Agenda – Day 3

Jessica L. Gustafson is a founding shareholder with The Health Law Partners, P.C. Ms. Gustafson represents hospitals, health systems, hospices, home health agencies, physicians and other health care providers and suppliers in an array of health care legal matters. Ms. Gustafson devotes a substantial portion of her practice to representing providers in the Recovery Audit (“RAC”) and Medicare audit appeals process. She also regularly assists clients with compliance and reimbursement matters, overpayment refunds, Medicare enrollment matters, as well as other health care regulatory matters.

Ms. Gustafson is a member of the American Health Lawyers Association, American Bar Association (Health Law Section) and Michigan Bar Association (Health Care Law Section). She is actively involved in the ABA Health Law Section, serving in multiple leadership roles. She also serves as a member of the Advisory Board to the American College of Physician Advisors.

Abby Pendleton is a founding shareholder of The Health Law Partners, P.C. Ms. Pendleton has been practicing healthcare law since 1996. She regularly provides counsel to healthcare providers and organizations in a number of areas, including but not limited to: compliance, Recovery Audit (“RAC”), Medicare and other payor audits, fraud and abuse, reimbursement matters, and HIPAA Privacy and Security, and physician staff privilege and licensure matters.

Ms. Pendleton is a member of the State Bar of Michigan (Member, Health Care Law Section) and State Bar of New York (Member, Health Law Section); the American Bar Association; the American Health Lawyer’s Association; the Health Care Compliance Association; the Medical Group Management Association and the Michigan Medical Group Management Association. She also serves as a member of the Advisory Board to the American College of Physician Advisors.

Michele Marcum has over 30 years of experience serving in a variety of roles in the healthcare finance industry. In addition to experience in payer contracting for health systems and networks, Michele has worked in network development and contracting on the payer side for Humana and Aetna. Prior to moving into the contracting arena, Michele served as Director of Patient Financial Services and Patient Access and worked for a Medicare Fiscal Intermediary.

As Senior Contract Specialist for Saint Alphonsus Health System, and the Saint Alphonsus Health Alliance Network (a clinically integrated network) in southwest Idaho and eastern Oregon. Michele manages the contractual relationships with major payers for the health system and the Alliance with a focus on value based agreements.

Saint Alphonsus Health System, owned by Trinity Health, is a four hospital system with facilities ranging from Critical Access to a ## bed hospital with the only trauma center in the state and a multi-specialty medical group with ## providers. The Saint Alphonsus Health Alliance is a clinically integrated provider network that extends beyond the Saint Alphonsus Health System.

Michele is actively involved with the Healthcare Financial Management Association Idaho Chapter, serving as an officer on the Idaho board, as the Regional Executive for Region 10 and on the National Certification Committee. In addition to other HFMA awards, she has received the Founder’s Medal of Honor award for her service in HFMA.

Ernie de los Santos is Founder of Appeal Academy and Creator of Finally Friday! LIVE, President and Co-Founder of Top Gun Audit School, LLC, and the Executive Director of the Council for Certification of Medical Auditors, Inc. – the CCMA. He has produced over 2,500 webinars for his own companies and clients. Before entering the healthcare industry in 2006, he spent over 20 years in research and development of new business models, working on projects for Fortune 100 corporations, including Coca-Cola, Kodak, SONY, Panasonic and the International Olympic Committee. He holds degrees in Archaeology, Computer Science, and Marketing.

Dr. Timothy Brundage is medical director and chief executive officer of Brundage Group. He is a diplomate of the American Board of Internal Medicine. Dr. Brundage is a past board member of the Association of Clinical Documentation Improvement Specialists (ACDIS) and earned his CCDS certification through ACDIS. Dr. Brundage is the co-chair of the CDI committee for the American College of Physician Advisors (ACPA). Dr. Brundage educates physician groups nationwide on quality, utilization, denials management, clinical documentation improvement and physician advisor education. He is a frequent presenter at the ACDIS annual conference and has spoken nationally for AHIMA at its annual meeting and its CDI Summit. Dr. Brundage was selected by Tampa Bay Business Journal as a Health Care Heroes award winner in the health care educator category.

