Keynote Speaker
Mark Zezza, Ph.D.
Dr. Zezza is an Associate Director in the State, Provider, and Payer practice at The Lewin Group. While at Lewin, he has worked on several state and national health reform projects involving microsimulation models analyzing the cost and health insurance coverage impacts of reform proposals. Dr. Zezza also manages several projects for the Centers for Medicare & Medicaid Services (CMS) including the effort to develop health care efficiency measures to be used in the outpatient prospective payment system. These measures aim to further the CMS initiative of value-based purchasing by promoting the use of publically reported metrics of care based on evidence-based medicine and clinically accepted practice guidelines. He has also conducted several analyses used to assist clients to respond to CMS’s proposed changes to Medicare hospital payment policies, particularly those related to coding adjustments.
Prior to Lewin, Dr. Zezza spent over seven years working at CMS performing data analysis for health care financing issues. He worked in several divisions at CMS responsible for provider reimbursements, including inpatient hospital and long-term care hospital prospective payment systems, as well as Medicare Advantage and Prescription Drug Plan payments. Dr. Zezza has presented at several health economics conferences on Medicare payment systems and also co-authored articles and reports on national health expenditure estimates, last-year-of-life Medicare spending, and Medicare managed care payments. Dr. Zezza received a Ph.D. in policy science from the University of Maryland, Baltimore County, in 2005.
Speakers
Paula Allen
An experienced training and instructional design professional, Paula Allen helps Ingenix craft the ideal educational experience for its clients, whether it’s instructor-led, self-paced, or blended learning solutions. With a Lean Six Sigma Green Belt and more than 10 years experience in training and development, Paula excels at managing projects and finding efficiencies for her clients. Prior to joining Ingenix, Paula held instructional design and project management responsibilities across the health care, financial services, chemical manufacturing and technology sectors.
Suzan Berman-Hvizdash, CPC, CEMC, CEDC
Suzan Berman-Hvizdash is responsible for teaching 300+ staff/faculty documentation and billing practices as the Senior Manager of Coding and Compliance for the Departments of Surgery and Anesthesiology at the University of Pittsburgh Medical Center. She also oversees the coding operation for these specialties.
Berman-Hvizdash serves on the Ingenix Advisory Board and the Editorial Advisory Board Member for Eli Publishing. She is a former member of the AAPC National Advisory Board and currently sits on the AAPCCA Board of Directors.
She speaks both locally and nationally for organizations such as the University of Pittsburgh, The Coding Institute, AAPC, MGMA, and Ingenix. She recently acquired ACE-Med, an education and auditing consulting firm.
Pamela Childress, RHIA, CCS
Pamela Childress is a Registered Health Information Administrator and a Certified Coding Specialist. She attended school at the University of Louisiana at Lafayette (Go Ragin' Cajuns!!!) Pam has worked in a variety of facilities ranging from Multi-Specialty Physician Clinics and Acute Care Hospitals to HMOs. In addition, she was the coding instructor for LSU-E’s coding certificate program for 2 ½ years. She has been a featured speaker on coding topics at the Louisiana Regional Physician Hospital Organization (LRPHO).
She has been in the consulting realm for over 5 years and recently joined Ingenix Consulting in 2008 as a Senior Health Information Management Consultant. Pam’s consulting experience involves many different areas such as education and readiness for ICD-10 CM/PCS and RAC reviews, APC/DRG reviews, Clinical Documentation Improvement Programs, Medicare Advantage reviews as well as many other areas that our profession has the privilege in which to become involved.
Andrea Clark, RHIA, CCS, CPC-H
Andrea
Clark is a nationally prominent health information management
consultant who focuses specifically on outpatient coding and billing
systems, charge capture, coding and billing, data integrity, and
outpatient compliance training services. Ms. Clark has over
20 years of hospital outpatient coding, information
systems, operational and compliance training experience which
includes hospital-based and freestanding day surgery sites,
emergency room, hospital-based clinics, and ancillary diagnostic
services areas.
Ms. Clark is the founder of Health Revenue Assurance Associates,
Inc. which is a nationwide consulting and education group
specializing in Revenue IntegrityTM strategic
analyses and compliance-focused implementation for hospitals,
physicians, and freestanding centers. The company provides in-depth
coding and documentation audits; customized education/certification
programs; Ambulatory Payment Classifications (APCs) strategic
position and operational assessments; chargemaster/CDM data
integrity reviews and updates; and seminar speaking engagements.
