Welcome to Healthcare Payment & Revenue Integrity Congress South!
The Healthcare Payment and Revenue Integrity Congress is an opportunity for leaders in PI and RI/RCM to come together and discuss emerging solutions to prominent issues including improving audits, resource prioritization, adjusting to new trends in healthcare demands and policy, and improving payer-provider relationships.
As a health plan, this congress will give you the resources to strengthen, redefine, or establish your own payment integrity strategies by analyzing case studies from industry peers and joining interactive discussions that span the entire claims continuum.
As a revenue cycle management expert, you can evaluate the use of intelligent automation and AI within your organisation to optimize revenue integrity, while also getting to address chargemaster integrity, understand value-based payment models and establishing strong cross functional collaboration on coding, billing, compliance and beyond.
Join industry experts, participate in hands-on workshops, and connect with peers. Be at the forefront of healthcare finance transformation!
REGISTER YOUR INTEREST
2023 Highlights
How To Get Involved
Partner With Us
Partner with us to elevate your brand, and make valuable new connections. Subject to availability, we offer opportunities for thought leadership, branding, and facilitated networking.
Please contact our Partnerships Director, Harry Ludbrook, for more information. [email protected].
Register Your Interest
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies.
Register your interest and be the first to hear updates on the West Coast edition.
OUR COMMUNITY OF PAYERS
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies today:
OUR PARTNERS
I thoroughly enjoyed the conference and came away having learned something new or with new perspectives from each workshop.
Elevance Health
It was a seamless process and the intimate meeting space was ideal to allow for more collaboration
Health Care Services Corporation
The quality of the event, sessions, speakers and Health Plan attendees scored high
Performant Corp
Great job putting on your inaugural show. I'm certain that the show will continue to grow and get even better in the future.
MedReview
I think the conference has good potential going forward. It fits a niche in the industry.
ClaimLogiq
This conference filled the much needed gap in focusing on Payment Integrity issues and initiatives
Blue Cross and Blue Shield of North Carolina
We finally have a PI conference!
EXL
This PI conference was wonderful. We’d rank it 10/10 with representation from all across the industry
Carelon
This was the most meaningful industry event of the year for Payment Integrity professionals
Advanced Medical Solutions
Great event focused on the PI space
Coverself
2
Main Event Days
35+
Industry Leading Speakers
180+
Industry Experts
15+
Dedicated Networking Hours
OUR SELECTION COMITTEE
Brannon Morisoli
Director
SWK Holdings
Mr. Morisoli joined SWK Holdings as a Senior Analyst in March 2016. Prior to joining SWK, he was an Investment Analyst and Portfolio Manager for a family office that invested in equities, fixed income, real estate, and alternative investments. Prior to that, he was an Investment Analyst for Presidium Group, a real estate private equity firm, where he played an integral role in closing over $100mm in transactions. Mr. Morisoli began his career at Neurografix, a startup medical technology company in Santa Monica, CA that was doing groundbreaking work in the MRI imaging of peripheral nerves. While with Neurografix, he was published in two leading neurology journals. Brannon graduated from UCLA with a B.S., was awarded a fellowship and graduated from the University of Notre Dame with an M.B.A, and was awarded a Samson Fellowship from the University of Wisconsin Law School, where he graduated with a J.D. Mr. Morisoli is an inactive member of the State Bar of Wisconsin
Thomas Busby
Vice President
Outcome Capital
Thomas Busby is a Vice President and has been with Outcome Capital since 2015. He focuses on medical technology, digital health and life science services segments with particular interest in innovative life science companies that deliver patient impact by leveraging novel approaches. Thomas is driven by the desire to identify disruptive technologies and services that require unique strategic thought and assistance to realize their full market potential. Thomas has been published in leading life science journals Life Science Leader and The Pharma Letter, and also serves on the board of HealthTech Build, a Boston-based digital health innovation group.
