Open Line Friday: ICD-10 Edition Provider Teleconference Series Program Panelists

Transcription

1 s Diana Brijbag, CMM, CPC, CCP, CMSCS Office Manager The Springs Family Medical Center, P.A. Springhill, FL Diane has operated as the office manager for the Springs Family Medical Center, P.A. located in Spring Hill (Tampa) Florida, for over 20 years. Prior to this, she worked for Medicare Part B. She is a member of the Professional Association of Health Care Office Managers (PAHCOM) and a PAHCOM Certified Medical Manager (CMM). Laurie Darst Revenue Cycle Regulatory Advisor Mayo Clinic Rochester, MN Laurie is a Regulatory Advisor for Revenue Cycle at Mayo Clinic in Rochester, MN. Her primary focus is administrative simplification mandates impacting Mayo Clinic s Revenue Cycle and EDI activities. Joseph Gonzalez VP Business Development Secure EDI Charlotte, NC Joseph served as the primary consultant for initiatives with the nation s leading companies in financial, healthcare and clinical data verticals. These include financial institutions, healthcare clearinghouses, practice management vendors, EMR vendors, labs, and related technology firms. Mary Rita Hyland, RN, BS, MBA CPO & VP Regulatory Affairs The SSI Group, Inc. Mobile, AL Mary has over 35 years of professional experience in the health care industry which includes Hospital Administration, Physician Practice Management, Payer, Clearinghouse and Vendor IT organizations as well as consulting for hospitals nationally. Gale Scott EDI Regulatory Compliance Administrator Department of Information Technology Tampa General Hospital As the EDI Regulatory Compliance Administrator for Tampa General Hospital, Gale has been responsible for HIPAA EDI development at Tampa General Hospital since January 2003.

2 s Deborah Stewart, M.D. Medical Director, Provider and Client Solutions Florida Blue, Jacksonville, FL Dr. Stewart joined Florida Blue in the spring of 2012 as a Medical Director for Provider and Client Solutions. In her role, Dr. Stewart manages relationships with providers including helping practices transform into PCMH (Patient Centered Medical Homes) and ACO (Accountable Care Organizations). Matthew Ketterman Director of Business Solutions Availity, L.L.C., Jacksonville, FL As Director of Business Solutions for Availity 1, which operates one of the nation s largest health information networks, Matthew is responsible for developing and managing the execution of product strategy for health plans and vendors. Lee Ratliff Clinical Business Technology Consultant Baptist Health South Florida, Miami, FL Lee is currently employed with Baptist Health South Florida as a clinical business technology consultant for ICD-10 planning and implementation. Prior to this, Lee was involved in HIPAA 4010 implementation and 4010 to 5010 migration at a number of hospitals. George V. Vancore, Jr. Senior Manager Mandates and Compliance Portfolio Delivery Systems Florida Blue, Jacksonville, FL George has been with Florida Blue for over 19 years. In his current role, he is responsible for ensuring the successful technical and business process integration and implementation of external regulatory mandates and compliance programs. 1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit Availity s website at

3 Diana Brijbag, CMM, CPC, CCP, CMSCS Office Manager The Springs Family Medical Center, P.A. Springhill, FL Diane has operated as the office manager for the Springs Family Medical Center, P.A. located in Spring Hill (Tampa) Florida, for over 20 years. Prior to this, she worked for Medicare Part B. She is a member of the Professional Association of Health Care Office Managers (PAHCOM) and a PAHCOM Certified Medical Manager (CMM). In 2001, Diane was nominated for and secured the title of National (PAHCOM) Office Manager of the Year. Additionally, Diane is a National Certified Coder through the American Academy of Professional Coders (AAPC), and a Local member, nationally certified as a Multi-Specialty Coding Specialist (CMSCS) from the Professional Association of Healthcare Coding Specialist (PAHCS), and a Certified Compliance Professional Physician (CCP) from the Board of Medical Specialty Coding and Compliance (BMSCC). In 2002, Diane founded and worked as president of the Nature Coast Chapter of PAHCOM, currently the Spring Hill Chapter. She s served on the PAHCOM Spring Hill Chapter board for 12 years and has since resigned to focus on the challenges of ICD-10 and Meaningful Use Attesting, achieving compliance for her office, and sitting for her HITECH-PP certification. Return to Page 1