Barbara Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P,
CPC-I, CHCC
Barbara Cobuzzi is Director of Outreach Programs
for the American Academy of Professional Coders. She formerly sat on
the National Advisory Board as well as the Executive Board of the
National Advisory Board of the American Academy of Professional
Coders. She is the consulting editor of The Coding Institute's
Otolaryngology Coding Alert and Medical Office Billing. She also
serves on the editorial advisory board of various publications. Ms.
Cobuzzi has done educational classes for the American Academy of
Otolaryngology / Head and Neck Surgery, state societies of
Otolaryngology as well as the American College of Ophthalmology and
Otolaryngology, including a CME course at the AAO/HNS Washington
Advocacy week in 2006 on Coding and Documentation. She has also
spoken for the AAPC, PAHCOM, AAMA, and MGMA among other
organizations. She is a nationally sought after consultant, expert
witness, and educator.
Cheryl D'Amato, RHIT, CCS
As
Director, Health Information Management, Cheryl D'Amato is
responsible for the development, enhancement, and maintenance of
Ingenix data files with a facility coding focus. She brings to
Ingenix more than two decades of experience in implementing and
managing utilization, quality assurance, and health information
coding systems.
D'Amato has bylined articles for numerous
industry publications. She currently co-authors the well-read
CCS-Prep! column in Advance for Health Information Professionals. In
addition, she has conducted presentations on coding, medical
necessity, OPPS, and compliance at more than 50 industry seminars,
webinars, and conferences including the AHIMA National
Convention.
D'Amato maintains many professional affiliations.
She is currently a member of AHIMA's Coding Community Council and
has served as a member of the Clinical Classification Practice
Council, CCS-P Job Analysis Task Force and Coding Policy and
Strategy Committee. She has also held several high-ranking positions
on the Board of the AHIMA's Society for Clinical Coding (SCC),
including Director and Chair-Elect. She also is a member of CTHIMA
(Connecticut Health Information Management Association), from which
she has not only received the Distinguished Member Award, but has
served as President and Delegate along with numerous other
positions.
Ryan Devey
Ryan is the Product Manager for Ingenix ePhysician Solutions. He graduated from the University of Utah in Healthcare Administration in 1996 and has held several different healthcare related positions ever since. Starting out paying claims for a large payer in the Salt Lake City area, Ryan has worked for payer organizations in several different roles such as Provider Relations Representative, Case Manager, Disease Management Program Manager, and Worksite Wellness/HEDIS Program Developer. Additionally, Ryan has physician office experience having worked as a Practice Administrator for a 8 doctor, 3 PA, pediatric clinic. For the past 5 years, Ryan has designed and managed medical coding data management systems, workers compensation rebilling systems, and medical coding/fee schedule software.
Catherine Duffy, BS, RHIT, CHC
Catherine Duffy has almost 30 years experience in coding, compliance, health policy and health information technology and management. Currently at Ingenix, she is the Director of Clinical Assessment Solutions, NV Market, for Medicare Advantage and RAPS (Risk Adjustment Payment System). Her activities include implementing a physician coding/documentation program for Medicare Advantage.
Prior, Catherine was the Director of CPT® Information & Education Services for the American Medical Association (AMA) where her activities included CPT® education, technical editor - CPT® Assistant, and various CPT® publications. She has also conducted various coding presentations around the country. Catherine has held a variety of healthcare positions such as Director of Health Information department for Memorial Hospital, Woodstock, IL, coding instructor and RHIT curricula advisory member at the College of Lake County, Grayslake, IL, as well as various ICD-9/CPT® coding consulting services for physicians’ offices and mental health. She has worked on AHIMA coding certification workgroups for the CCS-P certification and the newly created CHDA certification. Catherine participates in various professional organizations such as American Health Information Management Association, NV Health Information Management Association, Healthcare Compliance Association and the Association of Clinical Documentation Specialists.
Cynthia M. Farrell
With a master’s degree in human resources development and more than 12 years of training experience, Cynthia Farrell leads instructional design for Ingenix. Her expertise includes analyzing client needs, developing engaging courses, and ensuring Ingenix’s offerings maximize retention and return-on-investment for clients. Prior to Ingenix, Cynthia managed learning solution development, design and delivery teams, including offshore resources, across a wide variety of industries.
