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4th Annual HCC Best Practices for Proactive Medical Management


From Generalities to Interventions to Outcomes
April 2013
TBA
Jacksonville, FL
United States

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Conference Details
We are pleased to announce we will be returning to Jacksonville for our 4th Annual HCC Best Practices conference. This conference will build on the success of the 2011 and 2012 conferences while providing practical, timely updates to help you continue to evolve your medical management practices with sound HCC coding.
Rave Reviews from the Inaugural Event:
"I attended the conference in Jacksonville last week and I have to say it was the best one so far! You did an awesome job with the whole program!!"
-- Donna Kober, Director of QA, COVENTRY HEALTH

"I enjoyed the conference -- you did a great job!"
-- Samuel Heller, Sr. Vice President and CFO, VISITING NURSE SERVICE OF NEW YORK

"This conference turned out to be an excellent program. Lots of health plan attendees. Good speakers. Good informal chat time. I came back with lots of good tips and follow up items."
-- Kevin Mowll, Vice President, Medicare Products, CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN

More Testimonials
Who Will Attend:
This event has been designed specifically for executives from health plans and physicians groups, specifically:

Chief Executive Officers
Chief Compliance Officers
Chief Financial Officers
Chief Medical Officers
Chief Operating Officers
HCC Specialists
HCC Risk Management

Vice Presidents, Directors, Managers and Analysts of:
  • Risk Adjustment
  • Enrollment
  • Revenue Management and Analysis
  • Medical Management
  • Utilization Management
  • Reconciliation
  • Finance
  • Accounting
  • Medicare
  • Quality
  • Compliance
  • Senior Products
  • Government Programs
  • Product Development
  • Special Needs Plans
  • Medicare Part D Plans
The conference will also appeal to:
  • Third-party administrators
  • Pharmacy Benefits Managers
  • Disease Management Companies
  • Technology companies
  • Government representatives
  • Public policy experts
Hotel Info:
TBD
Conference Registration Prices:
Early Bird Rate
Standard Rate
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
First 100 FREE
$995
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995
Service Providers
$1895
Register Now!
Group Discounts:
Register 3 people and receive 10% off ***
Register 4 people and receive 15% off ***
Register 5 people or more and receive 20% off ***

If you'd like to be invoiced, please submit your contact details on the registration page and select "Please invoice me" at the bottom of the page.

If you are interested in sponsorship, exhibiting, or speaking opportunities, please call 212-532-9898 or email information@opalevents.org
* TERMS & CONDITIONS
Subject to approval. To qualify you must be currently employed by a non-vendor company. Eligibility will be verified by conference producer. Opal reserves the right to allocate places and to refuse applications.

* Health plans must be CMS approved as Medicare, Medicare Advantage or Medicaid health plans

***Registrations must be made online on the same date. Discount will be applied after all registrants have been received.