4 Laurie Darst Revenue Cycle Regulatory Advisor Mayo Clinic Rochester, MN Laurie is a Regulatory Advisor for the Revenue Cycle at Mayo Clinic in Rochester, MN. Her primary focus is administrative simplification mandates impacting Mayo Clinic s Revenue Cycle and EDI activities. Laurie actively participates in a number of national standard setting organizations including: ANSI X12N, National Uniform Claim Committee (NUCC), National Uniform Billing Committee (NUBC), and HL7 Attachments Workgroup. She currently serves on the Workgroup for Electronic Data Interchange (WEDI) Board of Directors Executive Committee, co-chairs WEDI s ICD-10 Workgroup and serves as Vice Chair of WEDI s Programs and Services. At a state level, Laurie is currently serving as co-chair of the MN Administrative Uniformity Committee and is also actively involved with the MN Payer/Provider ICD-10 Implementation Collaborative Committee. Return to Page 1

5 Joseph Gonzalez VP Business Development Secure EDI Charlotte, NC Joseph served as the primary consultant for initiatives with the nation s leading companies in financial, healthcare, and clinical data verticals. These include financial institutions, healthcare clearinghouses, practice management vendors, EMR vendors, labs, and related technology firms. In addition to professional responsibilities, Joseph has held leadership roles with industry driving organizations. He has served as Vice Chairman and Trustee of the Board of Directors to the National Dental EDI Council, Has chaired or co-chaired committees and workgroups within Workgroup for Electronic Data Interchange (WEDI), Center Affordable Quality Healthcare s CORE initiative and the Electronic Healthcare Network Accreditation Commission (EHNAC). Joseph currently serves as President of the Cooperative Exchange s Executive Committee. In the past, Joseph has been a featured speaker on 4010/5010 transaction transition, innovations in electronic remittance, and authored white papers on clinical data and electronic medical record strategies and solutions. Return to Page 1

6 Mary Rita Hyland, RN, BS, MBA CPO & VP Regulatory Affairs The SSI Group, Inc. Mobile, AL Mary has over 35 years of professional experience in the healthcare industry which includes Hospital Administration, Physician Practice Management, Payer, Clearinghouse and Vendor IT organizations as well as consulting for hospitals nationally. She currently serves as the Chief Privacy Officer and Vice President of Regulatory Affairs for The SSI Group, Inc., a leader in claims management technology, EDI platforms and networking clearinghouse and revenue cycle data analytics software. Over the past eleven years, Ms. Hyland provided expertise and strategic direction for corporate regulatory initiatives and chairs the HIPAA Task Force as well as leading initiatives for EHNAC, SSAE 16, CORE/CAQH, HFMA Peer Review certification, as well as governmental and non-governmental audits. Mary is an active participant in establishing national standards for health information technology, interoperability, health information exchange, and the HIT Tiger Teams for Privacy and Security and Data Architecture. She is a speaker at national conferences and events that include HIMSS, WEDI, The World Health Care Congress, National Women Legislators, AHIMA, MGMA, HFMA, HBMA, AAHAM and more. Return to Page 1

7 Gale Scott EDI Regulatory Compliance Administrator Department of Information Technology Tampa General Hospital As the EDI Regulatory Compliance Administrator for Tampa General Hospital, Gale has been responsible for HIPAA EDI development at Tampa General Hospital since January Highlights of her experience include seven years as Director of Management Information Systems for a hospital system, 13 years of healthcare consulting with a focus on revenue cycle improvement and many years of direct operational and system involvement within the hospital information technology and financial areas. Gale has been an active member of ASC X12N since 2003 with emphasis on the 837 and 835 workgroups. She s been an active member of WEDI (Workgroup for Electronic Data Interchange) since 2003 with direct involvement in several workgroups as well as serving on the WEDI NPI Outreach Initiative Steering Committee. Gale is frequently called upon to present at various industry organizations and she has written for several industry publications. Return to Page 1

