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MONDAY, JULY 29, 2019
PRECONFERENCE SESSION: BASICS 101
Medicare 101 – A,B,C,D
President and Founder, AR Systems, Inc. and Patient Financial Navigator Foundation, Inc., Twin Falls, ID
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.
Medical Director, Brundage Group, Saint Petersburg, FL
P2P 101 – Provider and Payer
Medical Director, Customer Experience, Change Healthcare, Formerly 23 years in managed care with BCBSKC, Coventry, Aetna and Molina, Leawood, KS
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.
Physician Advisor, Toledo, OH
She is a physician with a Masters in Business Administration, and was certified as a professional in healthcare quality. She comes with over twenty -five years of experience in the fields of Utilization Review, Quality, Denials and Appeals, Joint Commission, Clinical Documentation, Safety and Infection Control. She is trained in LEAN methodology for system improvements.
Prior to working for Ensemble Health Partners she worked as an Independent Physician Advisor for the UH Health system, ProMedica Health System, Mercy Health System, Lima Memorial Health System and Liberty Medical Center. She has worked with the Ohio State Medicaid board on several process improvement initiatives. She has worked as a private consultant to physician offices and Hospitals. She is a published author, writing a book called DRG Tools in 2011. She was awarded the Inventor of the year in 2016 for a web-based solution to prevent surgical denials, saving millions for the organizations that are currently using it.
She lives in Toledo with her family. She married her college sweetheart 32 years ago, has two boys and two dogs. She loves to travel and has cruised multiple times to find the sun during the winter months.
She sits on the Lucas county suicide prevention board, and is a member of the American College of Physician Advisors, National and State case management associations and the National Association of Healthcare Quality. She is a faculty member for a several national webcasts like Finally Friday, Empowering Physician Advisors and Top Gun Audit Academy.
Vice President of Case Management, Post-Acute Services, & CarePledge Alliance (ACO), Quorum Health, Fort Smith, AR
As a Certified Case Manager, DeVonne provides knowledge that bridges the clinical aspects of healthcare to the ever-changing financial aspect of healthcare while remaining centered on high quality patient care. She is a Certified InterQual Instructor. DeVonne graduated Magna Cum Laude from ATU. DeVonne went on to earn her Master’s Degree in Nursing Administration from the University of South Alabama in 2007.
Appeals 101 – Internal
System Coordinator of Clinical Audits and Disputes, Infirmary Health, Former Coordinator Of Patient Financial Services, Infirmary Health, Mobile, AL
Back-end Denial Work – Key Action Items Plus Appeal Writing 101
President and CEO, ERN Enterprises, Inc., President, National Council of Reimbursement Advocacy (NCRA), and CCO, The Reimbursement Advocacy Firm (TRAF), Cypress, CA
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.
Preconference Faculty Q&A Panel