Agenda
9:30 AM 6:15 PM
8:30 AM 5:15 PM
7:30 AM 4:15 PM
6:30 AM 3:15 PM
Commonwealth Prefunction
Pre-Conference Workshop Registration Desk Hours: 8:30AM - 1:30PM
Additional Registration Required
Main Conference Registration Desk Hours: 1:30PM - 5:15PM
9:30 AM 10:30 AM
8:30 AM 9:30 AM
7:30 AM 8:30 AM
6:30 AM 7:30 AM
Commonwealth 6-7-8 Foyer
Additional Registration Required
Additional Registration Required
Lunch for Pre-Conference Workshop A & B Attendees: 1:00PM - 1:30PM
10:30 AM 6:00 PM
9:30 AM 5:00 PM
8:30 AM 4:00 PM
7:30 AM 3:00 PM
Commonwealth 6
Additional Registration Required
Susan Waterman RHIT, CCS, CPC, CRC
Director of Risk Adjustment
Baylor Scott and White Healthcare
Ava Johnson
Associate Director, Ambulatory CDQI
Mount Sinai Hospital, NYC
Second Half of the Day Presenter
Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP
Director Risk Capture, Population Health Management
Mass General Brigham
10:30 AM 6:00 PM
9:30 AM 5:00 PM
8:30 AM 4:00 PM
7:30 AM 3:00 PM
Commonwealth 7
Additional Registration Required
The HCC Coding for Accuracy workshop is not just for those directly involved in HCC coding work. It is designed for other disciplines, as well, including finance and analytics professionals. Join us for an introduction to best practices, the opportunity to work through case examples, and to share experiences with your peers. This workshop will zero-in on regulatory compliance while teaching you how to optimize the accuracy of the information gathered and submitted at the practice level. What you will also learn about the way charting is often done, how to overcome “disconnect” with the clinicians and how their typical charting practices and EMRs can create significant problems, and how RADV views documentation in contrast with the way clinicians were taught and EMRs were built initially. Please note: Attendees are encouraged to bring questions to pose to our expert workshop facilitators and to table for the group. We provide your workbook which includes copies of the slide deck. You will not need your coding manuals, but most people bring a laptop or a tablet, as well, for note-taking.
Dialogue, interact and work in small, facilitated groups with peers and colleagues
Deb Curry, MBA, RHIA, CCS-P, CRC, Risk Adjustment Programs Director
Paramount Insurance Company
Colleen Gianatasio
Director Clinical Documentation Integrity and Coding Compliance
Capital District Physician’s Health Plan (CDPHP)
Laura Sheriff, RN, MSN, CPC, CRC,
Risk Adjustment Industry Expert
Additional Registration Required
10:30 AM 2:00 PM
9:30 AM 1:00 PM
8:30 AM 12:00 PM
7:30 AM 11:00 AM
Commonwealth 8
Additional Registration Required
Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP
Director Risk Capture, Population Health Management
Mass General Brigham
6:00 PM 7:00 PM
5:00 PM 6:00 PM
4:00 PM 5:00 PM
3:00 PM 4:00 PM
Location: Commonwealth 1-4
Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.
9:00 AM 5:45 PM
8:00 AM 4:45 PM
7:00 AM 3:45 PM
6:00 AM 2:45 PM
Commonwealth Prefunction
9:00 AM 6:45 PM
8:00 AM 5:45 PM
7:00 AM 4:45 PM
6:00 AM 3:45 PM
Commonwealth 1-4
9:00 AM 10:00 AM
8:00 AM 9:00 AM
7:00 AM 8:00 AM
6:00 AM 7:00 AM
Commonwealth 1-4
10:00 AM 10:10 AM
9:00 AM 9:10 AM
8:00 AM 8:10 AM
7:00 AM 7:10 AM
Commonwealth 5
Deb Curry, MBA, RHIA, CCS-P, CRC, Risk Adjustment Programs Director
Paramount Insurance Company
Laura Sheriff, RN, MSN, CPC, CRC
Risk Adjustment Industry Expert
10:10 AM 11:00 AM
9:10 AM 10:00 AM
8:10 AM 9:00 AM
7:10 AM 8:00 AM
Commonwealth 5
Join RISE for a special presentation with Jennifer Podulka, Senior Vice President of Federal Policy for America’s Physician Groups (APG), a national association of about 360 medical groups and independent practice associations that deliver patient-centered, high-quality care to nearly 90 million patients.
Jennifer joins RISE to discuss the results of the Election and assess how the incoming Administration may impact Medicare Advantage plans and risk-bearing provider groups.
Jennifer Podulka, Senior Vice President of Federal Policy
America’s Physician Groups (APG)
Moderator:
Jenn Kerfoot, Chief Strategy & Growth Officer
DUOS
11:00 AM 11:45 AM
10:00 AM 10:45 AM
9:00 AM 9:45 AM
8:00 AM 8:45 AM
Commonwealth 5
Join CMS representatives as they discuss HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) updates applicable to the individual and small group markets. This conversation will include an overview of the proposed policy changes to risk adjustment and HHS-RADV in the 2026 Payment Notice proposed rule and an overview of current 2024 risk adjustment and 2023 HHS-RADV requirements and deadlines.
