How to prevent getting a flat tire!
No matter where you are on your payment integrity journey, encountering challenges are common. Reducing costs, having robust insights, and streamlining operations are key to avoiding the potholes. We'll examine these common challenges along the payment integrity journey to bring in-house key payment integrity functions and establishing a robust operation that is more predictive and preventive in nature. Additionally, we'll share best practices to galvanize the relationship between the provider and payer, creating a partnership that helps ensure payment accuracy (PEDAL methodology).
David Ott
David Ott has over 28 years of experience in the healthcare and financial services industries. David has provided leadership and direction to department leaders and teams that support a variety of functions, including business development, payment integrity, claims processing, global project management and quality practices.
Karen Ballard
Karen Ballard is Director of Consulting Services, CGI, where she is responsible for managing the CGI ProperPay payment integrity platform. With a nearly 20-year career in the health payer space, Karen possesses a deep knowledge of claims processing, product management, payment integrity, and the Blue payer dynamic. Prior to joining CGI, Karen held a variety of positions in claims operations, BlueCard, and payment integrity during her 17-year tenure with Elevance Health (Anthem).
Karen holds a Bachelor of Arts and a Master of Business Administration from Southern New Hampshire University. She co-founded and previously co-facilitated the Blue PI Committee, comprised of payment integrity leaders from all 33 Blue Cross and Blue Shield plans and partnered with the Blue Cross and Blue Shield Association to drive change in the payment integrity space.