Registration price reflects $100 online discount
Untitled Document
2012 Attendees
CEO, Access Health Care Physicians
Vice President, Accountable Care Associates
COO, AE & Associates
Health Facility Surveyor, Agency for Healthcare Administration Florida
Client Ratlions/Regional Sales, Altegra Health
Director of Business Development, Altegra Health
Executive VP & Chief Sales Officer, Altegra Health
VP-Sales & Marketing, Altegra Health
VP, Physician Services Organization, Altus Healthcare Management Services
Director, Coding and Classification, American Hospital Association
Director, Deliver System Initiatives, Arizona Priority Care Plus
VP of Business Development, Best Doctors
Consultant LA, BlueCross BlueShield of Florida
Director, BlueCross BlueShield of Florida
Director, BlueCross BlueShield of Florida
Network Design and Strategy Consultant, Blue Cross Blue Shield of Florida
Provider Educator, Blue Cross Blue Shield of Florida
Senior Director, Medicare, BlueCross BlueShield of Florida
Senior Manager, Blue Cross Blue Shield of Florida
Sr. Manager Analyst, Blue Cross Blue Shield of Florida
Specialist llla - Provider Audit, Blue Cross Blue Shield of Florida
Vice President, BlueCross BlueShield of Florida
VP, BlueCross BlueShield of Florida
Senior Medical Director, Government Programs, Blue Cross Blue Shield of Minnesota
Coding Analyst, Buckeye Community Health Plan
Financial Analyst, Capital Health Plan
Medical Records Supervisor, Capital Health Plan
Vice President, Finance, Centene Corporation
Director of Quality Improvement, Central Florida Inpatient Medicine
Clinical and Coding Specialist, Central Health Plan of California
Business Development & Operations Director, Chinese Community Health Plan
HCC Auditor, Citizens Choice Healthplan
HCC Manager, Citizens Choice Healthplan
Senior HCC Manager, Risk Adjustment / Reimbursement, Citizens Choice Healthplan
CAO, Clark & Daughtrey
Manager, CLSC
President, CLSC
Coding PI
CEO, Columbus Clinic
Clinical Technology Manager, Community Hospice of NE Florida
IT Director, Community Hospice of NE Florida
Patient Accounting Manager, Community Hospice of NE Florida
Network Services Supervisor, Community Hospice of NE Florida
Risk Manager, Community Hospice of NE Florida
Director, Client Services, Coventry Healthcare
Director, Operation Support, Coventry Healthcare
Director, Provider Finance, Coventry Healthcare
V.P. IT Development, Coventry Healthcare
Data Analyst, Desert Oasis Healthcare
Director of Coding Services, Desert Oasis Healthcare
Lead Medicare Audit Specialist, EmblemHealth
National Sales Manager, EMSI
RVP, Managed Markets, Epocrates
ARNP, Evercare
ARNP, Evercare
Associate Medical Director, Family Physicians Group
Billing Manager, Family Physicians Group
Business Analyst, Family Physicians Group
Chief Medical Officer, Family Physicians Group
Clinical Operations Executive Assistant, Family Physicians Group
Complex Case Management, Family Physician Group
EMR/MRA, Department Director, Family Physicians Group
FPG-MRA Tampa Area Team Leader, Family Physicians Group
Founder and President of Clinical Affairs, Family Physicians Group
Medicare Risk Adjustment, Family Physicians Group
Medicare Risk Adjustment, Family Physicians Group
Medicare Risk Adjustment, Family Physicians Group
Director Risk Management, Flagler Hospital
Risk Manager, Flagler Hospital
Benefit Plans and Coding Manager, Florida Health Care Plans
Senior Auditor/Analyst, Florida Health Care Plans
Senior Coordinator Coding/Training, Florida Health Care Plans
Application Analyst, Florida Hospital GME
Assistant Director, Florida Hospital GME
Certified Coding/Reimbursement Auditor, Florida Hospital GME
Practice Manager, Florida Hospital GME
Executive Director, Florida Society of Clinical Oncology
Administrator, Florida Sports and Family Medicine
MRA/HCC Analyst/Certified Coder, Florida Sports and Family Medicine
MRA/HCC Analyst/Certified Coder, Florida Sports and Family Medicine
MRA/HCC Analyst/Certified Coder, Florida Sports and Family Medicine
Practice Manager, Florida Sports and Family Medicine
VP of Medicare Revenue Management, Freedom Health Inc.
Community Support, Friendship Community Care, Inc.
MIS Director, Friendship Community Care, Inc.
MIS Director, Friendship Community Care, Inc.
Mgr. Budgeting and Analysis, Gateway Health Plan
VP for Medicare, Gateway Health Plan
CPC, Sr. Coding Coordinator Risk Management, Geisinger Health Plan
Chief Medical Director, HealthCare Partners Medical Group of California
Associate Risk Adjustment Analyst, Health First Health Plans
Associate Risk Adjustment Analyst, Health First Health Plans
Lead Risk Adjustment Analyst, Health First Health Plans
RA Data Reporting Coordinator, Health First Health Plans
Risk Adjustment Analyst, Health First Health Plans
RISK Revenue Specialist, HealthNow NY
Practice Manager, Health Specialists of Central Florida
Coding Quality Analyst, HealthSpring
Sr. Special Projects Manager, Revenue Cycle, HIM Professional Excellence
Medical Director, Humana
Medicare Risk Adjustment Director, Humana
Sr. Director of Coding/Billing, Interamerican Medical Center
VP of HS and Member Services, Inter Valley Health Plan
Medicare Risk Adjustment Manager, Island Doctors
HCC Coder Compliance Apprentice, Kelsey Care Advantage Health Plan
HCC Coding Compliance Specialist, Kelsey Care Advantage Health Plan
Manager KCA Coding Compliance, Kelsey Care Advantage Health Plan
Sr. Clinical Training Specialist, Leprechaun
Utilization Coordinator, MAPFRE Life Insurance Company
Vice President, Martin Health System
Executive Vice President, Matrix Medical Network
MD, SVP, Matrix Medical Network
Mgr - Patient Financial Services, Mayo Clinic
PFS Systems Analyst III, Mayo Clinic
Report Developer, Mayo Clinic
Supervisor Coding, Mayo Clinic
Systems Analysis III, Revenue Cycle, Mayo Clinic
System Analyst III, Mayo Clinic
Conference Coordinator, MedAssurant
MRA Manager, Medica Healthcare Plans
MRA Manager, Medica Healthcare Plans
MRA Manager, Medica Healthcare Plans
Billing Assistant, Medical Office of Dr. David T Sicard
LPN, Metcare of Central Florida
M.D., Metcare of Central Florida
MRA Liaison , Metcare of Central Florida
Director of Operations, MetroHealth
MRA Specialist, MetroHealth
MRA Specialist, MetroHealth
Medicare Risk Adjustment Manager, Metropolitan Health Networks
CEO, Mid Coastal IPA
Director, Medicare Risk Adjustment, Network Health Plan
Manager, Risk Adjustment, Network Health Plan
Director, Technology Policy Department, New York Presbyterian Hospital
Billing Specialist, North Florida Ob-Gyn Associates PA
EMR Coordinator, North Florida Ob-Gyn Associates PA
EMR Coordinator, North Florida Ob-Gyn Associates PA
Nurse Practitioner, Optum Health
Director of Utilization Management & Case Management, Pacific Health Corp.
Project Manager, Paradigm Health IPA
CEO & Chief Medical Officer, Parses
Provider Relations Manager, Physicians Alliance Corp
Chief Executive Officer, Physicians of Southwest Washington
Coding Consultant, Physicians of Southwest Washington
Director Network Management, Physicians United Plan
Sr. Director, Health Services, Physicians United Plan
Vice President of Health Services and IT, Physicians United Plan
CDI Specialist, Preferred Care Partners
Internal Medicine/Geriatric, Prime Aging
CEO, Primary Care Associates
Practice Manager, Red Hook Family Practice
HCC Risk Adjustment Manager, Riverside Physician Network
MRA Manager, Simply Healthcare Plans
Director Revenue Cycle, St. Elizabeth & St. Luke Hospitals
Coding Accuracy & Education Specialist, Soundpath Health
Director, Quality Programs, Southwest Medical Associates
Manager, Clinical Applications, Southwest Medical Associates
Project Manager, Tummah Foundation
Quality Assurance Supervisor, United Health Group
Advanced Registered Nurse Practitioner, UnitedHealthcare
Medical Director, UnitedHealthcare
Operations Manager, UnitedHealthcare
Vice President 5010/ICD-10, UnitedHealthcare
Medicare Risk Adjustment Auditor, Universal Health Care
Medicare Risk Adjustment Auditor, Universal Health Care
Manager, UPMC Health Plan
Chief Medical Officer, VNSNY Choice Health Plans
Director, Provider Relations & Network Development, VNSNY Choice Health Plans
Medical Coding Specialist, Wellcare Health Plans
Sr. Coding Specialist, Wellcare Health Plans
Home Health Agency Director, WellMed Medical Management
Medical Coding Advisor, WellMed Medical Management
Chief Informatics Officer, Wenatchee Valley Medical Center
Compliance/Reimbursment Manager, Wenatchee Valley Medical Center
Managed Care Manager, Wenatchee Valley Medical Center
Past Conference Day 1: Tuesday, April 3, 2012
1:30 pm
Chair's Welcome

