Optimizing Appeals & Grievances Summit

Jun 22, 2020 ‐ Jun 23, 2020

The Optimizing Appeals and Grievances Summit is carefully crafted to improve ODAG and CDAG outcomes, bringing together compliance experts from the nation to share insights, experience, and expertise in an intimate, open forum. Ensure you're knowledge is up to the minute by discussing critical changes to CMS regulation, audit experience, and readiness techniques at this two day immersion event.

Chairperson Welcome Remarks

Preview Available

Chairperson Welcome Remarks

Jun 22, 2020 9:00am ‐ Jun 22, 2020 9:10am

Identification: MON01

• Ana Handshuh, Principal, CAT5 Strategies

Pre-Conference Workshop: Creating a Watertight Tracer

Preview Available

Pre-Conference Workshop: Creating a Watertight Tracer

Jun 22, 2020 9:10am ‐ Jun 22, 2020 10:45am

Identification: MON02

• Overview of the tracer requirements to avoid missing critical components
• Testing your tracer to locate errors and avoid costly mistakes
• Strategies to create business owner accountability to improve efficiency

• Deborah Marine, JD, CHC, Compliance Officer, SummaCare
• Tracy Jones, Senior Compliance Coordinator, SummaCare

Chairperson Welcome Remarks

Preview Available

Chairperson Welcome Remarks

Jun 22, 2020 10:55am ‐ Jun 22, 2020 11:05am

Identification: MON03

• Ana Handshuh, Principal, CAT5 Strategies

Deep Dive- CMS Audit Protocols 2021 Impacting ODAG and CDAG

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Deep Dive- CMS Audit Protocols 2021 Impacting ODAG and CDAG

Jun 22, 2020 11:05am ‐ Jun 22, 2020 11:50am

Identification: MON04

• Interpret the changes CMS to audit protocols for 2021 and how they impact how you are currently operating
• Examine which protocol changes will drastically impact the way that you operate and implement strategies to prepare for the 2021 audit cycle
• Prepare and introduce training for your audit team on the new protocols and apply them in a mock audit setting

• Deborah Marine, JD, CHC, Compliance Officer, SummaCare

CMS Changes to Part C & D Appeals and Grievances

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CMS Changes to Part C & D Appeals and Grievances

Jun 22, 2020 12:00pm ‐ Jun 22, 2020 12:45pm

Identification: MON05

• Explore the CY20 CMS Part C &D Enrollee Grievances, Determinations and Appeals Guidance update
• Evaluate how changes to the guidance impact plan processes, reporting, and technology
• Examine which important changes still need to be made and create a plan of action to implement changes to existing plan process
• Discuss changes that plans have made to adapt to CMS changes including barriers

• Karen A. Iapoce, MS, CAPA, CPHQ, Director of Government Solutions, Senior Analyst, ZeOmega

Know Your Risk! Review your Own Data to Identify and Mitigate Risk

Preview Available

Know Your Risk! Review your Own Data to Identify and Mitigate Risk

Jun 22, 2020 1:00pm ‐ Jun 22, 2020 1:45pm

Identification: MON06

• Conduct a compliance review using the reports you create on a monthly basis to identify trends
• Discover the root cause of the trends to distinguish its origin and educate the team members involved of recurring issue
• Employ preventative measures to reduce trends in A & G that are commonly found in your reports to improve efficiency

• JoAnn McDaniel-Chinn, Medicaid Compliance Officer, Simply Healthcare Plans
• Ana Handshuh, Principal, CAT5 Strategies

The Art of Successful Interactions with External Auditors

Preview Available

The Art of Successful Interactions with External Auditors

Jun 22, 2020 2:15pm ‐ Jun 22, 2020 3:00pm

Identification: MON07

• Discover how to build rapport and inspire confidence with external auditors
• Understand behaviors that can negatively affect performance and expose your organizations to risk (and how to avoid them)
• Learn best practices and proven strategies that help ensure your organization is trained and prepared to communicate effectively with auditors

• David Reid, Senior Director, Operational Performance & Regulatory Support, Florida Blue
• John Tanner, Chief Compliance Officer, Beacon Healthcare Systems

Categorize the Differences Between an Appeal and a Grievance

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Categorize the Differences Between an Appeal and a Grievance

Jun 22, 2020 3:15pm ‐ Jun 22, 2020 4:00pm

Identification: MON08

• Assess the definitions of an Inquiry, Complaint, Appeal, and Grievance to provide clarity
• Utilize tested compliance tips to improve identification
• Implement delegation to appropriate teams when an appeal or grievance occurs

• Deborah Marine, JD, CHC, Compliance Officer, SummaCare
• Tracy Jones, Senior Compliance Coordinator, SummaCare

Chairperson Closing Remarks

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Chairperson Closing Remarks

Jun 22, 2020 4:00pm ‐ Jun 22, 2020 4:20pm

Identification: MON09

• Ana Handshuh, Principal, CAT5 Strategies

Chairperson Welcome Remarks

Preview Available

Chairperson Welcome Remarks

Jun 23, 2020 9:00am ‐ Jun 23, 2020 9:10am

Identification: TUE01

• Ana Handshuh, Principal, CAT5 Strategies