
Angie Fedderson
AVP of Payment Integrity
SelectHealth

Sean Ryder
Value Based Program Manager
Blue Cross Blue Shield of Arizona
101 for modernization of each step of the claims continuum. 8 separate discussion across:
- Itemized Bill Reviews
- DRG Validations
- Claim Receipts
- Clinical Review
- Provider Reviews
- Resolutions
- Formal Appeal
- The Changing World Of Payment Integrity As It Relates To VBC
- Implementing various strategies to encourage appropriate utilization of emergency outpatient facilities, such as: network management, preauthorization and utilization reviews, promoting alternative care settings, and investing in care coordination programs to prevent unnecessary readmissions.
- A look to how data analytics can be leveraged to identify patterns of overbilling or potential fraud within emergency outpatient facilities
Track 1: Payment Integrity