Co-Chairs:
MD, Chief Medical Officer, CENSEOHEALTH
CEO, INNOVATIVE CLINICAL PARTNERS LLC
1:35 pm
Chair's Welcome, Audience Demographics & Keynote Address:
RAISING THE CLINICAL BAR: TRANSFORMING THE ASSESSMENT INTO A CLINICAL PATHWAY
  • Shifting your focus to the current year: building an assessment program that can impact care right now
  • Addressing lack of specificity and accuracy in member targeting and in your evaluation program execution
  • Focusing on the needs of your chronically ill members: Chronic kidney disease and diabetes
  • Using your evaluation program to positively impact your utilization costs-what can happen when your members understand their care pathway
Speaker:
Chief Medical Officer, CenseoHealth
2:35 pm
Spotlight Session:
The Clinical Impact of ICD-10
  • Impact on the clinicians workflow
  • How does a clinical observation, patient examination or procedure result in the proper ICD-10 coding of that diagnosis or procedure?
  • What if documentation is not adequate to allow for proper coding using ICD-10?
  • How is the patient's medical history affected by ICD-10 coding?
Speaker:
Senior Coordinator Coding/Training, FLORIDA HEALTH CARE PLANS, INC.
3:20 pm
Afternoon Refreshment & Networking Break
3:50 pm
(The Secrets to) Getting More Out of Prospective Assessments than Just an Assessment
  • Improve care coordination
  • Reduce medical costs
  • Improve member retention
  • Better revenue management
Speaker:
MD, MBA, MSCE, Managing Partner, VOJTA AND ASSOCIATES
Made possible by:
MATRIX MEDICAL NETWORK
4:35 pm
Practical Strategies, Practitioner Case Studies:
Developing Provider Motivations for Enhancing HCC Integrity

