What does a health plan actually gain when it moves from random sampling DRG claims to smart triaging them? Horizon's Ron Jones and Alaffia's TJ Ademiluyi discuss the answer: shorter review cycles, a stronger case for bringing DRG review in-house, and a rigorous test of the approach against sepsis DRG, one of the more contested determinations in claims review.
In partnership with Alaffia Health
Speaker(s):
Moderator
Ryan Everist
VP Growth
Alaffia Health
Panelists
TJ Ademeluyi
CEO
Alaffia Health
Ron Jones
Senior Director Payment Integrity
Horizon Blue Cross Blue Shield of New Jersey
Time:
10:00am
Session Type:
Panel
Force Inline Description:
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