct instructor for HCPro’s Revenue Integrity and Chargemaster Boot Camp and as a frequent presenter at NAHRI sponsored events

Deepak Manmohan Goyal, MD, MBA, is an internal medicine trained board certified physician who is currently an executive medical director at Monument Health in Rapid City, South Dakota. He has a master’s in business training from University of Massachusetts. He is a key executive for leading significant number of system level initiatives like financial clearance process, value analysis/enhancement, quality improvement, denial management and presumptive charity care processes. He has been chairman of utilization review committee at Monument Health for more than five years. With more than 23 years of progressive responsibilities in various medical fields, Goyal’s diverse medical experience spans general and trauma surgery and orthopedics as house officer, emergency services, primary care, hospitalist services and physician leader in various administrative and executive roles. He has served as medical director, chief of staff, and program director in the past. Goyal has been a national speaker at prestigious conferences like ACMA, AHRMM, HFMA, GHX, and IDN on various key topics related to healthcare management.

Kristine Green, MSN, RN, is vice president, clinical documentation, at Northwestern Memorial HealthCare (NMHC). Green has worked in the healthcare industry for 25 years and in the quality and CDI realm for the past 16 years. During her time in this role, she aligned clinical documentation as a system function and integrated clinical documentation nurses with physicians and advanced practice providers through in-person rounding experiences at each NMHC hospital to drive measurable and sustained improvements in accuracy and expected outcomes. Green also serves as a member of the ACDIS Leadership Council and is a past ACDIS conference speaker.

Salisha Hamid, CPA, is a senior manager for the Florida-based Mayo Clinic revenue integrity team. She has been with Mayo Clinic for 19 years and held multiple positions in finance. Her career began in plant, property and equipment accounting in 2005 and transitioned to financial planning and analysis in 2006. From 2006 to May 2019 she worked as an analyst supporting clinical practices in financial planning and analysis progressing from an analyst 1 to senior financial analyst. In May 2019 she joined the Florida revenue integrity team as a manager. During her role in revenue integrity, she has led the team to recover more than $5 million in additional net revenue, develop additional reporting tools and streamline revenue integrity processes. In addition, she has helped stand up the advanced care at home billing model for revenue cycle. She holds a bachelor’s degree in accounting and an MBA from the University of North Florida. She is also an active CPA in the state of Florida.

Ronald L. Hirsch, MD, FACP, CHCQM, CHRI, is vice president of R1 RCM in Chicago. Hirsch was the medical director of case management at Sherman Hospital in Elgin, Illinois. 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.

Kelli Howard, MBA, is a senior manager of revenue integrity at Mayo Clinic.

Kimberly A. Hoy, JD, CPC, is the director of Medicare and compliance for HCPro LLC. 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. Hoy 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.

Kristen Hunter, RHIA, CHRI, CCS, CPC, CPMA, CRC, CANPC, CEDC, CEMC, CRCR, is the director of revenue Integrity for Blanchard Valley Health System in Findlay, Ohio. Hunter received her bachelor’s degree from the University of Cincinnati in health information systems. She is a member of the 2024 NAHRI Leadership Council. Problem-solving is what she loves, and she appreciates that her career path has provided her the knowledge that she will never run out of opportunities to find solutions. She is married with five children and one granddaughter. In her spare time, she loves gardening and spending time boating and fishing in Tennessee.

Amy Inch, COTA, CPC, CPMA, is an instructor of HCPro’s Medicare Boot Camp for Physicians as well as the Medicare Boot Camp Denials and Appeals version. She has over 25 years of experience in healthcare, primarily in the roles of senior and lead investigator as well as lead investigations trainer with a Medicare Unified Program Integrity Contractor. Amy conducted extensive policy research and data analysis in the development of successful investigations. She also created and delivered education on a variety of Medicare and Medicaid topics to investigators, analysts, medical reviewers, and law enforcement.

Lori Jayne is the senior director of HIM at Maine Medical Center.

Penny Jefferson, MSN, RN, CCDS, CCDS-O, CDIP, CCS, CRC, CHDA, CPHQ, CRCR, entered the world of healthcare 34 years ago as a medic in the U.S. Army. Her career includes a variety of roles (CAN, LPN, RN, BSN, MSN) and 14 years as a critical care nurse and 13 years in CDI. She accepted a position with Mayo Clinic in 2019 where she started as a concurrent CDI reviewer and progressed to Supervisor of CDI. December 2022, she accepted my current position with UC Davis Health as CDI manager where she is excited to continue her career path in CDI leadership.

