Small Group Discussions of Real-Life AI Use cases
Presentation on AI use cases and success stories for your implementation
Break out groups to discuss health plans' strategies and feedback to the wider group
Michael Devine
Stephanie Sjogren
Stephanie Sjogren is a director of coding and provider reimbursement, working with payment integrity to ensure proper claims adjudication and to prevent fraud, waste, and abuse. Prior to joining ConnectiCare/EmblemHealth, she performed provider audits and education at a women’s healthcare group. Sjogren has also worked with physicians and staff to integrate and use electronic health record systems effectively and to stay in compliance with the Centers for Medicare & Medicaid Services’ rules and regulations. Her areas of specialty are payment integrity, auditing, and clinical documentation improvement.
Josh Miller
Matt Akromis
Discussion around where artificial intelligence has beneficial uses and where human expertise is necessary to achieve results- with a specific focus on complex claim review
Ceris Health
Website: https://www.ceris.com/
CERIS has 30 years of prepay and post pay claim review and repricing experience with a 97% client retention rate. Our solutions are deep, consistent, and defensible reviews, which make CERIS the partner of choice for health plans, Medicare and Medicaid plans, and third-party administrators. CERIS’ longstanding review services and clinical expertise offer incremental value and are grounded in a sincere dedication to our valued partners. CERIS' mission is to continue to grow and deliver long term Payment Integrity services for our partners and to help them save.
Identify how contract language can be altered to ensure you limit unnecessary payments and save money “indirectly"
Meet interoperability requirements and ensure EHR exchange is efficient for appropriate patient care and timely coverage decisions