Jillian Harrington, MHA, CPC, CPC-P,
CPC-I, CCS-P, MHP
Ms. Harrington serves as President
& CEO of ComplyCode, a health care compliance consulting firm
based in Binghamton, NY, and has more than 16 years of experience in
the health care profession. She is the former chief compliance
officer and chief privacy official of a large academic medical
center, and also has extensive background in both the professional
and technical components of CPT®/HCPCS and ICD-9-CM
coding. She teaches CPT® coding and is an approved
instructor of the Professional Medical Coding Curriculum, awarded by
the American Academy of Professional Coders. She has spoken
frequently on health care compliance and health information
management issues at regional and national professional
conferences.
Ms. Harrington holds a bachelor's degree in health care
administration from Empire State College and a master's degree in
health systems administration from the Rochester Institute of
Technology. She is a member of the American Academy of Professional
Coders (AAPC) and a former member of their National Advisory Board,
a member of the American Health Information Management Association
(AHIMA) and the Health Care Compliance Association (HCCA), and is an
associate of the American College of Healthcare Executives (ACHE).
Laurine Johnson, MS, RHIA,
CPC-H
Laurine Johnson brings over twenty years of experience
in health information management, quality assessment, risk
management, utilization management, and coding and reimbursement.
Her current specialization is APC/DRG review, RAC
education/services, ICD-9-CM/CPT®/HCPCS coding and
education, and transitioning to ICD-10-CM/PCS. One recent exciting
project was working with the National Health Services in the United
Kingdom regarding coding and documentation audit strategies.
Previous to joining Ingenix, Ms. Johnson directed auditing,
educational, and training programs for several nationally recognized
consulting firms. She has affiliations with numerous state and
national health care associations including AHIMA, Pennsylvania
Health Information Management Association, Western Pennsylvania
Health Information Management Association, and American Academy of
Procedural Coding.
Ms. Johnson has also been a featured speaker at more than twenty
conferences and seminars including AHIMA audioconferences. She was a
four-year member of AHIMA’s Classification and Clinical Terminology
Practice Council and is a current member of Quality Initiatives and
Secondary Data Practice Council. She holds a B.S. in Health Records
Administration from University of Pittsburgh, and a M.S. in
Healthcare Information Systems, also from University of
Pittsburgh.
Claire Kapilow, MSM
As Director of
Regulatory Affairs and Compliance, Claire Kapilow is responsible for
tracking and analyzing health care regulations, identifying those
that affect Ingenix customers and business partners, and translating
these regulations into requirements for software and data. She has
more than two decades of professional experience and is an expert in
case mix classification systems, prospective payment, Medicare
reimbursement in all settings, and software development for the
management and analysis of health care information. Prior to
Ingenix, she served as Director, Administrative Information Systems,
at Columbia Presbyterian Medical Center (CPMC), one of the largest
health care providers in the country. In this capacity, she directed
the design, development, installation, and operations of all hospital
corporate systems including patient management, accounts receivable,
and contract management.
Kapilow maintains professional
affiliations with the Healthcare Financial Management Association
(HFMA) and the National Uniform Billing Committee (NUBC). She has
co-authored articles in several well-respected publications and
conducted seminars on case mix management, prospective payment, and
other topics. Kapilow holds a B.S. in Applied Mathematics from Brown
University as well as a Masters of Science in Management from the
Massachusetts Institute of Technology.
Kelly Maloney, M.S.
Kelly has over twenty years of experience working in the managed care field with both payers and providers. Her expertise has grown from her primary concentration in the Network Development arena where she has overseen managed care contract negotiations amongst payers, hospitals, physicians and ancillary providers. She also has extensive experience in managed care sales and marketing, regulatory and compliance, administration and client relationship management. She has worked in leadership positions with both regional and national health plans including UnitedHealthCare and Highmark Blue Cross Blue Shield as well as for various hospitals and health care systems. Currently she is a Director with Ingenix, Clinical Assessment Solutions, where she is responsible for risk adjustment activities with providers in the Midwest markets.