Prior to his career in life-science investment banking, Thomas pursued his passion for the public service and non-profit sectors working in a variety of leadership and management positions, and at one time held a Massachusetts teaching license.
Thomas completed his MBA at Suffolk University’s Sawyer Business School on full academic scholarship where he was President of the school’s Graduate Business Association and class speaker at graduation. Prior, he completed a BS in Philosophy with Honors from Suffolk’s College of Arts & Sciences. Committed to giving back, Thomas is currently the President of the College of Arts & Sciences Alumni Board of Directors. Thomas is a FINRA Registered Securities Representative holding his Series 79 and 63.
Robert Crousore
Managing Partner
Health Frontier Ventures
Robert has 28 years of experience in the health care products and
services industry. Crousore is a serial entrepreneur with multiple
successful product and services company exits. His experience spans
the entire business enterprise including Sales, Marketing, Operations,
Product Innovation and, most recently M & A.
Highlights Include:
- Has successfully managed a global commercial organization in the wound care business.
- Has a number of patent credits for products in the wound care industry.
- Sits on multiple boards of healthcare technology companies.
- His passion is creating meaningful changes in patient care by combining great products with great teams that are focused on empowering improved clinical and financial outcomes.
Brannon Morisoli
Director
SWK Holdings
Mr. Morisoli joined SWK Holdings as a Senior Analyst in March 2016. Prior to joining SWK, he was an Investment Analyst and Portfolio Manager for a family office that invested in equities, fixed income, real estate, and alternative investments. Prior to that, he was an Investment Analyst for Presidium Group, a real estate private equity firm, where he played an integral role in closing over $100mm in transactions. Mr. Morisoli began his career at Neurografix, a startup medical technology company in Santa Monica, CA that was doing groundbreaking work in the MRI imaging of peripheral nerves. While with Neurografix, he was published in two leading neurology journals. Brannon graduated from UCLA with a B.S., was awarded a fellowship and graduated from the University of Notre Dame with an M.B.A, and was awarded a Samson Fellowship from the University of Wisconsin Law School, where he graduated with a J.D. Mr. Morisoli is an inactive member of the State Bar of Wisconsin
Thomas Busby
Vice President
Outcome Capital
Thomas Busby is a Vice President and has been with Outcome Capital since 2015. He focuses on medical technology, digital health and life science services segments with particular interest in innovative life science companies that deliver patient impact by leveraging novel approaches. Thomas is driven by the desire to identify disruptive technologies and services that require unique strategic thought and assistance to realize their full market potential. Thomas has been published in leading life science journals Life Science Leader and The Pharma Letter, and also serves on the board of HealthTech Build, a Boston-based digital health innovation group.
Prior to his career in life-science investment banking, Thomas pursued his passion for the public service and non-profit sectors working in a variety of leadership and management positions, and at one time held a Massachusetts teaching license.
Thomas completed his MBA at Suffolk University’s Sawyer Business School on full academic scholarship where he was President of the school’s Graduate Business Association and class speaker at graduation. Prior, he completed a BS in Philosophy with Honors from Suffolk’s College of Arts & Sciences. Committed to giving back, Thomas is currently the President of the College of Arts & Sciences Alumni Board of Directors. Thomas is a FINRA Registered Securities Representative holding his Series 79 and 63.
Robert Crousore
Managing Partner
Health Frontier Ventures
Robert has 28 years of experience in the health care products and
services industry. Crousore is a serial entrepreneur with multiple
successful product and services company exits. His experience spans
the entire business enterprise including Sales, Marketing, Operations,
Product Innovation and, most recently M & A.
Highlights Include:
- Has successfully managed a global commercial organization in the wound care business.
- Has a number of patent credits for products in the wound care industry.
- Sits on multiple boards of healthcare technology companies.
- His passion is creating meaningful changes in patient care by combining great products with great teams that are focused on empowering improved clinical and financial outcomes.