Prashant Karamchandani, PMP, FHMFA, CRCR, is a director in financial transformation and co-leads the revenue cycle transformation practice at The Chartis Group. He brings more than 19 years of experience in revenue cycle, strategic planning, business intelligence, technology, and healthcare consulting to provide innovative solutions that enhance business and technical operations, accelerate revenue growth, and produce actionable change. His most recent experience includes oversight and management of numerous revenue transformation assessments and implementation projects for hospitals, physician organizations, and nationally integrated health systems. He serves as a strategic advisor to revenue cycle executives at various health systems across the country, helping them improve current state operations and plan for future changes using technology and enhanced operations. Karamchandani received his master of science in health informatics from the University of Illinois at Chicago. He has also earned a master of business administration, a master of health administration from Georgia State University, and a bachelor of science from the University of Akron.

Howard Kung, CPA, MBA, FHFMA, FACHE, CPC, CRCR, has more than years of experience in revenue cycle, charge capture, healthcare finance, and reimbursement. Kung is currently the senior director, revenue integrity at the Mayo Clinic. Howard holds a bachelor of arts in economics from UCLA and an MBA from Loyola Marymount University.

Kay Larsen, CHRI, is a revenue integrity specialist at Adventist Health Glendale in California. She has more than 20 years’ experience in healthcare revenue integrity, many of those as a chargemaster coordinator. Larsen’s favorite part of her job is working with departments to maximize revenue through education and charge review. She also enjoys networking with her peers both internally and externally, sharing ideas and best practices. Larsen has presented at the last seven Revenue Integrity Symposiums, written articles for the NAHRI Journal and presented during several NAHRI podcasts. She is a NAHRI Advisory Board member.

Suzanne Lestina is the executive director, revenue integrity and strategic innovations at UChicago Medical Center in Chicago.

Anjani Mahabashya, M.D., CHCQM-PHYADV, is a physician advisor and chair of the utilization management committee at Geisinger Medical Center. After experiencing an unfortunate injury, she underwent a transformative reinvention as a physician advisor, discovering her true passion in the dynamic healthcare field. Alongside her professional pursuits, she actively engages with a non-profit organization dedicated to closing the digital gap among senior citizens in her community. As a strong advocate for leveraging technology, Mahabashya firmly believes it holds the key to revolutionizing healthcare delivery. She envisions a future where healthcare providers collaborate, innovate, and address the gaps in the healthcare system, all while striving for health equity for all individuals. A seasoned public speaker, Mahabashya has delivered two impactful TEDx talks. Her exceptional volunteer work has been recognized with the prestigious Presidential Volunteer Service Award, which she has received three times.

Robin Matthews, RN, BSN, CCDS, is the Director of the clinical documentation management program at MaineHealth. With a background in frontline patient care from critical care to the emergency room, she oversees the clinical documentation management program across five acute care hospitals within the MaineHealth system. Matthews manages a dynamic team of 25 CDI nurses and collaborating with six physician advisors to improve quality and financial outcomes. Collaborating across interdisciplinary teams in denials management requires effective communication, mutual understanding, and a shared commitment to resolving challenges. She participates in joint problem-solving sessions where representatives from different teams come together to analyze specific denials cases and strategize on resolutions.

LaTonya O’Neal, RHIA, is a principal with The Chartis Group in the revenue cycle transformation practice. O’Neal is an accomplished revenue cycle leader with more than 30 years of providing innovative solutions that enhance business operations, accelerate revenue growth, and produce sustainable change in the areas of patient access, health information management, coding, clinical documentation integrity (CDI), and patient financial services. Her most recent experiences include the management and oversight of a denials management and prevention program, development of coding and CDI transformation strategies, and optimization of utilization management programs. O’Neal holds a bachelor of science in health information management from the University of Central Florida.

Diana Ortiz RN, JD, CCDS, CCDS-O, joined 3M in 2018 with 15 years’ experience working as a clinical nurse and in clinical documentation integrity (CDI), leading organizational development and implementation. She has been a marketing manager and a product owner for CDI and hierarchical condition categories, senior manager leading coding and clinical content teams providing knowledge support for our natural language understanding products and is currently the senior business director of revenue cycle.

