JOIN THE SERIES
The Healthcare Payment and Revenue Integrity Congress connects leading figures in PI and RI/RCM to encourage information sharing, discuss the latest solutions being leveraged to ensure the integrity of claims, nurture payer-providers relationships and support the transition to value-based payments.
Health plans use this forum to strengthen, redefine, or establish their own payment integrity strategies by analyzing case studies from industry peers and joining interactive discussions that span the entire claims continuum.
It also empowers providers to make revenue cycle decisions with confidence by leveraging intelligent automation, optimizing RCM based on value, and effectively communicating concerns around emerging payment initiatives.
Topics to be covered include:
- Strengthening payer-provider relationships and outlining strategies for reducing provider abrasion
- Optimizing workflows and encouraging cross functional collaboration between claims, audit, FWA, SIU, and PI teams
- Leveraging advanced tech, such as GenerativeAI, to increase efficiencies across the healthcare value chain
- Preventing revenue leakage by deploying intelligent automation and building proactive denial management systems
- Discussing best practices for building payment integrity programs from the ground up at smaller health plans
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
It was a great opportunity to connect with others whom are passionate about providing excellent service and resources to organizations whom want to be transformative and innovative in the world of Payment Integrity.
WellSense
It was a great opportunity to hear from many subject matter experts over a wide topic of subjects specific to Payment/Revenue Integrity.
Devoted Health
It's a unique forum that brings together providers, payors, vendors and regulators for collaboration, education and information sharing.
UnitedHealth
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
OUR COMMUNITY OF PAYERS
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].
Payers And Providers Attend For Free
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies.
To deliver maximum value for our community, all payers and providers are eligible for complimentary passes.
I'M INTERESTED
PREVIOUS SPEAKERS
Lori Jensen
Director of Value Analysis
University of Utah Health
Janell Zuckerman
Director, Provider Network Development
Select Health
Janell Zuckerman has been at Select Health since 2021 as the Provider Network Development Director for Idaho. She leads the strategy and operations for network development including provider relations, contracting, and performance. Her focus is on building partnerships with regional clinically integrated networks and hospitals, and improving interaction models between payers and providers. She has successfully developed a direct Select Health network in Idaho and new clinically integrated network agreement, with new product launches across Southern Idaho for commercial and Medicare lines of business.
Janell has 15 years of experience in areas of acute care and ambulatory operations, clinically integrated networks, value-based care, and public health and policy, with time at St. Luke’s Health System and the YMCA. In 2023 she was an Idaho Business Review’s Women of the Year honoree. She is a board member and vocal artist with Opera Idaho and association member with HFMA and ACHE. She is a purpose-driven leader and serves as a connector across the health care ecosystem.
Janell is an Idaho native and lives with her husband and two children in Boise, Idaho. She holds a B.A. in English from Tufts University and Masters in Health Administration from Ohio University.
Sean Ryder
Value Based Program Manager
Blue Cross Blue Shield of Arizona
Josh Miller
Director, Payment Integrity
Prominence
Stacy Reck
Director of Clinical Documentation Improvement and Utilization Review
Avera Health
Michael Devine
Director Special Investigations Unit
L.A Care
AGENDA HIGHLIGHTS
Panel: Strengthening Payer and Provider Relationships
- A discussion focused on strengthening ties and reducing provider abrasion
- Case studies of successful payer-provider initiatives and effective provider engagement strategies
- Progressing mutually beneficial initiatives in a collaborative manner
Janell Zuckerman
Director, Provider Network Development
Select Health
Janell Zuckerman has been at Select Health since 2021 as the Provider Network Development Director for Idaho. She leads the strategy and operations for network development including provider relations, contracting, and performance. Her focus is on building partnerships with regional clinically integrated networks and hospitals, and improving interaction models between payers and providers. She has successfully developed a direct Select Health network in Idaho and new clinically integrated network agreement, with new product launches across Southern Idaho for commercial and Medicare lines of business.
Janell has 15 years of experience in areas of acute care and ambulatory operations, clinically integrated networks, value-based care, and public health and policy, with time at St. Luke’s Health System and the YMCA. In 2023 she was an Idaho Business Review’s Women of the Year honoree. She is a board member and vocal artist with Opera Idaho and association member with HFMA and ACHE. She is a purpose-driven leader and serves as a connector across the health care ecosystem.
Janell is an Idaho native and lives with her husband and two children in Boise, Idaho. She holds a B.A. in English from Tufts University and Masters in Health Administration from Ohio University.
Stina Redford
Director of Payment Innovation
Blue Cross of Idaho
Payment Integrity Protecting Your Healthcare Dollar, Recent Schemes and Trends
- Payment Integrity Begins at the Top
- The SIU’s Greatest Need-Data
- Recent Schemes & Trends
- Internet Based Providers
- Behavioral Health Providers
- Telehealth Providers
Carl Reinhardt
Director of Special Investigations Unit – West
Anthem Blue Cross
Revenue and Value Analysis Teams Collaborating to Achieve Decrease Cost
- In healthcare to optimize skills, understanding, and expertise used to improve the value of products, it is essential to remove clinical and financial silos. Collaborating and aligning revenue teams with value analysis teams provide a platform to tell the entire business story in healthcare, decrease cost, and increase revenue.
