Return to calendar

Provider Disputes and Appeals: Best Practices for Health Plans

Event Date:4/23/2019

Event Overview

Tuesday, April 23, 2019
1:00 PM CT – 2:00 PM CT (60 minutes)
Hosted by: Physicians Health Plan

This event is hosted on our ReadyTalk platform

 

Physicians Health Plan shares their provider appeals process which has served them well for over 10 years. Members will engage in lively discussion about their own challenges around handling provider disputes on claims, and ways they have reduced the incidence of appeals through education and other means. Join us to hear about best practices for dispute resolution.

Audience

Those involved in claims management and processing.


Ask your peers a question or share a resource anytime through the Alliance discussion forum

You can visit the discussion forum and post a question anytime. It's only available to Alliance members, so you question is private and secure. When submitting a question, you can select which topics your question is related to, such as "risk adjustment" or "coding". Individuals who have indicated in their Alliance profile they are interested in those topics and are opted in to discussion forum emails will receive your question. You can also add an attachment to your question or reply, making this tool another great resource for sharing best practices with your peers.

 


 

Other recommended events

Register now for these upcoming events

View the presentation materials from these recent events

 

Registration
ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
Fee End Date Description Amount
4/23/2019 choose this option if you are an employee of an Alliance member health plan FREE
ALLIANCE GUEST
Fee End Date Description Amount
4/23/2019 choose this option if you have been invited to attend as a guest of the Alliance GUEST PASS
SPEAKER
Fee End Date Description Amount
4/23/2019 choose this option if you are not an Alliance member, but have been invited to speak at this event SPEAKER PASS
Documents
Attendees

Below is a list of all delegates registered to date for this event

  • Allen Chen
  • ALLIANCE GUEST
  • Director of Network Operations at Central Health Plan of California
  • Annie Shieh
  • ALLIANCE GUEST
  • Senior Compliance Counsel at Central Health Plan of California
  • Carrie Abenante
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Special Investigations Unit at Sentara Health Plans (Optima)
  • Olamide Akanbi
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medicare Compliance Coordinator at Paramount Health Care
  • Jessica Arrambidez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager Strategic Projects and Business Process Improvement at CHRISTUS Health Plan
  • Sandi Bascove
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Provider Relations Manager at Health New England
  • Stephanie Belue
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager of Quality Assurance, RIsk Management, and Training at Alliant Health Plans
  • Lisa Boucher
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Accreditation Program Manager at Network Health
  • Katrina Briguglio
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Operations Director(Claims) at Health First Health Plans
  • Virginia Burford
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Claims Supervisor, Health One Alliance at Alliant Health Plans
  • Martha Cisneros
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Member Services Manager at Valley Health Plan
  • Serena Clark
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Network Liaison at HealthTeam Advantage
  • Emily Corley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • QI Program Specialist at CommunityCare
  • Jacqueline Crews
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Government Programs & Regulatory Affairs at AvMed
  • Crystal Djordjevic
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Risk Adjustment Coding Consultant at Health Alliance Medical Plans
  • Phyllis Fisher
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Operations at Physicians Health Plan
  • Damaris Gautier
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Medical Director - Office of the CMO at Scott & White Health Plan
  • Loriann Heinssen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of HFHP Compliance at Health First Health Plans
  • Marjorie Henriksen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Operations, Prominence Heatlh Plan/CDS Group Health at Prominence Health Plan
  • Freda Hogan
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP Network Development at Health Alliance Plan (HAP)
  • Nancy Johnson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP, Compliance & Regulatory Affairs at Community Health Options
  • Cindy Jorgensen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Medicaid Programs at Scott & White Health Plan
  • Julie Kai
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager-Medical Appeals at Health Alliance Plan (HAP)
  • Tina Korty
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Vice President of Legal, Compliance, and Regulatory at Indiana University Health Plans
  • Cassie Lane
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Associate-Senior Claims Coding at Indiana University Health Plans
  • Doris Livingston
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Customer Service Government Programs at Sentara Health Plans (Optima)
  • Jessica Lopez
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Provider Support Supervisor at Care N' Care Insurance Company, Inc.
  • Angie Lovell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Operations Manager at Prominence Health Plan
  • Greta Matus
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • FWA Special Investigator at Health Alliance Medical Plans
  • Millie McConnell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Claims Analyst III at Indiana University Health Plans
  • Margie McNett
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • VP - General Counsel - Health Plan Operations at Presbyterian Health Plan
  • Amy Meldeau
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Appeal and Grievance Manager at Health First Health Plans
  • Janna Miller
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Operations Claims Manager at Health First Health Plans
  • Daniel Morrissey
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Assistant Coordinator at Paramount Health Care
  • Deana Myers-Voyk
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding Auditor at SummaCare
  • Sandra Nary
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Auditor at Neighborhood Health Plan of Rhode Island
  • Wendy Owen
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Sr. Fraud & Abuse Investigator at Sentara Health Plans (Optima)
  • Charles Palermo
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director at Health Alliance Plan (HAP)
  • Joyce Petermann
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Coding validator/risk adjustment specialist at Avera Health Plans (DAKOTACARE)
  • Dipali Portwood
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Lead Compliance Auditor at Scott & White Health Plan
  • Julie Powell
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Investigator at Sentara Health Plans (Optima)
  • Jasmine Rabsatt-Ross
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Member Services at Sentara Health Plans (Optima)
  • Abbie Reckley
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Compliance Specialist at Passport Health Plan
  • Jeanne Skinner
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Payment Integrity & Recovery at Network Health
  • Donna Sossamon
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Appeals and Grievance Specialist at Alliant Health Plans
  • Leslie Sprites
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director of Claims at Alliant Health Plans
  • Sara Stiles
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager at Sentara Health Plans (Optima)
  • Jill Stoken
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Contract & Provider Relations Manager at Network Health
  • David Stuart
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director, Claim Operations at Community Health Options
  • Debra Tracy
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Senior Business Analyst at Health First Health Plans
  • Bhargavi Vemuri
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Claims Quality at Indiana University Health Plans
  • Elizabeth Waite
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Manager, Appeals & Grievances at Network Health
  • Kimberly Walker
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Clinical Operations Manager at Care N' Care Insurance Company, Inc.
  • Rebecca Welling
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Director Coding Compliance at Providence Health Plans
  • Jered Wilson
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Chief Operating Officer at Paramount Health Care
  • Christopher Zapart
  • ALLIANCE MEMBER HEALTH PLAN/PROVIDER AFFILIATE
  • Investigator at Geisinger Health Plan
Speakers