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RISE Risk Adjustment Forum
November 17-19, 2024
Louisville, KY

Agenda

Sunday - November 17, 2024

9:30 AM 6:15 PM

8:30 AM 5:15 PM

7:30 AM 4:15 PM

6:30 AM 3:15 PM

Registration Desk Open

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

Networking Breakfast for Pre-Conference Workshop Attendees

Commonwealth 6-7-8 Foyer

Additional Registration Required

Full Day Pre-Conference Workshops 10:30 AM - 6:00 PM 9:30 AM - 5:00 PM 8:30 AM - 4:00 PM 7:30 AM - 3:00 PM

Additional Registration Required

Lunch for Pre-Conference Workshop A & B Attendees: 1:00PM - 1:30PM 

Track Chairs:

10:30 AM 6:00 PM

9:30 AM 5:00 PM

8:30 AM 4:00 PM

7:30 AM 3:00 PM

Workshop A

Workshop A - Risk Adjustment Practitioner

Commonwealth 6

Additional Registration Required

  • The essentials of and differences between Medicare Advantage, Commercial and Medicaid risk adjustment  
  • Understanding how risk scores are calculated  
  • Making sense of varying payment models  
  • An intro into using data and predictive analytics to optimize your risk adjustment practices  
  • Tools for achieving data accuracy  
  • Where do we stand with the transition from RAPS to EDS? The latest in a long journey  
  • Provider engagement strategies that will impact your risk adjustment initiatives  
  • Risk adjustment vendor selection and management  
  • Determining whether you need RA vendors  
  • How do you effectively vet potential vendors and ultimately select them?  
  • Strategies for on-going, thorough vendor management  
  • The future of risk adjustment – what you need to know to stay ahead of possible changes  
  • Initial steps for preparing for a RADV audit  
  • Which staff is essential to overseeing your RADV audit prep?  
  • Staying ahead – key items to monitor well in advance of an actual audit  

 

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

Workshop B

Workshop B - Advanced HCC Auditor

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   

  • Understanding the financial overlay – HCC codes mapping to risk adjustment scores   
  • A single coding and documentation process for  
  • Risk adjustment   
  • Skill development on choosing diagnoses from portions of the encounter – permitted and not permitted   
  • Clinical documentation barriers for risk adjustment purposes (data validation audit risks)  

 

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  

Half Day Pre-Conference Workshop 10:30 AM - 2:00 PM 9:30 AM - 1:00 PM 8:30 AM - 12:00 PM 7:30 AM - 11:00 AM

Additional Registration Required

Track Chairs:

10:30 AM 2:00 PM

9:30 AM 1:00 PM

8:30 AM 12:00 PM

7:30 AM 11:00 AM

Workshop C

Workshop C - You’ve Been Selected! Prepare your RADV Audit Team for a Seamless Audit

Commonwealth 8

Additional Registration Required

  • Assess CMS changes to RADV Extrapolation that has the potential to financially damage your organization 
  • Identify key stakeholders that will be part of your RADV Audit team 
  • Utilize sample audits on a quarterly basis to prepare your team for a successful CMS RADV Audit 
  • Review coding accuracy to identify opportunities for coding education and eliminate errors that may lead to a RADV Audit 
  • Assess different approaches for preparation for an audit based on the size of your organization 

 

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

Networking Cocktail Reception for All Conference Attendees

Location: Commonwealth 1-4

Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.  

Monday - November 18, 2024

9:00 AM 5:45 PM

8:00 AM 4:45 PM

7:00 AM 3:45 PM

6:00 AM 2:45 PM

Registration Desk Open

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

Exhibit Hall Open

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

Networking Breakfast

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

Welcome Remarks

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

Keynote: Unpack the Results of the 2024 Election

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

Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Update

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

Networking Break

Commonwealth 1-4

Concurrent Sessions 12:15 PM - 1:00 PM 11:15 AM - 12:00 PM 10:15 AM - 11:00 AM 9:15 AM - 10:00 AM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

Track A: Risk Adjustment Excellence

ACA Risk Adjustment Update and Projections

  • Hear about the challenges and changes to ACA risk adjustment for 2025 and 2026
  • Assess how states can compensate for inaccurate or inadequate risk adjustment transfers
  • Analyze the issues with the ACA RADV process and how to fix them
  • Generate new ideas to better understand and explain the differences between ACA and MA risk adjustment

 

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

Track B: Compliant Coding

Strategies to Identify Discrepancies in Coding

  • Implement AI tools to target areas for both increased accuracy of Risk adjustment and increased staffing efficiencies 
  • Enhance current workflows to help capture identified opportunities
  • Understand the impact of these interventions on your population 

 

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 

Concurrent Sessions 1:00 PM - 1:45 PM 12:00 PM - 12:45 PM 11:00 AM - 11:45 AM 10:00 AM - 10:45 AM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