- Relationships in this arena generate opportunities to find billing and charging errors, and implement best practices into workflow, procedures, and buying trends. Collaboration benefits the teams by offering vital evidence that helps providers make judicious choices about the products they may want to bring into facilities. A revenue cycle analyst can aid in the discovery of problems with processes or old ways of how and where procedures are performed. Using dashboards, reports, and charging and reimbursement data can be seamlessly be integrated into existing value analysis processes making it easy to collaborate on the best ways to achieve your revenue targets.
Lori Jensen
Director of Value Analysis
University of Utah Health
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].
OUR COMMUNITY
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies today:
OUR PARTNERS
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
Lori Jensen
Director of Value Analysis
University of Utah Health
Janell Zuckerman
Director, Provider Network Development
Select Health
Janell Zuckerman has been at Select Health since 2021 as the Provider Network Development Director for Idaho. She leads the strategy and operations for network development including provider relations, contracting, and performance. Her focus is on building partnerships with regional clinically integrated networks and hospitals, and improving interaction models between payers and providers. She has successfully developed a direct Select Health network in Idaho and new clinically integrated network agreement, with new product launches across Southern Idaho for commercial and Medicare lines of business.
Janell has 15 years of experience in areas of acute care and ambulatory operations, clinically integrated networks, value-based care, and public health and policy, with time at St. Luke’s Health System and the YMCA. In 2023 she was an Idaho Business Review’s Women of the Year honoree. She is a board member and vocal artist with Opera Idaho and association member with HFMA and ACHE. She is a purpose-driven leader and serves as a connector across the health care ecosystem.
Janell is an Idaho native and lives with her husband and two children in Boise, Idaho. She holds a B.A. in English from Tufts University and Masters in Health Administration from Ohio University.
Sean Ryder
Value Based Program Manager
Blue Cross Blue Shield of Arizona
Josh Miller
Director, Payment Integrity
Prominence
Stacy Reck
Director of Clinical Documentation Improvement and Utilization Review
Avera Health
Michael Devine
Director Special Investigations Unit
L.A Care
Kay Larsen
Revenue Integrity Specialist
Adventist Health
Carl Reinhardt
Director of Special Investigations Unit – West
Anthem Blue Cross
Stina Redford
Director of Payment Innovation
Blue Cross of Idaho
Karen Weintraub
Executive Vice President
HEALTHCARE FRAUD SHIELD
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.
Dave Cardelle
Chief Strategy Officer
AMS
Rajeev Ronanki
Chief Executive Officer
Lyric
CONFERENCE PACKAGES
We accept the following cards through Stripe:
Thursday, February 23, 2023 to Thursday, November 30, 2023
Healthcare Payers & Providers
COMPLIMENTARY PASS
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
Thursday, February 23, 2023 to Thursday, November 30, 2023
Vendors/ Service Providers
$4,999
Payment Integrity Vendors
Revenue Integrity Vendors
Consultants
Preparing registration...
GOLD PARTNERS
AMS Intelligent Analytics
Website: https://www.mdstrat.com/
Please visit our website for more information.CGI
Website: https://www.cgi.com/us/en-us
Founded in 1976, CGI is among the largest IT and business consulting services firms in the world. We are insights-driven and outcomes-based to help accelerate returns on your investments. Across hundreds of locations worldwide, we provide comprehensive, scalable and sustainable IT and business consulting services that are informed globally and delivered locally.
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.
Reception Host
Exhibitor
Media Partners
Fierce Healthcare
Website: https://www.fiercehealthcare.com/payers
Please visit our website for more information.Healthcare IT Today
Website: https://www.healthcareittoday.com/
Please visit our website for more information.Managed Healthcare Executive
Website: https://www.managedhealthcareexecutive.com/
Managed Healthcare Executive® covers the cost and delivery of healthcare. We provide insight, information and analysis on developments in value-based care, cost effectiveness research and programs, pharmacy benefit management and population health. We publish a monthly print publication and maintain a news-driven website.
HealthTech Magazines
Website: https://www.healthtechmagazines.com/
LinkedIn: https://www.linkedin.com/company/health-tech-magazines/
Twitter: https://twitter.com/HTMagazines
Description: HealthTech Magazines is a Wilmington-based award-winning publication that offers robust platform for healthcare technology professionals to express their views and exchange knowledge on emerging technologies that are transforming the healthcare industry.
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, hosting private dinners, to showcasing your brand and making valuable new connections. Opportunities predominantly lie in 3 main categories: Thought Leadership, Branding, and 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 & 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.
Venue
Sheraton Grand Los Angeles 711 S. Hope St Los Angeles, CA 90017
We're excited to welcome you face-to-face in LA at Sheraton Grand Los Angeles for the Healthcare Payment & Revenue Integrity Summit!
To book your room at a discounted rate, email [email protected]
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.