Catherine Pesek Bird, DO, MBA, CHCQM-PHYADV, is a physician advisor at Lakeland Regional Medical Center, with more than 25 years of healthcare experience. Prior to her current role, Pesek practiced as an academic cardiologist in a large Big Ten medical center, leading teams of fellows, residents, and medical students. She provided direct patient care including to patients with transplants, congenital heart disease, and pregnancy. She worked on quality improvement programs in heart failure, sepsis, pneumonia, cardiac catherization, and medication adherence. Pesek also taught high school chemistry and wrote a book on understanding and determining end-of-life choices. She enjoys playing tennis and golf. She is a proud alumna of the University of Notre Dame.

Sheldon Pink, MBA, FHFMA, LSSBB, is the vice president of revenue cycle at Luminis Health.

Victoria Sina is a revenue integrity coordinator at Intermountain Health.

David Sowers, BSN, MS, RN, CCDS, is a clinical documentation specialist at Northwestern Memorial Hospital in Chicago, Illinois. He started his nursing career in 2004, with clinical nursing experience in medical ICU, cardiothoracic surgery ICU, IR, and PACU. He transitioned to CDI in 2016 and joined Northwestern Memorial Hospital in 2021. He is currently the CDI RN working on the clinical validation denials and appeals at Northwestern Memorial Hospital.

Andrew Wade is the director of revenue integrity at Children’s Colorado.

Diane Weiss, CPC, CPB, CHRI, is the vice president of revenue integrity and education with RestorixHealth, where she oversees several internal auditing processes and monitors all external payer audit activity and programs. Weiss also oversees the coding team and provides reimbursement and denials management for the organization’s professional services division. She works closely with senior leadership on a national and regional basis and serves on the audit and compliance committee. Weiss provides coding, billing, and documentation education to all internal staff as well as to providers and staff in the wound care centers that RestorixHealth manages. She and her audit team participate in auditing follow-up calls with payers through the SMRC D&E process as well as all education provided through CMS’ TPE program. Previously, Weiss was the internal Medicare consultant for Ochsner Health System and a provider relations education specialist at Pinnacle Medicare Services, a Medicare contractor.

Deanne Wilk, MPS, BSN, RN, CCDS, CCDS-O, CDIP, CCS, is a CDI education specialist for ACDIS at HCPro. She serves as a full-time instructor for the CDI Boot Camps and as a subject matter expert for ACDIS. Wilk is an accomplished healthcare professional with a diverse background in health information, medical coding, nursing, and clinical documentation integrity (CDI). With a strong passion for making a difference, Wilk has dedicated her career to improving the quality and integrity of clinical documentation within the healthcare environment for improved patient care. Having received a master’s degree from Penn State University in Leadership and BSN from Drexel University, she acquired the necessary skills and knowledge to establish CDI programs, direct CDI departments from community hospitals to quaternary large academic medical systems and educate throughout the CDI profession. Over the years, Wilk has worked on numerous projects aimed at advancing CDI education, growth, and awareness.

Caroline Znaniec, MBA, MS-HCA, CRIP, CRCR, is a managing director and Protiviti’s healthcare provider operations practice leader. She has extensive professional consulting and industry experience in healthcare. She has experience serving in industry roles such as corporate compliance officer and corporate director of revenue integrity for integrated health systems. She is a recognized industry speaker and author in the areas of revenue integrity; revenue cycle transformation; regulatory compliance; electronic health record design, implementation, and optimization; and data analytics. She is a NAHRI Advisory Board member and leader of the NAHRI Mid-Atlantic Chapter.

2024 Revenue Integrity Symposium

Location

Hilton Chicago/Oak Brook Hills Resort & Conference Center
3500 Midwest Road
Oak Brook, IL 60523

Room rate: $205.00/night
Hotel cut-off date: Monday, August 19, 2024
Reservation Phone #: 1-630-850-5555 and referencing the ACDIS/NAHRI Event room block
Reservations URL: https://www.hilton.com/en/attend-my-event/chibhhh-nahris-85e4592c-61b3-4eb3-975f-b13858579ae/
Hotel website: https://www.hilton.com/en/hotels/chibhhh-hilton-chicago-oak-brook-hills-resort-and-conference-center/

HCPro has no affiliation with any third-party companies or travel assistance providers. Rooms should be booked directly with the event hotel using the official information provided on the website and in the brochure.

Self-parking is complimentary for conference attendees.

Pricing

Retail Price: $1,299.00
Early Bird Price: $1,199.00 — Early Bird Deadline is June 10, 2024

NAHRI Member Retail Price: $1,199.00
NAHRI/ACDIS Member Early Bird Price: $1,099.00 — Early Bird Deadline is June 10, 2024

2024 Revenue Integrity Symposium

Continuing Education

Coming Soon!

2023 Revenue Integrity Symposium

Sponsors

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