The 8th Annual Optimizing Appeals and Grievances Summit
Jun 6, 2023 ‐ Jun 7, 2023
Sessions
Pre-Conference Workshop Part 1: Adaptability and Beyond: Maximizing the Potential of Your Internal Compliance Systems
Preview Available
Pre-Conference Workshop Part 1: Adaptability and Beyond: Maximizing the Potential of Your Internal Compliance Systems
Jun 6, 2023 9:00am ‐ Jun 6, 2023 10:00am
Identification: TUES01
Understand how to improve your collaborative network within your organization
Discuss best practices for managing reconsideration processes
Learn how to implement creative staffing models
- Stephenie Erickson, Independent consultant, Altman Erickson Consulting
Pre-Conference Workshop Part 2: Maximizing Efficiencies in Your Root Cause Analysis
Preview Available
Pre-Conference Workshop Part 2: Maximizing Efficiencies in Your Root Cause Analysis
Jun 6, 2023 10:00am ‐ Jun 6, 2023 11:45am
Identification: TUES02
Discuss how to use data effectively to identify the root cause of grievances
Interact with other organizations to better understand how they approach their root cause processes
Learn step by step how to approach a root cause analysis based on the type of grievance you are analyzing
- Deb Curry, MBA, RHIA, CCS-P, CRC, Manager, Risk Adjustment, ProMedica
Day 1 Opening Remarks/ CMS Highlights on ODAG and CDAG
Preview Available
Day 1 Opening Remarks/ CMS Highlights on ODAG and CDAG
Jun 6, 2023 12:00pm ‐ Jun 6, 2023 1:00pm
Identification: TUES003
Day 1 Opening Remarks
Preview Available
Day 1 Opening Remarks
Jun 6, 2023 12:00pm ‐ Jun 6, 2023 12:15pm
Identification: TUES03
Speaker(s):- Mark Dwinnells, CHC, CHC Director, Commonwealth Care Alliance
CMS Highlights on ODAG and CDAG
Preview Available
CMS Highlights on ODAG and CDAG
Jun 6, 2023 12:15pm ‐ Jun 6, 2023 1:00pm
Identification: TUES04
- Review the major Part C and Part D provisions that were proposed and finalized in CMS 2024 Final Rule
- Review the operational implications of CMS 2024 Final Rule
- Discuss updating your playbook of strategies to meet new expectations
- Laurie Delgado, VP A&G, Market Lead A&G, Beacon Health System
- Crescent Moore, Senior Consultant, Part D Lead, BluePeak Advisors
Addressing Gaps in Your FDR's and Reviewing Operations
Preview Available
Addressing Gaps in Your FDR's and Reviewing Operations
Jun 6, 2023 2:00pm ‐ Jun 6, 2023 2:45pm
Identification: TUES05
Identify how to improve communication between FDR's and health plans
Highlight the value of monitoring cases to identify potential pitfalls in your systems
Discuss the risks and liabilities associated with your FDRs.
- Beth Socoski, MBA, MSW, MSCL, CHC, CCEP, Medical Compliance Director, Longevity Health Plan
- JoAnn McDaniel-Chinn, Medicaid Compliance Officer, Simply Healthcare Plans
Classifying Appeals and Grievances: How to Ensure Better Patient Outcomes / Day 1 Closing Remarks
Preview Available
Classifying Appeals and Grievances: How to Ensure Better Patient Outcomes / Day 1 Closing Remarks
Jun 6, 2023 2:45pm ‐ Jun 6, 2023 3:45pm
Identification: TUES007
Classifying Appeals and Grievances: How to Ensure Better Patient Outcomes
Jun 6, 2023 2:45pm ‐ Jun 6, 2023 3:30pm
Identification: TUES06
Discuss best practices for categorizing complex cases
Outline the impacts of having an effective review system in place
Explore the challenges related to balancing member satisfaction with accurate and timely classifications
- Mark Dwinnells, CHC, CHC Director, Commonwealth Care Alliance
Day 1 Closing Remarks
Preview Available
Day 1 Closing Remarks
Jun 6, 2023 3:30pm ‐ Jun 6, 2023 3:45pm
Identification: TUES08
Speaker(s):- Mark Dwinnells, CHC, CHC Director, Commonwealth Care Alliance
Day 2 Opening Remarks and Day 1 Takeaways / Forming an Audit Playbook: Implementing Strategies for a Successful Examination
Preview Available
Day 2 Opening Remarks and Day 1 Takeaways / Forming an Audit Playbook: Implementing Strategies for a Successful Examination
Jun 7, 2023 10:00am ‐ Jun 7, 2023 11:00am
Identification: WED001