Ally has 20 plus years of successful healthcare management experience working with for profit acute care hospital organizations, physicians, patients, and attorneys. She is a highly seasoned professional in revenue cycle management, patient access, charge capture/integration, medical and financial auditing, and reimbursement optimization. She has led many healthcare organizations and executive leaders to achieve a strong revenue reimbursement infrastructure.

Ally’s certifications are: Certified Medical Audit Specialist, Certified Clinical Financial Auditor, Certified Coding Specialist, and EPiC CDM Management. She has written and recorded Webinars on Healthcare Documentation, and is an author for CDM Optimization Guidelines.

Day Egusquiza brings over 40 years experience in health care reimbursement, hospital business office operations (20 years in an Idaho hospital), contracting, auditing and compliance implementation. Additionally, her experience includes eight years as a Director of a Physician Medical Management billing service which included completing an integrated business office between a hospital and a large multi-specialty physician clinic. She has been an entrepreneur in hospital and physician practice accounts receivable management and a leader in redesigning numerous organizations. Her work includes providing guidance as a compliance & reimbursement educator while providing operational insight on the revenue cycle impacts of disruption, lost charges, coding validation and yes, why I love Traditional Medicare’s 2 MN rule. Day’s strength is her ability to ‘operationalize’ complex regulations into teachable components.

Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance- both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. She has been highlighted in JCAHO’s Six Hospitals in Search of Excellence, Zimmerman’s Receivable Report, HFMA’s HFM and Patient Account, AHIA Prospective, and numerous healthcare newsletters along with a contributing author to 2006 Health Law and Compliance Update. She received the Idaho Hospital Association “Distinguished Service Award” for her legislative work and training on new indigent law. Attendees at HFMA’s ANI rated her in the top 25% for each year she has presented, earning her the ‘Distinguished Speaker’ award.

Her greatest accomplishments are her four wonderful children and her eight fabulous grandchildren.

What makes her unique? She has been in the trenches with us!

Points of Interest:

• AICPA: Planning Committee member for healthcare, Chair 2004-2011
  Speaker at 14 annual conferences, board member 8 years
  
• AHIA: National conference key note speaker
  
• HFMA: National faculty member; presenter at ANI; national revenue cycle conference; two-day cluster; CFO Forums; regional conferences with continual evaluations in the top 25% -earning the Distinguished Speaker Award yearly.
  
• Instructor: College of Southern Idaho, continuing education program on “Understanding the Medicare Benefit.”
  
• Board of Directors: Special Olympics of Idaho,2003-2007. Secretary 2004
  
• Contributing Editor; AAHAM Technical Certification Study Guide, revised March 2004; CPAT & CCAT exams
  
• Co-Chair of national RAC Summit (2009-current)
  
• Co-Creator of the national Physician Advisor and UR Boot camp (2012-current)
  
• President and Founder of the Patient Financial Navigator Foundation, Inc, – a Idaho-based family foundation- transforming the hassle factor in healthcare thru education.

Day Egusquiza brings over 40 years experience in health care reimbursement, hospital business office operations (20 years in an Idaho hospital), contracting, auditing and compliance implementation. Additionally, her experience includes eight years as a Director of a Physician Medical Management billing service which included completing an integrated business office between a hospital and a large multi-specialty physician clinic. She has been an entrepreneur in hospital and physician practice accounts receivable management and a leader in redesigning numerous organizations. Her work includes providing guidance as a compliance & reimbursement educator while providing operational insight on the revenue cycle impacts of disruption, lost charges, coding validation and yes, why I love Traditional Medicare’s 2 MN rule. Day’s strength is her ability to ‘operationalize’ complex regulations into teachable components.

Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance- both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. She has been highlighted in JCAHO’s Six Hospitals in Search of Excellence, Zimmerman’s Receivable Report, HFMA’s HFM and Patient Account, AHIA Prospective, and numerous healthcare newsletters along with a contributing author to 2006 Health Law and Compliance Update. She received the Idaho Hospital Association “Distinguished Service Award” for her legislative work and training on new indigent law. Attendees at HFMA’s ANI rated her in the top 25% for each year she has presented, earning her the ‘Distinguished Speaker’ award.

