Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit
Medicare RAC Summit



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RAC SUMMIT PRESENTATIONS
Speaker presentations are password protected for 90 days from the start of the Summit. Registrants may log in by clicking here. For further information, email registration@hcconferences.com or call 800-503-0510.

Agenda: Preconferences
Wednesday, July 22, 2015

Preconference registration optional; required for RAC Certificate Program
12:00 pm Registration Opens

PRECONFERENCE I: PHYSICIAN ADVISORS -- BEYOND THE BOOT CAMP -- THE EVOLVING PA ROLE
(Registration optional -- one preconference is required for the RAC Certificate program)
Co-Sponsored by the American College of Physician Advisors (ACPA)
1:00 pm

Welcome and Overview of the Afternoon
The Continuing Role of the Physician Advisor -- Areas of Influence


Ronald J. Rejzer, MD, CHCQM
Senior Vice President/ Chief Physician Advisor, Parkland Health and Hospital Systems; President, American College of Physician Advisors (ACPA), Dallas, TX (Chair)

    Speaker Bio

    Dr. Ronald J. Rejzer is SVP, Chief Physician Advisor for Parkland Health and Hospital System in Dallas, TX. A native of Northwest Pennsylvania, he received his medical degree in 1980 from the Hahnemann Medical University in Philadelphia, followed by a residency at the Medical College of Virginia/VCU in Family Medicine. Dr. Rejzer practiced full time Emergency Medicine in the Tidewater area of Virginia for over eighteen years and was Board Certified in both Family Medicine and Emergency Medicine. For the past 15 years, Dr. Rejzer has held various Physician Executive roles, including VPMA and Chief Medical Officer positions for several prominent healthcare organizations and Administrative Director for a large Mid-Atlantic Hospitalist management company. Additionally, Dr. Rejzer has served as a consultant for Hospitalist programs, Utilization Management development and Physician Advisor programs and participated on several hospital boards and was elected President of a local medical society in Virginia. He has participated in Physician Advisor roles either part time or fulltime, for over twelve years. He currently serves full time as the SVP, Chief Physician Advisor at Parkland Hospital in Dallas, TX. Dr. Rejzer was recently elected as the President of the American College of Physician Advisors, Inc. Dr. Rejzer is also a Diplomat of the ABQAURP.
    Presentation Material (Acrobat)
1:30 pm Exploring the Spokes of the Wheel of Influence
Speaking the Language of the C-Suite -- From the CEO Perspective
Elizabeth Lamkin
Chief Executive Officer & Partner, PACE Healthcare Consulting, Hilton, Head Island, SC

    Speaker Bio

    Elizabeth Lamkin is the PACE Healthcare Consulting CEO & Partner. She has over 30 years' experience in the healthcare industry and brings extensive experience in all aspects of hospital governance and operational effectiveness. Prior to forming PACE Healthcare Consulting, Ms. Lamkin served for 20 years as a hospital CEO. She has been consulting for five years and successfully assisted clients in achieving improvements based upon her industry expertise and enterprise wide, data driven methodology.

    She is a national speaker and author on RAC and denial reduction.

    Ms. Lamkin holds a Master's Healthcare Administration and a BA Cum Laude, Core in Business Administration, both from University of South Carolina, Columbia.

    PUBLICATIONS
    Lamkin, Elizabeth and Berglund, Amanda, The RAC Toolkit for Hospitals and Health Systems, HCPro, 2011
    Lamkin, Elizabeth and Berglund, Amanda, The RAC Toolkit for Physicians, HCPro, 2011
    RAC Toolkit for CV Services (2014). Private publication for Medtronic, Inc.
    Complete article list available at www.pacehcc.com
    Presentation Material (Acrobat)
Speaking the Language of the C-Suite -- From the PA Perspective
Michael A. Salvatore, MD, FACP
Physician Advisor, Beebe Medical Center, Lewes, DE

    Speaker Bio

    Dr. Michael Salvatore received his MD from the University of Arizona in 1977. His post-graduate training 1977 - 1982 was at Duke University. He practiced Critical Care Medicine for 30 years before becoming a full time PA at Beebe Healthcare in 2012. He has been married for 43 years and has 2 daughters. When not working as a PA, he is watching birds with his wife.
    Presentation Material (Acrobat)
Strategies for Reducing Appeals
Howard Stein, DO
Physician Advisor, Centrastate Medical Center, Freehold, NJ

    Speaker Bio

    Dr. Howard Stein is the Associate Director of Medical Affairs and Physician Advisor at Centrastate Healthcare System, Freehold, New Jersey. He graduated from Nova Southeastern College of Osteopathic Medicine and is Board Certified in Family Medicine. Dr. Stein graduated with his Masters in Health Administration from the University of Maryland. He served as an Emergency Room Physician in the U.S. Air Force. He practiced Family Medicine in New Jersey for 13 years. He is a Fellow in the American Board of Quality Assurance and Utilization Review Physicians. He has worked in the Physician Advisor Role since 1993 and is an Executive Board Member of the American College of Physician Advisors.
    Presentation Material (Acrobat)
The Power of Peer-to-Peer Appeals
Maria Johar, MD
Administrative Director, ProMedica, Toledo, OH

    Speaker Bio

    Dr. Maria Johar is the System Physician Advisor at ProMedica Health System.