Track A: Risk Adjustment Excellence

Impact and Implications of the Transition to V28

  • Assess the impact of the transition from V24 to V28 model on risk adjustment coding
  • Evaluate the success of a clinically driven approach to closing gaps and improving risk adjustment code capture
  • Comprehend the importance of accurate prospective and concurrent provider review of chronic diseases and disease progression

 

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

Track B: Compliant Coding

OIG Audit Review and Preparation Tactics

  • Explore recent findings from OIG audits to identify common fraudulent activities that are being identified to mitigate risk
  • Examine the OIG toolkit, and how it can help prepare your organization to better understand OIG’s objectives
  • Educate your audit response team to have an understanding of what to expect when experiencing an OIG audit

 

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

Networking Lunch

Commonwealth 1-4

Concurrent Sessions 2:45 PM - 3:30 PM 1:45 PM - 2:30 PM 12:45 PM - 1:30 PM 11:45 AM - 12:30 PM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

2:45 PM 3:30 PM

1:45 PM 2:30 PM

12:45 PM 1:30 PM

11:45 AM 12:30 PM

Track A: Risk Adjustment Excellence

Leverage Data to Generate Informed Organizational Decisions

  • Assess the value of capitalizing on valuable data for decision-making to enhance your risk adjustment efforts
  • Analyze which data sets should be reviewed to help guide leadership in the decision-making process
  • Explore solutions available to help collect and streamline data to improve organizational approaches to risk adjustment

 

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

Track B: Compliant Coding

Part D Risk Adjustment Spotlight

  • Discuss expanded importance of Part D Risk Adjustment following significant changes from the Inflation Reduction Act (IRA)
  • Review differences between the Part C and Part D Risk Adjustment Models
  • Examine risks and opportunities of Part D Risk Adjustment on overall Plan financial performance

 

Mark Koransky FSA, MAAA, Senior Consulting Actuary  

Wakely Consulting Group 

 

Laura Sheriff, RN, MSN, CPC, CRC 

Risk Adjustment Industry Expert  

 

Concurrent Sessions 3:30 PM - 3:45 PM 2:30 PM - 2:45 PM 1:30 PM - 1:45 PM 12:30 PM - 12:45 PM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

3:30 PM 3:45 PM

2:30 PM 2:45 PM

1:30 PM 1:45 PM

12:30 PM 12:45 PM

Track A: Risk Adjustment Excellence

Tools & Technology Spotlights

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

Track B: Compliant Coding

Transition to Networking Break

3:45 PM 4:15 PM

2:45 PM 3:15 PM

1:45 PM 2:15 PM

12:45 PM 1:15 PM

Networking Break

Concurrent Sessions 4:15 PM - 5:00 PM 3:15 PM - 4:00 PM 2:15 PM - 3:00 PM 1:15 PM - 2:00 PM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

4:15 PM 5:00 PM

3:15 PM 4:00 PM

2:15 PM 3:00 PM

1:15 PM 2:00 PM

Track A: Risk Adjustment Excellence

Autonomous Risk-Adjustment Coding: Rethink Your Approach to Risk and Quality: Combine for Improved Measures

  • Assess the value of combining efforts for accurate capture of data to positively impacting risk and quality measures 
  • Create a true understanding of patient health care needs through data interoperability 
  • Identify solutions that can assist in improving patient health care outcomes, quality measures, and risk scores 
  • Experts share best practices and lessons learned 

 

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

Track B: Compliant Coding

The Next Frontier for Completeness, Accuracy, & Speed

  • Understand the latest developments in risk-adjustment coding technology, from yesterday's NLP to today's deep-learning AI
  • Assess opportunities to increase completeness, specificity, and accuracy to find missing HCCs and advance coding integrity
  • Measure the operational impact of deep-learning AI for RA coding, based on real case studies

 

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 

Concurrent Session 5:00 PM - 5:45 PM 4:00 PM - 4:45 PM 3:00 PM - 3:45 PM 2:00 PM - 2:45 PM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

5:00 PM 5:45 PM

4:00 PM 4:45 PM

3:00 PM 3:45 PM

2:00 PM 2:45 PM

Track A: Risk Adjustment Excellence

Diversify Your Care Gap Closure Strategy

  • Utilize data and predictive modeling to identify gaps in care than need to be addressed
  • Avoid missed opportunities through coding review and utilize data to create an accurate risk score
  • Identify tools and solutions available to help close gaps in care and calculate which one is the best fit for your organization

 

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

Track B: Compliant Coding

RADV Extrapolation Changes Impacting Audits

  • Examine the changes to extrapolation and how they can financially damage your organization 
  • Assess CMS approach to RADV audits and how they calculate an extrapolated amount to be reimbursed 
  • Create and implement documentation review to identify potential costly errors prior to being selected for a RADV audit 

 

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

Networking Cocktail Reception

Commonwealth 1-4

Join us for drinks, hors d’oeuvres, and face-to-face networking with peers.