Her greatest accomplishments are her four wonderful children and her eight fabulous grandchildren.

What makes her unique? She has been in the trenches with us!

Points of Interest:

• AICPA: Planning Committee member for healthcare, Chair 2004-2011
  Speaker at 14 annual conferences, board member 8 years
  
• AHIA: National conference key note speaker
  
• HFMA: National faculty member; presenter at ANI; national revenue cycle conference; two-day cluster; CFO Forums; regional conferences with continual evaluations in the top 25% -earning the Distinguished Speaker Award yearly.
  
• Instructor: College of Southern Idaho, continuing education program on “Understanding the Medicare Benefit.”
  
• Board of Directors: Special Olympics of Idaho,2003-2007. Secretary 2004
  
• Contributing Editor; AAHAM Technical Certification Study Guide, revised March 2004; CPAT & CCAT exams
  
• Co-Chair of national RAC Summit (2009-current)
  
• Co-Creator of the national Physician Advisor and UR Boot camp (2012-current)
  
• President and Founder of the Patient Financial Navigator Foundation, Inc, – a Idaho-based family foundation- transforming the hassle factor in healthcare thru education.

Steve Neorr currently serves as Senior Vice President, Population Health for Cone Health. In this role, Mr. Neorr serves as Chief Administrative Officer of Triad HealthCare Network (THN), the Accountable Care Organization (ACO) affiliated with Cone Health, and Chief Executive Officer of HealthTeam Advantage (HTA), Cone’s provider-led Medicare Advantage health plan and oversees all activities, operations and strategic planning for both organizations. His broader responsibilities include implementing and maintaining a system-wide strategy of population health to achieve top decile wellness and well-being outcomes for Cone Health employees, businesses and employers, contracted risk populations and the community at large. Mr. Neorr previously served as Senior Consultant at WayPoint Health Care Advisors where he focused on providing support to large health systems regarding developing ACO/CIN strategies, implementation of Patient Centered Medical Home initiatives and performance-based contracting. Prior to WayPoint, Mr. Neorr served as Chief Operating Officer of a 140-physician multi-specialty medical group practice with over 40 medical offices located throughout the Dallas/Fort Worth metroplex. He has worked in healthcare and with physicians for over 20 years.

Mr. Neorr holds a Master of Business Administration degree from the University of Texas at Arlington and a Bachelor of Science degree in Health Care Administration from the University of Alabama, Tuscaloosa, AL.

Mr. Neorr serves on the Board of the Greensboro Science Center, America’s Physician Groups and various advisory committees for the North Carolina Medical Society and North Carolina Hospital Association. In addition, Mr. Neorr is a Past President of the North Texas Association of Medical Administrators and Past President of the Fort Worth Medical Group Administrators Association.

A of July of 2019, Jennifer Bartlett has served at Infirmary Health for 20 years. She has vast knowledge and expertise in patient access, revenue cycle, payer contracts, payer processes and denials management. Her many years of extensive research and study of payer practices and behaviors have been instrumental in holding payers to a greater level of accountability. She manages all prepay and postpay clinical audits including TPE, OIG, RAC, KePro 2MN, SMRC, CERT, MAC, Part C audits. In her organization, she is a current member of her System’s Information Governance/HIPAA Steering Committee, as well as a founding member of the Audit Steering Committee, which began in late 2018. In her state, she is an active member of the Alabama Hospital Association’s Revenue Integrity/Recovery Audit Steering Committee and the Palmetto GBA Provider Outreach and Education Advisory Board, (CMS JJ MAC region) and was a presenter in 2016, 2017 and 2019 at the AlaHA/HFMA Alabama Audit Summit. As well, she served on the faculty for the PA UR Boot Camp events since 2016.