8 Deborah Stewart, M.D. Medical Director, Provider and Client Solutions Florida Blue, Jacksonville, FL Dr. Stewart joined Florida Blue in the spring of 2012 as a Medical Director for Provider and Client Solutions. In her role, Dr. Stewart manages relationships with providers including helping practices transform into PCMH (Patient Centered Medical Homes) and ACO (Accountable Care Organizations). Responsibilities include programmatic and organizational focus on health care disparities. She is also responsible for working with sales and the network team on client relationships to provide clinical information to improve outcomes for members and employers. As part of the quality function, Dr. Stewart participates in several work groups charged with performance improvement and is chair of the credentialing and peer review committee for the organization. Previously, she served as Executive Vice President for Diversified Clinical Services, the largest wound care and hyperbaric medicine management company in the country with over 350 clinics in more than 40 states and Puerto Rico. During her tenure at Diversified she managed physician relations, clinical education and quality of services. Before Diversified, Dr. Stewart served as CMO at Brooks Health System, a rehabilitation-focused health system in Jacksonville, Florida which has the largest acute inpatient rehabilitation hospital in the southeast, is among the largest in the country and offers all levels of rehabilitation services. Dr. Stewart has an appointment as a courtesy Clinical Associate Professor of Aging and Geriatric Medicine at the University of Florida. She has authored numerous peer reviewed articles, book chapters, and presented hundreds of lectures nationally and regionally. She is board certified in physical medicine and rehabilitation and trained in internal medicine. Dr. Stewart has practiced medicine for more than 25 years. She obtained an MBA at Auburn University in Return to Page 2

9 Matthew Ketterman Director of Business Solutions Availity, L.L.C., Jacksonville, FL As Director of Business Solutions for Availity 1, which operates one of the nation s largest health information networks, Matthew is responsible for developing and managing the execution of product strategy for health plans and vendors. Prior to leading the Business Solutions group, Matthew served in various technical roles at Availity, most recently as Director of Implementation Services. Matthew began his health care IT career in 1994 at Rocky Mountain Health Care Corporation where he was responsible for marketing and technical support for EDI solutions. He has served in many advisory roles in the insurance and health care industries, spanning technical, project, product and sales roles. He has been active in numerous industry groups, including ANSI X12N and the Workgroup for Electronic Data Interchange (WEDI). Matthew graduated from the University of New Mexico with a bachelor s degree in Marketing Management. He resides in Jacksonville, Florida. 1 Availity, L.L.C. is a multi-payer joint venture company. For more information or to register, visit Availity s website at Return to Page 2

10 Lee Ratliff Clinical Business Technology Consultant Baptist Health South Florida, Miami, FL Lee is currently employed with Baptist Health South Florida as a clinical business technology consultant for ICD-10 planning and implementation. Prior to this, Lee was involved in HIPAA 4010 implementation and 4010 to 5010 migration at a number of hospitals. Lee has over 25 years of healthcare industry experience that has included many levels and areas of responsibility such as project management, strategic planning, contract negotiation, RFP management, vendor relations, policies and procedures, regulatory compliance, clinical systems, revenue cycle management systems, technical support and end-user support. Return to Page 2

11 George V. Vancore, Jr. Senior Manager Mandates and Compliance Portfolio Delivery Systems Florida Blue, Jacksonville, FL George has been with Florida Blue for over 19 years. In his current role, he is responsible for ensuring the successful technical and business process integration and implementation of external regulatory mandates and compliance programs. George s primary emphasis is on defect-free systems, technical infrastructure and business process integration. His role also includes external third-party readiness and assessment and the strategic development, delivery and support for integration testing and migration of external electronic trading partners, delegated entities, physicians, providers and customers. Prior to his tenure with Florida Blue, George was employed by several other Fortune 500 companies including AT&T, Warner- Lambert, Nabisco, and RJ Reynolds where he held various IT related positions. George holds an undergraduate degree in Computer Science with a minor in Mathematics from State University College at Potsdam New York. He is currently a 2012 candidate for his Master s Degree in Information Technology from the University of North Florida. Return to Page 2