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- Complement your staff with data mining experts who identify hard to find claim overpayments.
- Stay ahead of constant claim leakage. Use expertise to detect new savings opportunities.
- Improve your medical loss ratio: Return claim dollars to your team/company/bottom line.

Payment Integrity

Author:

Kathy Gonzales-Byrd

Chief Strategy Officer
MedReview

Kathy Gonzales is the Chief of Staff, collaborating with the CEO and other senior leaders on revenue growth, process improvement and organizational effectiveness. Kathy oversees new client implementations and operations for key strategic accounts; manages the organization’s strategic planning process; and oversees interdepartmental accountability processes to ensure operational efficiency.

Before joining MedReview’s senior leadership team, Kathy served as Vice President, Payment Recovery for Cotiviti, Inc. overseeing claim audit operations and client management for Blue Cross Blue Shield accounts. She also has a long-standing consulting career, which include leadership roles in healthcare revenue cycle and organization effectiveness with Accenture and Ernst & Young.

Kathy has a bachelor’s degree in psychology from West Chester University of Pennsylvania, and a master’s degree in business administration (MBA) and Health Care Administration and Finance from Widener University.

 

Kathy Gonzales-Byrd

Chief Strategy Officer
MedReview

Kathy Gonzales is the Chief of Staff, collaborating with the CEO and other senior leaders on revenue growth, process improvement and organizational effectiveness. Kathy oversees new client implementations and operations for key strategic accounts; manages the organization’s strategic planning process; and oversees interdepartmental accountability processes to ensure operational efficiency.

Before joining MedReview’s senior leadership team, Kathy served as Vice President, Payment Recovery for Cotiviti, Inc. overseeing claim audit operations and client management for Blue Cross Blue Shield accounts. She also has a long-standing consulting career, which include leadership roles in healthcare revenue cycle and organization effectiveness with Accenture and Ernst & Young.

Kathy has a bachelor’s degree in psychology from West Chester University of Pennsylvania, and a master’s degree in business administration (MBA) and Health Care Administration and Finance from Widener University.

 

- Unveiling the audit landscape and understanding the importance of timely responses
- Expediting audit responses through the establishment of a dedicated audit response team, implementing
standardized documentation and track systems, and utilizing advanced technologies
- Discussing the value of analyzing audit findings and leveraging them as opportunities for continuous
improvement in revenue cycle management

Revenue Integrity

- Providing an overview of the No Surprises Act, an explanation of key provisions, and the impact it has had on
provider billing practices
- Highlighting how the No Surprises Act has influenced provider-payer interactions and insights into new
payment methodologies introduced by the act to resolve billing disputes
- Examples of how providers have adapted their practices to comply with the act

Revenue Integrity
  1. Highlighting key pain points that healthcare organizations face in PI operations and how it impacts their operations
  2. Picture what other payer organization are doing to alleviate the pain points
  3. Talking about “what if” scenarios or successful use cases of technology, process, governance to help in PI operations
Payment Integrity

Author:

Ankur Verma

Vice President, Healthcare
Everest

Ankur Verma

Vice President, Healthcare
Everest

- Elucidating the impact of value-based care on revenue cycle management, including the need for new
metric, payment models, and performance measures
- Revisiting existing RCM approaches and understanding how RCM can be optimized based on value
- Case studies of successful revenue cycle management transformations based on VBC principles

Revenue Integrity
Payment Integrity
Speakers

Author:

Phillip Churchill

Assistant General Counsel
Blue Cross Blue Shield of Michigan

Phillip Churchill

Assistant General Counsel
Blue Cross Blue Shield of Michigan

Author:

Aaron Browder

President
Carelon Subrogation

Aaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.

Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.

 

Aaron Browder

President
Carelon Subrogation

Aaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.

Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.

 

Moderator

Author:

Kyle Pankey

Sales & Growth Leader
Carelon Subrogation

Kyle Pankey has over two decades of experience working within the healthcare and payer operations, with over 10 years specifically tied in to the payment integrity space.   Kyle lives in Chattanooga, TN and has served as Carelon Subrogation’s growth leader since mid-2022.

Kyle Pankey

Sales & Growth Leader
Carelon Subrogation

Kyle Pankey has over two decades of experience working within the healthcare and payer operations, with over 10 years specifically tied in to the payment integrity space.   Kyle lives in Chattanooga, TN and has served as Carelon Subrogation’s growth leader since mid-2022.

- Outlining how PI functions can adapt to help position providers for success in VBC partnerships
- Exploring new approaches to reimbursement, such as bundled payments, shared savings, and risk-sharing
arrangements

Payment Integrity