Master the essentials of membership and revenue reconciliation at the live-streaming virtual conference June 16-17.
The two-day event will take a deep dive into membership and revenue reconciliation, offering sessions that address high-level strategy and critical operational training. The program will review best practices for enrollment, premium payment reconciliation, and processes; how to navigate CMS changes; and the impact of COVID-19.
Here’s a look at what we’ve planned:
Nine featured sessions
Overlooked (and changing) basics of Medicare Secondary Payer compliance: Join Humana’s Brian Bargender, CSRP, for this session that addresses the steps plans should take to protect revenue and prepare for audits, how litigation is changing the Medicare Secondary Payer environment, and how changing rules for primary payers will impact Part C and Part D MSP efforts.
Capitalize on opportunity as the Medicare Advantage market share skyrockets: Kate Riordan, director, MSP Initiatives, will discuss the current revenue reconciliation climate and how to develop a success strategy to maximize revenue and close gaps. The session will also address how to capitalize on the significant increase of Medicare Advantage membership with an effective reconciliation strategy and effective implementation strategies to prepare for the PAID Act.
Success strategies for CMS revenue processes, accuracy, and recovery: Dissect the end-to-end flow chart to understand how CMS processes revenue with speaker Vivek Dubey, CSM, director, revenue management, Visiting Nurse Service of New York. Dubey will go over best practices for reconciliation batch input files, ECRS submissions, and RPC submissions, and will discuss the impact of mid-year sweep and final year sweep.
Key strategies to ensure data accuracy: Kwame Appiah-Yeboah, director, risk adjustment and revenue management, Sentara Health Plans–Virginia Premier, will present best practices and lessons learned to prepare and collect accurate data for CMS. Attendees will leave the session with an understanding of how CMS acquires the data and the risks of inaccuracy and the ability to identify errors and uncover fraud prior to CMS submission.
Master Medicare MMR reconciliation: This session will focus on best practices for effective MMR reconciliation. Cindy Murphree, director, Medicare enrollment, VIVA HEALTH, Inc., will discuss the challenges and benefits of risk factor reconciliation and capitation payments, as well as strategies to protect and position MMRs.
Navigate ESRD membership changes to significantly reduce costs: David Meyer, senior vice president, informatics, NationsBenefits, will discuss CMS changes to allow beneficiaries to enroll in Medicare Advantage. Attendees will come away with strategies to quickly shift members into the new product code to reduce costs for the patient and payer and will master specifics on how to submit ESRD forms correctly for full reimbursement to prevent lag time on the MMR.
Innovative tools for data management and reconciliation processes: Attendees will learn the pros and cons for outsourcing to determine their best approach to reconciliation. The session, led by Brian Bargender, CSRP, Humana, and Denyse Wise, chief administrative officer, Cody Consulting, will offer best practices to organize complex data and streamline reconciliation processes, technology recommendations and new approaches for automation regardless of health plan size, and tips to evaluate and select vendors.
Streamline operational reconciliation processes: Sherri Richardson, strategy, growth & project management director, coordination of benefits, program integrity, DBG, Anthem, Inc., will lead this session that addresses how to streamline reconciliation processes across your plan, the impact of operational reconciliation on your bottom line, and strategies to break down silos between operational and financial reconciliation.
Best practices for hospice claims: This session, led by Kwame Appiah-Yeboah, director, risk adjustment and revenue management, Sentara Health Plans–Virginia Premier, will address CMS changes to hospice reporting, best practices and lessons learned for navigating hospice claims, and how to manage hospital claims to ensure changes don’t impact your bottom line.
Virtual networking opportunities
The two-day event will feature several opportunities to network with other attendees and vendors. Our virtual networking lobby allows you to turn on your camera, hop from table-to-table to meet new connections, and say hello to familiar faces.
Virtual conference perks
The live-streaming sessions allow you to chat with other attendees and send questions directly to presenters and get answers in real time. The entire conference will also be made available to you for 90 days after the event so you can re-watch sessions anytime.
Editor's note: The Medicare Advantage Member Accounting and Reconciliation Summit will take place June 16-17. Click here for the full agenda, list of speakers, and registration information.