PREVIOUS INDUSTRY LEADING SPEAKERS
William Rothbauer
Vendor Relationship Management, Payment Integrity
UnitedHealth Group
Priscilla Alfaro
VP Payment Integrity
Blue Cross NC
Michael Manley
Director, Integrated Provider Partnerships
Highmark Health
Dutch Noss
Chief Operating Officer
Precision GX
Dutch Noss, COO of PrecisionGx is a highly versed Operations leader with 20+ years in Payment Integrity, Revenue Cycle Management, and Product Development. Dutch is an expert in the operational use of Artificial Intelligence, Machine Learning, Predictive Analysis, and Gaming Theory. Dutch’s specialties span both clinical and non-clinical audits including Contract Compliance, Duplicate Payments, IBill & DRG Review, COB, TPL, Retro-term, FWA and RAC audits in pre and post pay settings for Commercial, Medicare, and Medicaid payers.”
Kara Suter
Division Chair of Payment Innovation
Mayo Clinic
Stephanie Sjogren
Director, Coding and Provider Reimbursement
EmblemHealth/Connecticare
Constance Taylor (ne' Boone)
Director Provider Collaboration
ANTHEM
Sophia Gin
SVP Global Delivery Systems
Cigna
Michael Menen
Chief Medical Officer
MedReview
Michael McGauley
Founder
FCS
Michele Bear
Executive Director, Revenue Integrity
Baptist Health
Michele is a revenue cycle Executive Director, with oversight of revenue integrity, revenue cycle reporting and data analytics and front-end revenue cycle functions at Baptist Health & Baptist MD Anderson Cancer Center. She has over 30 years’ experience in healthcare operational, compliance and revenue cycle functions for both hospital and physician services. Michele holds multiple certifications in the healthcare industry.
Michele is a revenue cycle Executive Director, with oversight of revenue integrity, revenue cycle reporting and data analytics and front-end revenue cycle functions at Baptist Health & Baptist MD Anderson Cancer Center. She has over 30 years’ experience in healthcare operational, compliance and revenue cycle functions for both hospital and physician services. Michele holds multiple certifications in the healthcare industry.
Carl Brodarick
SVP Managed Care Contracting & Value Based Purchasing
AccentCare
Tamar Goldblatt
Senior Director, Pricing Strategy
Novant Health
Rani Khetarpal
Rani Khetarpal, VP Strategy
Moderna Therapeutics
Dale Carr
Director
Missouri Medicaid Audit and Compliance (MMAC)
Dale Carr currently serves as Director of the Missouri Medicaid Audit & Compliance (MMAC) unit, which
has overall responsibility for Medicaid program integrity efforts. Dale has worked for the State of
Missouri since 2011. Director Carr was previously a Police Officer in Fallon, NV; an Investigator for the
U.S. Office of Special Counsel; and a Supervisory Special Agent with the Coast Guard Investigative
Service. Dale holds a Bachelor’s degree in Administration of Criminal Justice and is a graduate of the
158th Session of the FBI National Academy.
Mark Johnson
Sr Vice President, Product
CERIS
Chad Roswick
Sr. Director II - Enterprise Shared Services
L.A. CARE HEALTH PLAN
Marlene Mullen-Clayton
DO, CPE, MBA, FAAPL Chief Medical Officer
PERFORMANT CORP
Dr. Michael Taylor
Chief Executive Officer
Alivia Analytics
- Founder, Former President and CEO, MARS (MultiPlan Payment Integrity Solutions)
- President of MultiPlan’s Payment Integrity division
- Founded MARS as a technologically-enabled provider of healthcare payment integrity services for payers and third-party administrators
- VP of Operations at Executive Health Resources, acquired by Optum in 2010.
- Previously medical director for Aetna / Schaller Anderson, as well as co-Founder and President of a rural family medicine practice.
