SNF Billing Summit (Virtual)
January 21, 2025
8:45am-3:15pm
Skilled Nursing Facility billing is some of the most complex and challenging billing in the healthcare sector. In the last year, billers of all experience levels have struggled with the transition to the Provider Network Management (PNM) system. During this comprehensive all-day summit, OHCA will feature representatives from CGS Medicare, OHCA Executive Director Pete Van Runkle and top healthcare billing consultants to provide practical solutions for your billing team. New billers can acclimate themselves with the best strategies and processes to get your claims paid the first time, while seasoned billing managers and revenue cycle directors will have opportunities to ask the experts their complex billing questions. Don?t miss this exclusive opportunity featuring Ohio specific industry guidance!
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8:45am Welcome (Erin Hart and Diane Dietz, OHCA)
9:00 am PNM Basics (Pauline Siler and Gabrielle Corwin Durbin, RCX Billing Consultants)
9:45 am Break
10:00 am Advanced Claims Troubleshooting in PNM (Tammy Davis, HW&Co)
10:45am Break
11:00 am Top Medicare Denials for Ohio SNFs and TPE Updates (Ruthie Glazer and Nykesha Scales, CGS Administrators)
11:45am Lunch
12:15 pm Navigating CHOPs for Ohio Medicaid (Pete Van Runkle, OHCA)
1:00 pm break
1:15 Leveraging Technology to Optimize Your Revenue Cycle (Dennis Antonelos, CoreCare and Kyle Crowder, MNS Network)
2:00 pm break
2:15 Winning the Game of Medical Reviews (Renee Cummings and Diane Indermuhle RN, AccessAdvantage)
3:15 adjourn
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Dennis Antonelos is the CEO and Co-Founder of CoreCare where he leads the company in its mission to transform the Post-Acute and Long-Term Care (PALTC) industry with AI-powered workflow solutions. Dennis has over two decades of experience leading teams to build enterprise-grade software in highly regulated industries such as financial services, healthcare, and government. Prior to CoreCare he served as Vice President of Digital Wallet Services for Arcus, which was acquired by Mastercard, and as Chief Financial Officer for a hedge fund-backed defense logistics company. CoreCare is currently utilized in more than a thousand skilled nursing facilities across the country and the solution has been featured in Skilled Nursing News, Bloomberg, and CNBC.
Gabrielle Corwin Durbin has over 14 years of long term care, assisted living waiver, behavior health, and managed care billing experience. Gabrielle is a Billing Specialist, Team Lead, and Vice President of Operations at RCX. Gabrielle specializes in cash management, EDI and portal management, and electronic remittances. She heads the technology arm of RCX Billing Solutions and works closely with the accountants at Corwin & Company CPAs for a complete solution on financial management for healthcare providers. She is RCX?s relationship manager with Managed Care and MyCare Ohio. Gabrielle graduated with a Bachelors in Business Administration from John Carroll University and is a member of the OHCA Billing Committee.
Kyle Crowder, National Business Development Executive
Kyle joined MNS several years ago after working for some of the largest NFP/FP SNF Organizations in Ohio where he compiled a book of business of over $20+ million dollars (annually). He also succeeded in implementing key strategic initiatives with many of the area?s largest hospital systems. Kyle has been instrumental in ?Making Managed Care Manageable? for thousands of MNS SNF clients across the country.
Kyle has more than 20 years of experience in the healthcare field, serving in roles with health systems as a Physician Credentialing Specialist and Physician Practice Manager, to a significant portion of his career being dedicated to the mission of Skilled Nursing Facility operations as a Regional Director of Business Development. He is a graduate from Purdue University with honors and is proud to now serve and support SNFs nationally and align with their missions to improve the health and wellness of the Elder Population.?
RENEE CUMMINGS, CEO of Access Companies, and affiliates, Access Advantage, a Post-Acute Care (PAC) Network, Access Innovations, a venue for progressive and new PAC opportunities such as the CMS Bundled Payment Pilot and Access Elite, a consulting firm providing individualized consulting services and project management.
Most recently, Access Advantage has focused on the use of performance metric profiling and electronic infrastructure for small PAC providers and the need for consolidated, scalable solutions in the managed care marketplace. Medicare Advantage, Medicaid managed care, ACOs, narrow networks, bundled payments and increasing payer care coordination of PAC populations, all present opportunities for post- acute providers here and now.
Renee's managed care interest dates to her introduction to managed care in 1986 with a small, gatekeeper PCP HMO Plan, Health America, in Alabama. Working with the provider community since 1996, Renee increasingly focuses on mutually beneficial payer/provider partnerships of value.
Tammy Davis is a Senior Healthcare Consultant with ECS/HW & Co, a firm that provides billing and consulting services for skilled nursing facilities and other health care providers. Tammy has over 44 years of experience in the SNF Industry, with her career beginning in 1980 as an administrative assistant to the owner/administrator of a 260-bed skilled nursing facility. Over the years she has honed her skills as an expert in business office functions, and has a well-established background in Medicare, Managed Care and Medicaid billing. She possesses a vast knowledge of both Medicare and Medicaid Guidelines as they pertain to skilled nursing facilities and billing. Tammy is a frequent seminar presenter and trainer for ECS/HW & Co and has also been a presenter for the Ohio Health Care Association, Health Care Association of Michigan, Michigan County Medical Care Facilities Council and LeadingAge. She is a major contributor to the ECS/HW Co Industry Update.
DIANE INDERMUHLE RN, BSN, Medical Records and Clinical Information Technician, twenty year career in skilled nursing began with STNA and Restorative Aide duties in NE Ohio and advanced to Floor Nurse, MDS Nurse, and QA and EHR Clinical Management with valuable experience in acute care telemetry, progressive and intensive care needs.
Over the past several years, her exposure to all facets of nursing home care has increasingly drawn her to the clinical implementation of electronic systems including EHR, QA, hospitalization tracking, education, ICD-10 coding, MDS, eMAR and STNA charting.
Diane now focuses on customized system solutions to address clinical, and facility care needs. Her background and clinical information expertise has become invaluable to Access Advantage and our Membership in systemizing responses to managed care initiated care reviews and effective responses to retrospective payment audits.
Pauline Siler has over 20 years of medical billing and coding experience with hospital systems, physician billing, behavior health, and a concentration in long term care. Pauline is a Billing Specialist, Team Lead, Point Click Care Setup Specialist, and Medicare expert. Pauline directly manages claims processing and collection, Medicaid adjudications, probe, RAC, exception reviews, and managed care audits. She is highly skilled in contracts, MyCare Ohio, revenue cycle management, home health, behavioral health, and waiver billing. Pauline attended Kent State University and earned a Data Entry/Operator Certification from TCU Training Center as well as her Billing & Coding Certification for the National Health Career Association. She is also a member of the OHCA Billing Committee
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There are no CEs for this event.
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Registration Fee:
Members, early $75 per person
Non-Members, early, $150 per person
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