Kelly Drury, Senior Advisor, Payment Policy and Financial Management Group
Centers for Medicare & Medicaid Services (CMS)
Leanne Scott, Health Insurance Specialist
Centers for Medicare & Medicaid Services (CMS)
Cathy Anderson, Director, Division of Risk Adjustment Operations
Centers for Medicare & Medicaid Services (CMS)
11:45 AM 12:15 PM
10:45 AM 11:15 AM
9:45 AM 10:15 AM
8:45 AM 9:15 AM
Commonwealth 1-4
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
9:15 AM 10:00 AM
J. Gabriel McGlamery J.D., Director of Commercial Market Strategic Integration
Florida Blue
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
9:15 AM 10:00 AM
Carrie Horn, MSHA, BBA, RN, CCDS, CCDS-O, CPC, CRC, Director Outpatient CDI
Baylor Scott & White Health
Dr. Sunita Varghees, System Vice President of CDI
Baylor Scott & White Health
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
1:00 PM 1:45 PM
12:00 PM 12:45 PM
11:00 AM 11:45 AM
10:00 AM 10:45 AM
Moderator:
Jeannine Bumford, CPC, CRC, Director of Risk Adjustment,
Christus Health
Panelists:
Rafael J. Gonzalez MD, Director of Clinical Coding & Clinical Documentation Integrity
Leon Medical Centers/Leon Health
Shannon Decker, PhD., MBA, MBA, M.Ed., M.Ed., Risk Adjustment Expert, Founder & CEO
VBC One
1:00 PM 1:45 PM
12:00 PM 12:45 PM
11:00 AM 11:45 AM
10:00 AM 10:45 AM
Moderator:
Dr. Ekaette Joseph-Isang, Principal Consultant
Ritebridge
Panelists:
Colleen Gianatasio, Director Clinical Documentation Integrity and Coding Compliance
Capital District Physician’s Health Plan (CDPHP)
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, Chief Operating Officer,
First Class Solutions, Inc.
1:45 PM 2:45 PM
12:45 PM 1:45 PM
11:45 AM 12:45 PM
10:45 AM 11:45 AM
Commonwealth 1-4
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
2:45 PM 3:30 PM
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
Danielle Kopetman, Associate Solutions Consultant
Episource
Caroline Hebron, MPH, Senior Manager, Quality & Risk Adjustment
Cedars-Sinai
2:45 PM 3:30 PM
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
Mark Koransky FSA, MAAA, Senior Consulting Actuary
Wakely Consulting Group
Laura Sheriff, RN, MSN, CPC, CRC
Risk Adjustment Industry Expert
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
3:30 PM 3:45 PM
2:30 PM 2:45 PM
1:30 PM 1:45 PM
12:30 PM 12:45 PM
Leading service providers will showcase their offerings in a quick-pitch setting. Evaluate the latest and greatest tech tools to bring back to your organization.
Nick Volpe, Sales Director – Risk Adjustment
Wolters Kluwer, Health Language
3:30 PM 3:45 PM
2:30 PM 2:45 PM
1:30 PM 1:45 PM
12:30 PM 12:45 PM
3:45 PM 4:15 PM
2:45 PM 3:15 PM
1:45 PM 2:15 PM
12:45 PM 1:15 PM
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Roxanna Cross, Solutions Architect
Reveleer
4:15 PM 5:00 PM
3:15 PM 4:00 PM
2:15 PM 3:00 PM
1:15 PM 2:00 PM
Moderator:
Andrew Lockhart, CEO,
Fathom
Panelists:
Carrie Horn, MSHA, BBA, RN, CCDS, CCDS-O, CPC, CRC, Director Outpatient CDI
Baylor Scott & White Health
Dr. Sunita Varghees, System Vice President of CDI
Baylor Scott & White Health
RaeAnn Grossman
Medicare Advantage Industry Expert
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
5:00 PM 5:45 PM
4:00 PM 4:45 PM
3:00 PM 3:45 PM
2:00 PM 2:45 PM
Megan Zakrewsky, Vice President, Clinical Data Exchange
Veradigm
Karen Bowers, RHIA, CCS, CPC, Director Risk Management
American Health Plans
5:00 PM 5:45 PM
4:00 PM 4:45 PM
3:00 PM 3:45 PM
2:00 PM 2:45 PM
Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP, Director Risk Capture, Population Health Management
Mass General Brigham
5:45 PM 6:45 PM
4:45 PM 5:45 PM
3:45 PM 4:45 PM
2:45 PM 3:45 PM
Commonwealth 1-4
Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.