Nannette Orme, CPC, CEMC, PCS
Ms. Orme has more than 15 years of experience in the health care profession. She has extensive background in CPT®, HCPCS, and ICD-9-CM coding. She previously was a consultant with PricewaterhouseCoopers. Her areas of expertise include physician audits and education, compliance, litigation support for Medicare self-disclosure cases, chargemaster maintenance, and E/M, multispecialty, and emergency department coding. Ms. Orme has presented at national professional conferences and contributed articles for several professional publications. She is a member of the American Academy of Professional Coders and the Utah Medical Group Management Association (UMGMA). She currently works at Ingenix as a clinical technical editor.
Glenda J. Schuler, RHIT, CPC,
CPC-H
Ms. Schuler has more than 30 years of experience with
the health care industry in all areas of medical records, as well as
utilization review and patient business services. She has working
knowledge of third-party reimbursement, electronic submission of
claims, and billing and collection issues. As a health care
consultant, her areas of expertise include ICD-9-CM, DRG, and
hospital CPT® coding and ambulatory payment
classifications (APCs), as well as chargemaster reviews. She has
developed and conducted coding and reimbursement seminars and has
been a featured speaker nationwide on the topic of Medicare APC
groups and their impact on hospital operations. Ms. Schuler is an
active member of the American Health Information Management
Association and the American Academy of Professional Coders.
Melinda Stegman, MBA, CCS
Ms. Stegman has more than 25 years of experience in the HIM profession and has
held several consulting and management positions in the HIM arena.
Areas of specialization include training related to inpatient coding
and DRG issues, outpatient coding issues and ambulatory payment
classifications (APCs) for HIM professionals, software developers,
and clients; developing an outpatient billing/coding compliance tool
for a major accounting firm; and managing HIM consulting practices.
Ms. Stegman is a regular contributing author for Advance for Health
Information Management Professionals and for the Journal of Health
Care Compliance. She has performed coding assessments and
educational sessions throughout the country. Ms. Stegman is
credentialed by AHIMA as a Certified Coding Specialist (CCS) and
holds a Master of Business Administration degree with a
concentration in health care management from the University of New
Mexico - Albuquerque.
James M. Taylor, MD, CPC
Dr. James M. Taylor is a Board Certified Family Medicine physician and Certified Professional Coder. He attended medical school at Medical College of Wisconsin and Residency in Dayton, Ohio. He went into private practice in Xenia, OH. His practice included typical small town responsibilities including CCU/ICU, Neonatal ICU, OB, and Office Practice. During that time, he was the physician business lead for his group and was also Chairperson for the Department of Family Medicine, Chair of the Quality Assurance Committee, and served on the Executive Committee for Greene Memorial Hospital. He was a Clinical Associate Professor at Wright State University School of Medicine.
In 1995 he joined Kaiser Permanente, an HMO in Denver, Colorado that currently has nearly 480,000 patients at 18 clinical locations. He was served on the Electronic Health Record team for 3 years as a physician trainer and system administrator. He served as the Physician Director of Coding from 2002 to 2007 and now is the Medical Director of Revenue Cycle. He recently was elected to the Board of Directors for Kaiser’s physician group, the Colorado Permanente Medical Group.
Ronda Tews, CPC, CHC, CCP-P
Ronda is a Corporate Compliance Project Manager at St. John’s Health System in Springfield, Missouri. St. John’s Health System includes St. John’s Clinic, which is a multi-specialty medical practice that consists of nearly 500 physicians and more than 100 midlevel providers in southwest Missouri and northern Arkansas. Ronda’s duties at St. John’s have consisted of establishing internal auditing and monitoring as well as teaching basic coding classes to coworkers and providing E/M documentation training to St. John’s physicians and midlevel providers. Current duties consist of implementing compliance education and training programs, management of the Report Line as well as compliance auditing and monitoring over hospital departments.
Ronda has been in the healthcare industry for 18 years and is a Certified Professional Coder (CPC), Certified in Healthcare Compliance (CHC) and Certified Compliance Professional – Physician (CCP-P). Ronda has also served as Secretary and President on the local AAPC Chapter as well as a member of the HCCA.
Melanie Witt, RN, CPC, COBGC, MA
Melanie Witt is an independent coding education consultant and a well-known speaker and recognized expert in the area of coding and reimbursement for Ob/Gyn services. She is the former program manager of the Department of Coding and Nomenclature and American College of Obstetricians and Gynecologists. Witt is also the consulting editor for Ob-Gyn Coding Alert.
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