Medicare Advantage Member Accounting & Reconciliation Summit

Jun 15, 2020 ‐ Jun 16, 2020

Offering both high-level strategy and critical operational training, 2020’s Medicare Advantage Accounting and Reconciliation Summit, now a live streaming virtual event, is the only specialist conference of its kind presenting a deep and evaluative look into membership and revenue reconciliation.

Standard: $500.00


Chairperson’s Welcome iconChairperson’s Welcome

Preview Available

Chairperson’s Welcome

Jun 15, 2020 12:05pm ‐ Jun 15, 2020 12:15pm


Best Practices for Enrollment Reconciliation

Jun 15, 2020 12:15pm ‐ Jun 15, 2020 1:15pm

Learning Objectives:

  • Hear best practices for timely and accurate reconciliation for membership pipeline from application to CMS approval to MMR. 
  • Understand how to manage the enrollment process to ensure your handling of special need members such as D-SNPs are optimized. 
  • Gain an overview of the membership pipeline from application to CMS approval to ensure you are getting the right payments for the right claims.


A Focus on Non-Group Health Plan Healthcare Economics

Jun 15, 2020 1:45pm ‐ Jun 15, 2020 2:45pm

Learning Objectives:

  • Review the statutory provisions permitting Medicare Advantage plans the right to seek reimbursement from NGHP.
  • Understand the regulations and policy provisions allowing Medicare Advantage plans the right to seek reimbursement from NGHP. 
  • Explore the Federal district court and appeals decisions affecting Medicare Advantage plans right of reimbursement from NGHP.


MSP Compliance 2.0: What Else is Medicare Doing?

Jun 15, 2020 3:00pm ‐ Jun 15, 2020 4:00pm

Learning Objectives:

  • Review case samples in which the US Department of the Treasury has offset beneficiaries’ benefits or responsible plans’ monies due. 
  • Analyze case samples in which the US Department of Justice has collected monies due from attorneys representing injured parties. 
  • Understand proposed rules on mandatory reporting civil money penalties to be imposed for responsible reporting entity’s noncompliance. 


Reconciling and Reporting on Hospice

Jun 15, 2020 4:15pm ‐ Jun 15, 2020 5:15pm

Learning Objectives:

  • Hear how the changes by CMS to hospice reporting can impact payments to your plan.
  • Understand how best to deal with hospice claims and ensure you aren’t paying claims for hospice members within this uncertain landscape.
  • Overcome operational challenges of dealing with hospice claims to ensure changes don’t impact your bottom line.

  • Kwame Appiah-Yeboah, Ph.D., CRC, Director, Risk Adjustment and Revenue Management, Sentara Health Plans – Virginia Premier

Chairperson's Closing Remarks iconChairperson's Closing Remarks

Preview Available

Chairperson's Closing Remarks

Jun 15, 2020 5:15pm ‐ Jun 15, 2020 5:30pm


Chairperson’s Opening Remarks

Jun 16, 2020 9:00am ‐ Jun 16, 2020 9:10am


Understanding Risk Adjustment and the Impact of COVID-19 on MA

Jun 16, 2020 9:10am ‐ Jun 16, 2020 10:10am

Learning Objectives:

  • Discuss the latest CMS regulatory changes. 
  • Understand more deeply the model for calculating risk score. 
  • Get to grips with Risk Adjustment Data Validation (RADV) audits terminology and definitions.
  • Learn the Do’s and don’ts – How to effectively manage emerging risk areas.

  • Scott Weiner, CRC, CMA, CFM, MBA, Director, Government Programs, Virginia Premier

CMS Best Practices iconCMS Best Practices

Preview Available

CMS Best Practices

Jun 16, 2020 10:25am ‐ Jun 16, 2020 11:25am

Learning Objectives:

  • Dive deeper into CMS data around reconciliation and best practice
  • Refresh on reconciliation points around co-ordination of benefits (COB) recovery
  • Analyse membership opportunities around data trends

  • Kate Riordan, Director, MSP Initiatives, ISO Claims Partner
  • Brian Bargender, CSRP, Management Consultant, Subrogation and Other Payer Liability, Humana

Streamlining Reconciliation Processes & Technology

Jun 16, 2020 11:40am ‐ Jun 16, 2020 12:40pm

Learning Objectives:

  • Hear how to streamline processes, whether you are reconciling daily, weekly, or monthly. 
  • Get best practice on technologies and processes that can support your reconciliation no matter what size your plan is. 
  • Learn how to administer inventory management optimally when you don’t have technology or automation systems in place.

  • Denyse Wise, Chief Administrative Officer, Cody Consulting

Closing Remarks iconClosing Remarks

Preview Available

Closing Remarks

Jun 16, 2020 12:40pm ‐ Jun 16, 2020 12:50pm