    ProMedica was acknowledged for being an integrated health system that serves more than 4.4 million patients across its 13 hospitals, four ambulatory surgery centers and more than 300 other facilities each year.

    She joined the Promedica family in Oct 2012. She comes with over fifteen years of experience in the fields Of Utilization Review, Quality, Appeals, Joint Commission, Clinical Documentation, Safety and Infection Control. She is trained in LEAN methodology for system improvements.

    Prior to working with ProMedica Health System, she worked with Mercy Health System, Lima memorial Health System and Liberty Medical Center. She has worked with Ohio State Medicaid board on several process improvement initiatives. She has worked as a private consultant to physician offices and Hospitals as well as writing a book called DRG Tools.

    She lives in Toledo with her husband, two boys and two dogs.

    She is sits on the Lucas county suicide prevention board, and is associated with the National Physician Advisors Association, national and state case management associations and the National Association of Healthcare Quality.
    Presentation Material (Acrobat)
Michael A. Salvatore, MD, FACP
Physician Advisor, Beebe Medical Center, Lewes, DE

    Speaker Bio

    Dr. Michael Salvatore received his MD from the University of Arizona in 1977. His post-graduate training 1977 - 1982 was at Duke University. He practiced Critical Care Medicine for 30 years before becoming a full time PA at Beebe Healthcare in 2012. He has been married for 43 years and has 2 daughters. When not working as a PA, he is watching birds with his wife.
    Presentation Material (Acrobat)
Break
The PA Role in Palliative Care
Michael A. Salvatore, MD, FACP
Physician Advisor, Beebe Medical Center, Lewes, DE

    Speaker Bio

    Dr. Michael Salvatore received his MD from the University of Arizona in 1977. His post-graduate training 1977 - 1982 was at Duke University. He practiced Critical Care Medicine for 30 years before becoming a full time PA at Beebe Healthcare in 2012. He has been married for 43 years and has 2 daughters. When not working as a PA, he is watching birds with his wife.
    Presentation Material (Acrobat)
Howard Stein, DO
Physician Advisor, Centrastate Medical Center, Freehold, NJ

    Speaker Bio

    Dr. Howard Stein is the Associate Director of Medical Affairs and Physician Advisor at Centrastate Healthcare System, Freehold, New Jersey. He graduated from Nova Southeastern College of Osteopathic Medicine and is Board Certified in Family Medicine. Dr. Stein graduated with his Masters in Health Administration from the University of Maryland. He served as an Emergency Room Physician in the U.S. Air Force. He practiced Family Medicine in New Jersey for 13 years. He is a Fellow in the American Board of Quality Assurance and Utilization Review Physicians. He has worked in the Physician Advisor Role since 1993 and is an Executive Board Member of the American College of Physician Advisors.
    Presentation Material (Acrobat)
PA Role and Strategies in Medicare Advantage Appeals
Maria Johar, MD
Administrative Director, ProMedica, Toledo, OH

    Speaker Bio

    Dr. Maria Johar is the System Physician Advisor at ProMedica Health System.

    ProMedica was acknowledged for being an integrated health system that serves more than 4.4 million patients across its 13 hospitals, four ambulatory surgery centers and more than 300 other facilities each year.

    She joined the Promedica family in Oct 2012. She comes with over fifteen years of experience in the fields Of Utilization Review, Quality, Appeals, Joint Commission, Clinical Documentation, Safety and Infection Control. She is trained in LEAN methodology for system improvements.

    Prior to working with ProMedica Health System, she worked with Mercy Health System, Lima memorial Health System and Liberty Medical Center. She has worked with Ohio State Medicaid board on several process improvement initiatives. She has worked as a private consultant to physician offices and Hospitals as well as writing a book called DRG Tools.

    She lives in Toledo with her husband, two boys and two dogs.

    She is sits on the Lucas county suicide prevention board, and is associated with the National Physician Advisors Association, national and state case management associations and the National Association of Healthcare Quality.
4:00 pm Faculty Panel
  • The Top Challenges for a PA in My Organization
  • Audience Q&A Session
Ronald J. Rejzer, MD, CHCQM
Senior Vice President/ Chief Physician Advisor, Parkland Health and Hospital Systems; President, American College of Physician Advisors (ACPA), Dallas, TX (Moderator)

