Medical Cost Containment Series (Including HPRI)

🍁 Happy Thanksgiving from the Medical Cost Containment Series! 🦃 This Thanksgiving, we’re especially grateful for: 🦃 The innovative minds uniting the payment integrity and revenue cycle management teams 🍃 The passionate professionals who dedicate their time to work in healthcare 🍂 Our attendees, partners and speakers that come together to help support the claims continuum From all of us at MCC, HPRI and RCM, we wish you a day filled with love, laughter, and time with your friends and families. #HappyThanksgiving #HPRI #MCC #healthcare #paymentintegrity #revenueintegrity

𝐖𝐞’𝐫𝐞 𝐋𝐚𝐮𝐧𝐜𝐡𝐢𝐧𝐠 𝐃𝐚𝐲 3 𝐨𝐟 𝐭𝐡𝐞 𝐌𝐂𝐂 𝐒𝐮𝐦𝐦𝐢𝐭! For the first time ever, the MCC Summit is adding an exclusive workshop day designed to turn conference insights into personalized, actionable strategies. Health plan and hospital leaders—get ready to dive deep into practical solutions tailored to your challenges! 𝐇𝐞𝐚𝐥𝐭𝐡 𝐏𝐥𝐚𝐧 𝐖𝐨𝐫𝐤𝐬𝐡𝐨𝐩 𝐇𝐢𝐠𝐡𝐥𝐢𝐠𝐡𝐭𝐬: 𝐀𝐈 & 𝐃𝐚𝐭𝐚 𝐀𝐧𝐚𝐥𝐲𝐭𝐢𝐜𝐬 𝐟𝐨𝐫 𝐏𝐚𝐲𝐦𝐞𝐧𝐭 𝐈𝐧𝐭𝐞𝐠𝐫𝐢𝐭𝐲: Explore real-world strategies from the conference and see how AI tools can revolutionize your early fraud detection and claims management processes. 𝐈𝐧𝐭𝐞𝐫𝐨𝐩𝐞𝐫𝐚𝐛𝐢𝐥𝐢𝐭𝐲 & 𝐃𝐚𝐭𝐚 𝐄𝐱𝐜𝐡𝐚𝐧𝐠𝐞: Collaborate with providers to streamline data sharing. Discover how seamless interoperability improves fraud detection, claim accuracy, and cost management—building on insights from our Day 1 payer-provider panel. 🏥 𝐏𝐫𝐨𝐯𝐢𝐝𝐞𝐫 𝐖𝐨𝐫𝐤𝐬𝐡𝐨𝐩 𝐇𝐢𝐠𝐡𝐥𝐢𝐠𝐡𝐭𝐬: 📊 𝐃𝐚𝐭𝐚 𝐃𝐢𝐥𝐞𝐦𝐦𝐚𝐬: Tackle your toughest RCM data challenges! Learn methods to enhance data quality, integrate disparate systems (EHRs, billing platforms), and leverage RPA/AI for efficiency—all while ensuring HIPAA and GDPR compliance. ⚙️ 𝐓𝐞𝐜𝐡 𝐈𝐧𝐭𝐞𝐠𝐫𝐚𝐭𝐢𝐨𝐧 𝐢𝐧 𝐑𝐂𝐌: Simplify the adoption of diverse technologies. From selecting the right tools to measuring ROI, navigate integration challenges, manage organizational change, and foster a culture of innovation. 🎯 𝐖𝐡𝐲 𝐀𝐭𝐭𝐞𝐧𝐝? ✅ 𝐈𝐧𝐭𝐞𝐫𝐚𝐜𝐭𝐢𝐯𝐞 𝐐&𝐀: Engage directly with industry experts to get your most pressing questions answered. ✅ 𝐓𝐚𝐢𝐥𝐨𝐫𝐞𝐝 𝐓𝐚𝐤𝐞𝐚𝐰𝐚𝐲𝐬: Walk away with actionable steps to drive cost savings, enhance fraud detection, reduce denials, and accelerate reimbursements. This isn’t just a conference—it’s your catalyst for operational excellence and financial improvement! #paymentintegrity #revenuecyclemanagement #aiinpaymentintegrity #rcmdata #techrcm https://hubs.ly/Q02Zwqmy0

Think your Revenue Cycle training is effective? Let’s put it to the test... At the 2025 RCM Summit (Feb 5-7, Nashville), Edward B. Thomas, MBA/ MSW will share how Trinity Health measures and improves training outcomes. Here’s what you’ll walk away with: 📘 A Training Effectiveness Dashboard tracking knowledge transfer and proficiency. ⚙️ Vendor-agnostic tools that work across 17 different systems. 📝 Lessons from training over 8,000 professionals. 🚶 A step-by-step guide to start improving your own training program. If you’re ready to measure and maximize the impact of your training efforts, don’t miss this session! Register your interest in the 2025 RCM Summit here: https://hubs.ly/Q02Zzg_m0 #RCMSummit2025 #RevenueCycleTraining #LeadershipInHealthcare

