Medical Cost Containment
Kersten Schmahl
Senior Director Ethics & Compliance Intercontinental
CSL Behring
Kersten Schmahl is Senior Director Ethics & Compliance Intercontinental at CSL, a global listed biotech company. He previously held various international Ethics & Compliance leadership positions with both listed and privately-held pharmaceutical, biotech and medical technology companies being based in Germany, Switzerland, and Sweden.
Kersten graduated from the University of St. Gallen, Switzerland, and Leuphana University in Luneburg, Germany. At the latter University, he has teaching assignments for Compliance & Investigations in Corporate Practice since 2009. Kersten is also a standing co-author for the chapter “Compliance in the Pharmaceutical & Medical Technology Industry” in the Handbook of Corporate Legal Management – Manual for Corporate Compliance in Germany.
Helen Alridge
Chief Integrity and Compliance Officer
VW Passenger Cars
Medical Cost Containment
Payment Integrity
Healthcare Fraud Shield
Website: https://www.hcfraudshield.com/
Healthcare Fraud Shield specializes in fraud, waste, abuse, and error detection and payment integrity for healthcare payers nationally by efficiently stopping claims prior to payment using utilizing post-payment advanced analytics and artificial intelligence insights. We save health plans millions annually incremental to existing pre-payment processes using our unique and proven approach. HCFSPlatform™ offers the combination of targeted rules, artificial intelligence, shared analytics across multiple payers resulting in higher ROI (up to 20:1) compared to other vendors. HCFSPlatform™ software was developed by industry leading healthcare subject matter experts and is a component of over 60+ clients’ including 7 of the 10 largest commercial insurers in the US. Our client satisfaction rating is exceptional with a net promoter score of 84 and client retention rate over 95%. HCFSPlatform™ – is a fully integrated platform consisting of PreShield (prepayment), AIShield (AI), PostShield (post-payment), RxShield (pharmacy analytics), Shared Analytics, QueryShield (ad hoc query and reporting tool), CaseShield (case management), HCFSAudit, and medical record retrieval.
Medical Cost Containment
Medical Cost Containment
Medical Cost Containment