- Michael is a graduate of Vanderbilt University School of Medicine and Harvard College
Toni Case
Vice President, National Sales
CERIS
Karen Weintraub
Executive Vice President
HEALTHCARE FRAUD SHIELD
Dave Cardelle
Chief Strategy Officer
AMS
Jake Hartberger
AVP of Payment Integrity
MOLINA HEALTHCARE
Kirstina Rollings
Chief Growth Officer
CAQH
Rajasekhar Maddireddy
Co-founder
COVERSELF
Mike Spellman
Sr. Director Consulting & Design
CLAIMSXTEN
Raghavendra Pawar
Co-founder
COVERSELF
REGISTER YOUR INTEREST
REGISTER YOUR INTEREST IN 2024
CONFERENCE PACKAGES
Sending Your Team? Group Discounts Available!
Applicable for Primary Market, Service Provider and Industry Rates Only. Not available for Academic or ‘Start-Up’ rates
Book a Team of 3+ - Save an Additional 10% Off
Book a Team of 5+ - Save an Additional 15% Off
If you would like to register a team of 3 or more, please email [email protected] for your discount coupon code before registering. PLEASE NOTE: Discounts cannot be combined with Early Bird Pricing or any other discount or offer. If you have any questions about your registration, please call us on +44 (0)20 3696 2920
We accept the following cards through Stripe:
Wednesday, December 7, 2022
Payment Integrity Vendors/ Claims Processing
$2,899
Standard rate
An organization that determine service prices, collect payments, and handle claims
A legal entity, or sub-set of a legal entity, which may contract for the provision of health care
Preparing registration...
MEDIA KIT
For more information on webinars, roundtables, content marketing packages, interviews and marketing solutions opportunities, download the Media Kit.
If you have any questions, please contact Harry Ludbrook, Sales Director, [email protected].
DIAMOND PARTNER
AMS Intelligent Analytics
Website: https://www.mdstrat.com/
Please visit our website for more information.GOLD PARTNERS
ClaimLogiq
Website: https://www.claimlogiq.com/
While the everchanging healthcare landscape can be challenging to navigate, ClaimLogiq’s advanced technology, streamlined processes, intelligent automation, and improved methods for data extraction to generate actionable clinical insights enables health plans across the country to gain control of payment integrity and risk adjustment programs. ClaimLogiq’s proprietary platform and scalable technology enhanced by industry-leading OCR and NLP technology are primary drivers for the delivery of accurate and consistent cost savings, efficient turnaround times, and coding results. The flexibility of the healthcare technology company’s engagement models allows health plans to achieve their goals and solve even the most complex healthcare data challenges no matter where they are in their program journey. As a collaborative partner, ClaimLogiq enables technology-based solutions and supplements existing resources and program capabilities as plans insource more work around their payment integrity and risk adjustment programs.
Healthcare Fraud Shield
Website: https://www.hcfraudshield.com/
Healthcare Fraud Shield specializes in fraud, waste, and abuse detection and payment integrity for healthcare payers nationally by efficiently stopping claims prior to payment using utilizing post-payment advanced analytics and artificial intelligence insights. We save health plans millions annually incremental to existing pre-payment processes using our unique and proven approach. FWAShield™ offers the combination of targeted rules, artificial intelligence, shared analytics across multiple payers resulting in higher ROI (up to 20:1) compared to other vendors. FWAShield™ software platform was developed by industry leading healthcare subject matter experts and is a component of over 50+ clients’ including 16 Blue plans Payment Integrity/SIU departments. Our client satisfaction rating is exceptional with a net promoter score of 97 and client retention rate over 95%.
FWAShield™ – is a fully integrated platform consisting of PreShield™ (pre-payment), AIShield™ (AI), PostShield™ (post-payment), RxShield™ (pharmacy analytics), Shared Analytics™, QueryShield™ (ad hoc query and reporting tool) and CaseShield™ (case management).