    Speaker Bio

    Dr. Ronald J. Rejzer is SVP, Chief Physician Advisor for Parkland Health and Hospital System in Dallas, TX. A native of Northwest Pennsylvania, he received his medical degree in 1980 from the Hahnemann Medical University in Philadelphia, followed by a residency at the Medical College of Virginia/VCU in Family Medicine. Dr. Rejzer practiced full time Emergency Medicine in the Tidewater area of Virginia for over eighteen years and was Board Certified in both Family Medicine and Emergency Medicine. For the past 15 years, Dr. Rejzer has held various Physician Executive roles, including VPMA and Chief Medical Officer positions for several prominent healthcare organizations and Administrative Director for a large Mid-Atlantic Hospitalist management company. Additionally, Dr. Rejzer has served as a consultant for Hospitalist programs, Utilization Management development and Physician Advisor programs and participated on several hospital boards and was elected President of a local medical society in Virginia. He has participated in Physician Advisor roles either part time or fulltime, for over twelve years. He currently serves full time as the SVP, Chief Physician Advisor at Parkland Hospital in Dallas, TX. Dr. Rejzer was recently elected as the President of the American College of Physician Advisors, Inc. Dr. Rejzer is also a Diplomat of the ABQAURP.
5:00 pm Preconference Adjournment
5:15 pm Networking Reception

PRECONFERENCE II: MAKING INTEGRATED CLINICAL DOCUMENTATION IMPROVEMENT WORK -- PARTNERSHIPS!
(Registration optional -- one preconference is required for the RAC Certificate program)
1:00 pm

Welcome and Overview of the Afternoon
Exploring an Integrated CDI Team -- Tying Traditional CDI with Patient Status/UR = One Voice


Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID (Chair)

    Speaker Bio

    Day Egusquiza is President of AR Systems, Inc. and brings over 30 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. 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, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA's ANI rated her in the top 25% for each year she has presented, earning her the 'Distinguished Speaker' award. She received her college degree at Lewis & Clark College in Portland, OR.
    Presentation Material (Acrobat)
    Handout Material "AR Systems - Clarification of INPT Order"(Acrobat)
1:45 pm

Indiana Case Study -- Taking Baby Steps

Kathy Shumpert, RN
Chief Quality Officer, Dukes Memorial Hospital, Peru, IN; Former Clinical Documentation Improvement Specialist, Community Howard Regional Health, Kokomo, IN

    Speaker Bio

    Kathy Shumpert's passion is to do purposeful worthwhile work by utilizing her 7 years of experience as a Clinical Documentation Improvement Specialist to educate physicians, CDI staff and coders to prevent revenue loss and improve physician documentation. Not only has she been a registered nurse for 18 years, but Kathy has recently earned a Master's degree in Nursing Administration from Indiana University. She has a strong background in long-term care administration, surgery, case management, and home health care. Kathy has conceptualized and created an Integrated CDI model. She is an expert CDI trainer providing ongoing education. Additionally, she successfully writes coding and medical necessity appeals. Kathy Shumpert has spoken at the national ACDIS conference and the National RAC/MAC Summit in 2014. In fact, she speaks as often as she can in hopes to find someone who is as passionate about CDI as she is. She is still looking for that individual.
    Presentation Material (Acrobat)
2:15 pm

Connecticut Case Study -- Continuing the Integration with Strong Leadership

Linda Gomes, RN
Clinical Reimbursement Manager, Bridgeport Hospital, Bridgeport, CT

    Speaker Bio

    Linda Gomes has more than thirty years of nursing experience, including clinical pediatrics, nursing management, and nursing informatics, before transitioning to her present position as Clinical Reimbursement Manager at Bridgeport Hospital in Connecticut. In addition to her nursing degree, she holds a BS in Business Management from Post College in Waterbury, CT. and an MS in Health Systems Management from Sacred Heart University in Fairfield, CT. Linda's interests outside of her career include a passion for the game of golf and a passion for spoiling her grandchildren.
    Presentation Material (Acrobat)
2:45 pm

Texas Case Study -- Challenges and Wins for a Fully Integrated CDI Team

Delana Knupp, RN, CRRN
Integrated CDI/Case Management Director, Wise Regional Health Systems, Decatur, TX

    Speaker Bio

    Delana Knupp is an Integrated CDI/Case Management Director at Wise Regional Health Systems in Decatur, TX. She is a nurse with approximately 18 years in the healthcare field -- everything from helping her younger brother open up his own Physical Therapy practice, to becoming an EMT Paramedic with four small children at home, to obtaining her ASN from Excelsior University in Albany, NY. She has experience in a wide variety of clinical areas, CDI, audit analyst and UR. She has over seven years in leadership positions bringing about electronic documentation, CDI and now, in the last year, Integrated CDI. Under her umbrella of Integrated CDI she has UR, traditional CDI, and audit analysis. Delana feels passionate about effective communication and loves this journey of being the bridge that holds together the clinical and revenue side of the house.
    Presentation Material (Acrobat)
3:15 pm Break
3:45 pm Faculty Panel
  • The Top Challenges to Integrated CDI in My Organization
  • Audience Q&A Session
  • Audience Response System Questions
Day Egusquiza
President, AR Systems, Inc., Twin Falls, ID (Moderator)

    Speaker Bio

    Day Egusquiza is President of AR Systems, Inc. and brings over 30 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. 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, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA's ANI rated her in the top 25% for each year she has presented, earning her the 'Distinguished Speaker' award. She received her college degree at Lewis & Clark College in Portland, OR.
5:00 pm Preconference Adjournment
5:15 pm Networking Reception


Go to Agenda:
Day 1 | Day 2




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