Tuesday - November 19, 2024

9:00 AM 12:00 PM

8:00 AM 11:00 AM

7:00 AM 10:00 AM

6:00 AM 9:00 AM

Registration Desk Open

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

Exhibit Hall Open

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

Networking Breakfast

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

Welcome Remarks and Day One Takeaways

 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

OIG Update - Health Risk Assessments and Chart Reviews

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

Panel: The Current State of RA Litigation and Risk Areas for MA Plans, Physician Groups, Vendors and Downstream Entities

Commonwealth 5

  • Hear about new developments in various FCA litigations, OIG audits, and other regulatory activities, with focus on what sorts of activities and fact patterns that the DOJ, as well as courts at the pleading stage, are finding to be plausible violations of the False Claims Act as opposed to fact patterns that are not meeting muster
  • Understand the risks and compliance implications of specific retrospective chart review methods, such as chart “refreshing” and “coding parties,” enabling providers and MAOs to make informed decisions and avoid potential pitfalls
  • Equip yourself with knowledge on the challenges and risks of documenting quality metrics under the Stars program in the post-pandemic era, ensuring your organization remains compliant and efficient in a changing environment
  • Stay informed of some predictions of where the future of fraud litigations related to the MA industry seem to be heading as it relates to Risk Adjustment and Star Ratings

 

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

Networking Break

Commonwealth 1-4

Concurrent Sessions 12:15 PM - 1:00 PM 11:15 AM - 12:00 PM 10:15 AM - 11:00 AM 9:15 AM - 10:00 AM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

12:15 PM 1:00 PM

11:15 AM 12:00 PM

10:15 AM 11:00 AM

9:15 AM 10:00 AM

Track A: Risk Adjustment Excellence

Build, Grow, and Retain a Successful Risk Adjustment Team

  • Explore the process of identifying, hiring, and developing valuable members of your risk adjustment team 
  • Implement policies and procedures to ensure collaboration between all team members to achieve organizational success 
  • Identify tactics to retain valuable employees to avoid disruption and help with organizational growth 

 

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

Track B: Member Engagement & Retention

Putting Members First: A Member-Centric Approach for Health Care Improvement

  • Hear different approaches to member engagement
  • Discuss best practices to integrate analytics for member-centric solutions to reach targeted goals
  • Identify new approaches to remove silos to better connect with members while navigating CMS compliance requirements

 

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   

 

Concurrent Sessions 1:00 PM - 1:45 PM 12:00 PM - 12:45 PM 11:00 AM - 11:45 AM 10:00 AM - 10:45 AM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

1:00 PM 1:45 PM

12:00 PM 12:45 PM

11:00 AM 11:45 AM

10:00 AM 10:45 AM

Track A: Risk Adjustment Excellence

The Trickle-Down Effect of Data Security Breaches

  • Analyze current cases of data security breaches and the impact it has had on the health care industry
  • Explore best practices and protocols to avoid costly mistakes with important confidential data
  • Discuss the impact of current data breaches on information sharing and interoperability

 

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

Track B: Member Engagement & Retention

Enhancing Health Outcomes with V28

  • Understand the Risks of Misdiagnosed Vascular Disease: Learn about the common misdiagnoses of vascular disease and their impact on patient outcomes. 
  • Implement Effective Documentation Practices: Discover actionable strategies for accurate diagnosis coding and documentation to improve patient care and financial performance
  •  Optimize opportunities in V28 risk recapture

 

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

Networking Lunch

Commonwealth 1-4

Concurrent Sessions 2:30 PM - 3:15 PM 1:30 PM - 2:15 PM 12:30 PM - 1:15 PM 11:30 AM - 12:15 PM

Track A Location: Commonwealth 5

Track B Location: Commonwealth 7-8

Track Chairs:

2:30 PM 3:15 PM

1:30 PM 2:15 PM

12:30 PM 1:15 PM

11:30 AM 12:15 PM

Track A: Risk Adjustment Excellence

Coding and Documentation Excellence

  • A comprehensive insight into coding and documentation best practices and practical coding of major conditions to reflect accurate risk adjustment
  • Discuss risk eligibility of CPT codes and how to navigate provider visits to improve point of care coding
  • Evaluate codes that have the ability to impact quality measures such as SDoH codes and advanced illness and frailty codes, and diagnosis codes that drive care management services

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

Track B: Member Engagement & Retention

Case Management to Improve Risk Adjustment

  • Understand how risk adjustment can be used to drive case management
  • Assess the value of case management on reduction of hospital admissions and unnecessary costs
  • Analyze which specialists need to be part of your case management team to improve health care and risk adjustment outcomes

 

 

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

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