MedReview
Website: https://www.medreview.us/
Headquartered in the financial district of New York City and serving all U.S. states and territories, MedReview has been a leading provider of payment integrity, utilization management and quality surveillance services for more than 40 years. A physician-led organization with a passion for ensuring that health care claims fairly represent the care provided, MedReview provides timely independent hospital billing audits and clinical validation reviews on behalf of health plans, government agencies and Taft-Hartley organizations, saving millions of dollars for its clients each year.
SILVER PARTNER
Performant
Website: https://www.performantcorp.com/home/default.aspx
Performant Healthcare Solutions is a leading independent provider of technology-enabled audit, recovery, and analytics services in the United States with a focus in the healthcare payment integrity industry. Performant works with healthcare payers through claims auditing and eligibility (coordination of benefits)-based services to identify improper payments. The Company’s commercial health plan clients include both national and regional payers that represent more than 100 million covered lives across all lines of business, including commercial, Medicare, and Medicaid coverages. Performant also supports numerous engagements with the Centers for Medicare & Medicaid Services, including multiple Recovery Audit Contractor contracts and the Medicare Secondary Payer Commercial Repayment Center contract, as well as a contract with the US Department of Health and Human Services, Office of the Inspector General for complex claim review nationwide. The Company also features a call center to serves clients with complex consumer engagement needs.
Powered by a proprietary analytic platform and workflow technology, Performant also provides professional services related to the recovery effort, including reporting capabilities, support services, customer care, and stakeholder training programs meant to mitigate future instances of improper payments. Founded in 1976, Performant is headquartered in Livermore, California. Visit www.performanthealthcare.com and follow us on Twitter: @PerformantCorp.
EXHIBITOR
PARTNER WITH US
Based on your objectives, we can create bespoke packages designed specifically for you – from presenting your expertise on the main stage, to hosting a private dinner. You can partner with us showcase your brand and make valuable new connections. Opportunities predominantly lie in 3 main categories: Thought Leadership, Branding & Networking.
To discuss your objectives and partnership opportunities please contact Harry Ludbrook, Sales Director [email protected]
Interested in a media partnership?
We'd love to hear from you and how we can support one another to connect with the industry. Contact Jodie Purser, Marketing Manager, [email protected]
PARTNER WITH US
Based on your objectives, we can create bespoke packages designed specifically for you – from presenting your expertise on the main stage, to hosting a private dinner. You can partner with us showcase your brand and make valuable new connections. Opportunities predominantly lie in 3 main categories: Thought Leadership, Branding & Networking.
To discuss your objectives and partnership opportunities please contact [email protected].
Interested in a media partnership?
We'd love to hear from you and how we can support one another to connect with the industry. Contact [email protected].
Delivering scalable and flexible solutions which ensure accuracy and integrity of claims
The Healthcare Payments and Revenue Integrity Congress is the only summit focused on addressing healthcare waste and ensuring that claims are paid correctly, reflecting current healthcare needs. You will join key decision-makers, within health insurers and providers, who are responsible for payment and revenue integrity, value-based payment, and networking relations.
At a time when both payers and providers are evaluating and streamlining internal payment and revenue integrity processes, this networking conference has been established to breakdown silos, by promoting discussion between clinical, coding, revenue cycle and payment departments to facilitate the development of efficient, value-based healthcare systems.
About Kisaco Research
Kisaco Research produces, designs and hosts B2B industry conferences, exhibitions and communities – focused on a specialized selection of topic areas.
Meet industry peers that will help build a career-changing network for life.
Learn from the mistakes of your peers as much as their successes—ambitious industry stalwarts who are happy to share not just what has made them successful so far but also their plans for future proofing their companies.
Note down the inspired insight that will form the foundation for future strategies and roadmaps, both at our events and through our online communities.
Invest both in your company growth and your own personal development by signing up to one of our events and get started.
We'd love to hear from you.
Contact us at +44 (0)20 3696 2920 and email [email protected], or let us know what subject area you're interested in below.