9:00 AM 12:00 PM
8:00 AM 11:00 AM
7:00 AM 10:00 AM
6:00 AM 9:00 AM
Commonwealth Prefunction
9:00 AM 2:30 PM
8:00 AM 1:30 PM
7:00 AM 12:30 PM
6:00 AM 11:30 AM
Commonwealth 1-4
9:00 AM 10:00 AM
8:00 AM 9:00 AM
7:00 AM 8:00 AM
6:00 AM 7:00 AM
Commonwealth 1-4
10:00 AM 10:10 AM
9:00 AM 9:10 AM
8:00 AM 8:10 AM
7:00 AM 7:10 AM
Commonwealth 5
Deb Curry, MBA, RHIA, CCS-P, CRC, Risk Adjustment Programs Director
Medical Mutual
Laura Sheriff, RN, MSN, CPC, CRC
Risk Adjustment Industry Expert
10:10 AM 10:55 AM
9:10 AM 9:55 AM
8:10 AM 8:55 AM
7:10 AM 7:55 AM
Commonwealth 5
Hear insights directly from the OIG on areas of risk to be mindful of and what to anticipate coming down the pike.
Jacqualine N Reid PhD, Team Leader/Social Science Analyst
HHS/OIG/Office of Evaluation and Inspections
11:00 AM 11:45 AM
10:00 AM 10:45 AM
9:00 AM 9:45 AM
8:00 AM 8:45 AM
Commonwealth 5
Max Voldman, Partner
Whistleblower Partners
Jason N. Silberberg, Esq., Partner
Frier Levitt
11:45 AM 12:15 PM
10:45 AM 11:15 AM
9:45 AM 10:15 AM
8:45 AM 9:15 AM
Commonwealth 1-4
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
9:15 AM 10:00 AM
Moderator
Alan Crop, Vice President of Sales
Innovihealth
Panelists
Jeannine Bumford, CPC, CRC, Director of Risk Adjustment
Christus Health
Yenney Orosa CPC, CPMA, CRC, CDEO, CPCO, AHCCA, Director, ACO Risk Coding, Billing & Revenue Cycle Management
American Choice Healthcare
12:15 PM 1:00 PM
11:15 AM 12:00 PM
10:15 AM 11:00 AM
9:15 AM 10:00 AM
Moderator:
John Criswell, Founder, CEO, and Chairman
Porter
Panelists:
Jennifer Hawkes CPC, CRC, Manager, Member Engagement
Blue Cross of Idaho
Helen L. Veet, DNP, RN, Director of Quality Manager ACP and KF – PA Medicaid
AmeriHealth Caritas Pennsylvania
Keystone First
Mark Bigelow, VP, Risk Adjustment
Cambia Health Solutions
Deb Curry, MBA, RHIA, CCS-P, CRC, Risk Adjustment Programs Director
Paramount Insurance Company
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
1:00 PM 1:45 PM
12:00 PM 12:45 PM
11:00 AM 11:45 AM
10:00 AM 10:45 AM
Deb Curry, MBA, RHIA, CCS-P, CRC, Risk Adjustment Programs Director
Paramount Insurance Company
Rose T. Dunn, MBA, RHIA, CPA, FACHE, FHFMA, Chief Operating Officer,
First Class Solutions, Inc.
1:00 PM 1:45 PM
12:00 PM 12:45 PM
11:00 AM 11:45 AM
10:00 AM 10:45 AM
Chris Trygstad, Vice President, Product
Biomedix
Ava Johnson, Associate Director, Ambulatory CDQI
Mount Sinai Hospital, NYC
1:45 PM 2:30 PM
12:45 PM 1:30 PM
11:45 AM 12:30 PM
10:45 AM 11:30 AM
Commonwealth 1-4
Track A Location: Commonwealth 5
Track B Location: Commonwealth 7-8
2:30 PM 3:15 PM
1:30 PM 2:15 PM
12:30 PM 1:15 PM
11:30 AM 12:15 PM
Moderator
Jeannie Hennum, Vice President of Health Plan Performance
Verisma
Panelists
Marilee Klock, MBA, CPC, CRC, Senior Director, Diagnosis Accuracy Program
GuideHealth
Kaitlin Sebourn, Senior Manager of Clinical Programs
DaVita Integrated Kidney Care
Leigh Anne Harmon, Manager of Clinical Documentation Integrity
DaVita Integrated Kidney Care
2:30 PM 3:15 PM
1:30 PM 2:15 PM
12:30 PM 1:15 PM
11:30 AM 12:15 PM
Moderator
Ryan Dodson, CRC, Risk Adjustment Consultant,
Choice Medical Group
Panelists
Kaitlyn Brack, BSHIIM, CPC, CEMC, CFPC, CPEDC, AAPC Approved-Instructor
Coding Auditor-Educator
Baptist Health Deaconess Madisonville
Tiffany Ferguson, LMSW, CMAC, ACM
Healthcare Industry Specialist
Adjunct Professor,
Northern Arizona University