In case you missed it! 👀 Here's some recent industry updates: 🤝 Oscar Health CEO Mark Bertolini is ready to take on the employer market and has outlined a three-year plan to become a bigger player in the employer market: https://hubs.ly/Q02Z8Q040 👩⚕️ HHS-OIG has released the Industry Segment-Specific Compliance Program Guidance for skilled nursing and nursing facilities, providing insight into key risk areas and recommendations for mitigating those risks: https://hubs.ly/Q02Z8PrH0 🎓 The University of Colorado Health has agreed to pay $23 million to resolve allegations it violated the False Claims Act in seeking and receiving payment from federal health care programs: https://hubs.ly/Q02Z8LT80 👨⚖️ Owens & Minor has filed suit against Anthem Blue Cross and Blue Shield alleging egregious misconduct by Anthem, including actively frustrating attempts by the plan sponsor to analyze claims data, leading to substantial losses for the self-funded healthcare plan: https://hubs.ly/Q02Z8VN80 #mcc #medicalcostcontainment #healthcare #healthcarepayment #revenueintegrity #healthcarenews

We had the pleasure of interviewing Willie Brown, MBA, MT(ASCP), CHFP, VP of Revenue Cycle at Sentara Health with over 30 years of experience in the healthcare industry. Under Willie’s leadership, his team at Sentara Healthcare has seen remarkable results: an increase in budgeted fill rate from 93.2% to 98.5%, a 117% reduction in turnover, and a 22.3% boost in team member engagement—all achieved within just 18 months. 🎤 At the 2025 RCM Summit, Willie will take the stage in his session, “Growing Top Performers,” to reveal the strategies behind these achievements, focusing on building accountability, prioritizing meaningful time with teams, and becoming a true “barrier buster.” 🔗 Register your interest here to secure your spot: https://lnkd.in/eSzPeGpM

📢 Exciting news for healthcare finance professionals! This February, join us in Nashville for a comprehensive event designed to tackle the most pressing challenges in healthcare business—from payment integrity to revenue cycle management. Gain actionable insights into: ✅ Claims optimization ✅ Value-based care ✅ Denial management …all while fostering stronger payer-provider collaboration. 💡 Plus, connect with our stellar speaker faculty and discover how you can join for free! 📄 Check out the brochure for all the details: https://hubs.ly/Q02YmC_N0 #HealthcareFinance #RevenueCycleManagement #ValueBasedCare

🚨 In 2023, metrics were trending in the wrong direction — nearly 3 out of 4 healthcare providers saw an increase in claim denials. 🚨 If you’re facing similar challenges, the RCM Summit (Feb 5-7 I Nashville) is your chance to get answers to your questions! 💡 This exclusive event brings together senior RCM executives from top U.S. healthcare providers to explore innovative strategies to maximize revenue cycle performance. Together, we’ll focus on accelerating reimbursements, safeguarding patient data, and fostering stronger collaboration across the industry to future-proof your revenue cycle 🤝. Register your interest in the 2025 RCM Summit here: https://lnkd.in/eAeZxZGW #RCM #RCMSummit #revenuecyclemanagement #revenuecycle

Definitely excited to speak again on the Provider's prospective at the Healthcare Payment & Revenue Integrity (HPRI) Congress, now part of the expanded Medical Cost Containment Series (Including HPRI) happening in Nashville - February 5-7, 2025. This has become one of my favorite conferences, as it provides a unique opportunity for deeper payer-provider collaboration which I love that focuses on shared solutions to boost efficiency, reduce waste, and enhance payment integrity processes. For details, download the MCC brochure and hope you can attend! https://lnkd.in/e8dJktqr #HPRI

🎙️ Tune in to our exclusive interview with Richelle Marting JD, MHSA,RHIA,CPC,CEMC,CPMA, Director of Managed Care Contracting at North Kansas City Hospital!   She’s giving a sneak peek of her RCM Summit session: Have the Upper Hand: Negotiate Payer Contracts Like a Pro. If you’re struggling with payer contracts, this is a must-attend to learn the art of negotiation and secure the best terms for your organization. Don't miss out - meet Richelle in person at the 2025 RCM Summit! Register your interest here: https://lnkd.in/exVFeVXS   #RCM #RCMSummit

Come join us at Music City this February 5-7, 2025! Famous for being the city of storytellers and dreamers, when you are not taking part in 1-1 meetings or roundtable discussions, you can be exploring all that the city of Nashville has to offer. Register to join us: https://hubs.ly/Q02XwFM90 #paymentintegrity #nashvilleconference #revenueintegrity #revenuecyclemanagement #fwa #siu #claimsmanagement