Marlene Allen: I am the Compliance and HIPAA Privacy Officer and the Internal Auditor at Harrisburg Medical Center in Harrisburg, IL. We are a small, short-term acute care hospital in extreme Southern Illinois with the majority of our patients being on either Medicaid or Medicare. I have worked in healthcare for 12 ½ years. I started out as the Supervisor of Patient Accounts before becoming the Compliance Internal Auditor. I have a Bachelor’s degree in Finance with a minor in Education and a Master’s degree in Business Administration. I am a Certified Healthcare Auditor, Certified HIPAA Compliance Officer and will be a Certified Compliance Officer before the end of the year. I have two grown children and four grandchildren. I won’t be racking up as many frequent flyer miles as I used to because my daughter and her family just recently moved to within an hour of where I live.

Diana Cokingtin, MD joined the team of physicians at Change Healthcare in 2017 with over 23 years of experience in medical management. She is trained in Internal Medicine and Pediatrics. She was formerly with Molina Health overseeing the development of evidenced based policies and managing the transplant program. She also worked closely with utilization management staff on prior authorization code list modifications. Streamlining the list into a more manageable cost-effective process which decreased the number of authorizations the providers had to submit allowing the insurance staff to be refocused on care management. Additionally, she implemented the genetic testing review process.

She previously worked with Aetna/Coventry initially as a CMO for the Kansas City, then moving to a corporate role writing evidence-based policy, running the transplant program and medical director education. Her administrative career began with Blue Cross Blue Shield Kansas City.

Ed Norwood is President of ERN/The National Council of Reimbursement Advocacy. He has been recognized as a unique and distinctive authority in transitional leadership and administrative laws that govern the healthcare delivery process.

Few have blazed the trail of success in the same inimitable style as Ed. With an entrepreneurial story which is both entertaining and inspiring, Ed has a seasoned, realistic perspective that inspires people: “It’s never too late to become what they might have been” (Eliot).

Multi-faceted, with a creative ability to inspire his audience, Ed combines his healthcare influence and expertise with his passion to help providers advocate for medically appropriate healthcare pursuant to federal and state laws.

Jessica L. Gustafson is a founding shareholder with The Health Law Partners, P.C. Ms. Gustafson represents hospitals, health systems, hospices, home health agencies, physicians and other health care providers and suppliers in an array of health care legal matters. Ms. Gustafson devotes a substantial portion of her practice to representing providers in the Recovery Audit (“RAC”) and Medicare audit appeals process. She also regularly assists clients with compliance and reimbursement matters, overpayment refunds, Medicare enrollment matters, as well as other health care regulatory matters.

Ms. Gustafson is a member of the American Health Lawyers Association, American Bar Association (Health Law Section) and Michigan Bar Association (Health Care Law Section). She is actively involved in the ABA Health Law Section, serving in multiple leadership roles. She also serves as a member of the Advisory Board to the American College of Physician Advisors.

Abby Pendleton is a founding shareholder of The Health Law Partners, P.C. Ms. Pendleton has been practicing healthcare law since 1996. She regularly provides counsel to healthcare providers and organizations in a number of areas, including but not limited to: compliance, Recovery Audit (“RAC”), Medicare and other payor audits, fraud and abuse, reimbursement matters, and HIPAA Privacy and Security, and physician staff privilege and licensure matters.

Ms. Pendleton is a member of the State Bar of Michigan (Member, Health Care Law Section) and State Bar of New York (Member, Health Law Section); the American Bar Association; the American Health Lawyer’s Association; the Health Care Compliance Association; the Medical Group Management Association and the Michigan Medical Group Management Association. She also serves as a member of the Advisory Board to the American College of Physician Advisors.

Ernie de los Santos is Founder of Appeal Academy and Creator of Finally Friday! LIVE, President and Co-Founder of Top Gun Audit School, LLC, and the Executive Director of the Council for Certification of Medical Auditors, Inc. – the CCMA. He has produced over 2,500 webinars for his own companies and clients. Before entering the healthcare industry in 2006, he spent over 20 years in research and development of new business models, working on projects for Fortune 100 corporations, including Coca-Cola, Kodak, SONY, Panasonic and the International Olympic Committee. He holds degrees in Archaeology, Computer Science, and Marketing.