- Strengthening payer-provider relationships through improved communication around claims adjudication, providing transparency into denials, accelerating payments, automating data exchange, and reassessing denial
reversals
Payment Integrity
Revenue Integrity
Join us for an engaging panel discussion featuring a lineup of industry experts as they tackle pressing questions at the intersection of health plan payment integrity and hospital revenue integrity. Discover the challenges and solutions in achieving payment accuracy and delve into the potential of collaboration and data sharing between health plans and hospitals. Explore critical topics, including the impact of payment inaccuracies on financial health, the role of technology and automation, navigating regulatory complexities. Gain insights into measuring success and envision the future of payment integrity in healthcare. Don't miss this opportunity to be part of a dynamic conversation that could reshape the healthcare landscape. Join us as we challenge conventional wisdom and seek innovative solutions to drive payment accuracy forward.
Payment Integrity
Revenue Integrity
Ritesh Ramesh
Chief Executive Officer
MDAudit
Conor McCauley
Director, Payment Integrity Clinical Capabilites
Highmark Health
My name is Conor McCauley. I am the Director of Payment Integrity Clinical Capabilities at Highmark. Being a Critical Care nurse, it is easy to see there are issues surrounding healthcare funding. Inserting clinical insights into reimbursement methodologies can lead to affordability and improved patient outcomes. Clinicians are well positioned to make a difference here. My passion is developing an engaged team, effective processes, and surrounding clinicians with the right technology, data, and market insights so they can work at the top of their licensure.
Dave Cardelle
Chief Strategy Officer
AMS
AMS Intelligent Analytics
Website: http://www.amspredict.com/
Advanced Medical Strategies (AMS) is the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.
Nyakio Grieco
Co-Founder & Founder
Thirteen Lune & Relevant
Brooke Switzer
Director, Global Public Policy
iHerb
Brooke Switzer is the Director, Global Public Policy at iHerb where she delivers the strategic direction for government relations, industry affairs, and public policy. She currently leads the public policy team on a variety of U.S. and international regulatory matters across a range of topics including accessible health and nutrition, e-commerce, digital services, ESG, and cross-border trade. Brooke is an international relations and public affairs specialist with over 20 years of experience developing strategic communications and advocacy campaigns for the private sector, nonprofit foundations, and trade associations. Brooke is pursuing a doctorate of law and policy from Northeastern University in Boston, Massachusetts, and holds an MBA from Lynn University in Boca Raton, Florida, and Bachelors of Business Administration from John Carroll University in Cleveland, Ohio.
Tim Gerke
President
Allergy Research Group
Tim Gerke is a noteworthy leader of positive disruption who specializes in strategies harmonizing people, process, and technology to take organizations to the next level in growth and profitability. With a passion to drive success for all stakeholders in human and animal health, Tim loves innovating business strategies that focus on an overall proactive approach in making sustainable health a centerpiece to a better world.
Tim has over 25 years of successful execution on this mission in executive and leadership roles with Fortune 500 companies like Bayer and Deloitte, preparing him to be a dynamic change agent for small to mid-size companies hungry to strengthen their position in the marketplace. In the last decade Tim has led the repositioning, rebuilding, and turnaround of several companies who were then sold in premium transactions to private equity including FoodScience with the DaVinci, VetriScience, and Pet Naturals brands sold to Wind Point Partners, Clinics Choice as part of the VetsPlus , Inc sold to DW Healthcare Partners, and most recently rejuvenating the Allergy Research Group, Nutricology, NutriLink and Clinical Education, UK to be sold as an attractive portfolio to WM Partners. Tim has partnered with numerous companies to reorganize sales and marketing strategy and leadership development, while also consulting to update and clear regulatory hurdles for several contract manufacturers for both pharmaceutical and nutraceutical products.
Tim is a sought-after speaker for organizations, groups, associations, and non-profits because of his innovative strategies for building effective leadership and culture. Tim has facilitated hundreds of forums on critical human skills such as trust, emotional intelligence, change management, conflict resolution, and effective communication.
Tim is committed to finding the next innovations that will advance the cause of optimal health for a world in need.