Case Study 1: Behavioral Health / Medical Integration Best Practice for Improving Quality and HCC Scoring
(12 minutes, 3 minutes for Q&A)

Speaker:
UM Medical director, Physicians Hospitalist Partners, FAMILY PHYSICIANS GROUP

Case Study 2:
(12 minutes, 3 minutes for Q&A)

Speaker:
CPC, Co-Founder & Vice President of Operations, CODING P.I.

Made possible by :
CLEAR VISION INFORMATION SYSTEMS
5:05 pm
Back by Popular Demand!
Partnering with Providers: Best Practices for System Organization & Workflow to Enhance HCC Data and Outcomes
  • Part 1: Creating strategic team solutions to improve workflow
  • Part 2: Developing a Payer/Provider Relationship Best Practices Checklist - "Its not what happens to us, it's how we deal with it...and who did it best...and why!"
    • Know who to contact at each facility - "Who's in charge here anyway?"
    • Know the "Quest" process for each provider - "It's not one size fits all"
    • Identify the barriers and obstacles early and accurately - "Sizing the opportunity"
    • Minimize the time impact on the provider - "Make the process 'seamless'"
    • Provide feedback on diagnostic coding - "Creating a 'Kodak' opportunity"
    • Offer training and incentives for proper coding - "I know there is a code in here somewhere..."
    • Beyond the "Getting It" and "Getting On" - "What's Next"
Speaker:
MD, MPH, President and CEO, AUK DOK, INC.
5:35 pm
Measuring the Success of Proper Coding
  • A number of potential metrics, measures, and/or indices are possible with the initiation and maintenance of proper coding - however, their implementation and content will vary depending on the operational platform and its capabilities, the needs, the integrity and reliability of source(s) of the information and the individual needs of the subject reviewed
  • Additionally, the "success" of proper coding may be found in assurances of the accuracy of the codes queued for submission - this is especially important in the expanding world of vendors, but equally important in the reliability of synchronization and maintenance of integrity vis-à-vis claims, chart review, and HCC generation
  • Finally the implementation of prospective coding capability demands real time or short turn around error/integrity processes to assure timeliness
Speaker:
Sr. Clinical Training Specialist, LEPRECHAUN
6:15 pm
Day One Closing Remarks and Cocktail Reception in the Exhibit Hall
Past Conference Day Two: Wednesday, April 4, 2012
7:00 am
Continental Breakfast & Registration
8:00 am
Chair's Welcome and Day One Re-Cap

Chair:
Chief Medical Officer, CENSEOHEALTH
CEO, INNOVATIVE CLINICAL PARTNERS
8:15 am
Spotlight Session:
Part 1: Developing a Bullet-Proof RADV Action Plan
  • It is a paper chase
  • How fast can you retrieve records?
  • Where do you go?
  • How do you validate diagnoses and HCC codes?
Speaker:
Partner, Chief Medical Officer, SUNERA LLC

Part 2: Lessons Learned from a RADV Audit Veteran

Speaker:
Vice President, FREEDOM HEALTH
9:30 am
Best Practices for Developing Your Own Coding Team
  • Case study: The Geisinger Health Plan "Gold Diggers"
  • Case study: Kelsey Care Advantage Health Plan
Speaker:
Government Programs, ICD-10 Trainer, GEISINGER HEALTH PLAN
Manager KCA Coding Compliance, KELSEY CARE ADVANTAGE HEALTH PLAN
10:00 am
Mid-Morning Refreshment & Networking Break
11:00 am
Chase Lists: Moving From ICD-9 to ICD-10
  • Developing criteria for identification
Speaker:
Adjunct Faculty, COLLEGE OF ST. SCHOLASTICA, MINNESOTA
11:45 am
Leveraging Provider Decision Support Tools to Achieve Risk Score Accuracy
  • Member-specific decision support tools for providers leads to more accurate coding and improve risk score accuracy. Learn strategies for:
    • Equipping providers with decision support tools to close documentation and assessment gaps
    • Prompting for additional diagnoses that may be otherwise overlooked
    • Ensuring CMS-compliant encounter forms are submitted
    • Deploying mobile, online and paper-based electronically-signed medical progress notes for prospective risk adjustment
Speaker:
Director of Prospective Advantage, MEDASSURANT
12:30 am
Luncheon
1:30 pm
The Power of C+D: Integrating Medical and Pharmacy Data to Enhance Care Management and Accountability for Quality and Cost

Pharmacy data can provide insights into member cost, risk for preventable admissions and safety management, especially when prescribing patterns are integrated with medical claims. VNSNY CHOICE has been using a new class of commercially available software for integrating Part C and Part D data to enhance its management of cost and quality. The software's power can be used by insurers, ACOs, union and employer groups. Its functionality will be demonstrated. Specific application to real-life care management will show its ability to prevent admissions and readmissions as well as to identify individuals at risk for such common ED encounters as falls, near syncope and other geriatric syndromes.

Speaker:
Chief Medical Officer, VNSNY CHOICE HEALTH PLAN
2:15 pm
Best Practices for Evaluating HCC-Related Vendors

Holding service providers to a higher level of integrity:
  • Prospective assessment vendors
  • Chart extractions
  • HCC software for tracking/educating providers
Moderator:
Director of Retrieval Services, Revenue Integrity Division, VERISK HEALTH

Panelists:
Director, Medicare Risk Adjustment, NETWORK HEALTH PLAN
CDI Specialist, CPC, PREFERRED CARE PARTNERS
3:00 pm
Mid-Afternoon Refreshment & Networking Break
3:30 pm
Surpassing Revenue And Quality Targets Through Collaborative Data

Speakers:
CEO, INNOVATIVE CLINICAL PARTNERS LLC
CEO, PRECISION HEALTH SYSTEMS, LLC
4:15 pm
Conference Adjourns

Following the conference, the presentations will be made available via a secure website. Look for an Opal Events email containing both a conference survey and the web address for the presentations within 10 days of the conference. Thank you for attending!
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