Timothy Kaja, Senior Vice President,
Physician and Hospital Relationships, UnitedHealthcare
Website:
UnitedHealthCare
Timothy Kaja has been with
UnitedHealth Group and/or affiliated companies for 24 years and is
currently responsible for leading the operational changes associated
with enhancing physician and hospital relationship equity throughout
UnitedHealthcare. This includes re-engineering UnitedHealthcare’s
provider call, an issue resolution experience, as well as enhancing the
portal and electronic data usability for physician and hospital
administrators. Tim is also leading the charge for the upcoming changes
associated with the v5010 and ICD10 upgrades for UnitedHealth Group
while promoting the principles of administrative simplification that
have become so important to healthcare reform.
Tim’s previous roles include: the development and
build out of the Corporate Network Operations organization within
UnitedHealthcare which brought together contract installation, physician
demographics, reimbursement policy development/implementation and coding
protocols, credentialing, and claim repricing operations. Tim launched
the start up of Audit and Recovery Operations, COB Cost Management, and
Claims Cost Management in 2001. Prior to joining the corporate team, Tim
had responsibility for claim, billing and enrollment, and accounts
receivable in the Wisconsin Health Plan. He spent his first 12 years
with the company with the AARP Claim Organization.
Tim has a MBA and BS from the University of Wisconsin
- Milwaukee. He is a Certified Coder with the American Academy of
Professional Coders, and a Certified Quality Manager and Senior Member
for the American Society for Quality.
Hear from the nation's biggest health insurance
carrier -- Mr. Kaja will address attendees about the future of carrier
reimbursement models, dynamics, cost of healthcare dollars, where costs
are headed, improving administration costs, EDI transactions and more.
 Tammy
Banks
American Medical Association
(AMA)
Website:
www.ama-assn.org
Tammy Banks,
MBA,
is currently the Director of the
Practice Management Center and
Payment Advocacy. The American
Medical Association Private
Sector Advocacy unit launched
the Practice Management Center
to help physicians understand
the necessity to focus on the
enhancement of their practice
financial viability, identify
and challenge unfair payer
business practices, implement
administrative information
technology solutions, and take
action to address these issues
within their practice.
The Private
Sector Advocacy unit works
closely with state, county, and
specialty medical societies to
confront unfair managed care
practices nationally and at the
local level. As a result of
this activity, a number of HMOs
and insurers have backed down
from objectionable policies that
were detrimental to patients and
physicians.
Prior to coming
to the AMA, Tammy served as the
Director of Socioeconomic
Affairs and Research and was
responsible for the health
policy, practice management,
reimbursement and research areas
for the North American Spine
Society. Tammy received her
Master’s degree in Business
Administration with an emphasis
in Quantitative Methods from
Roosevelt University, in
Chicago, Illinois; received a
Bachelor of Arts degree from
Alma College, in Alma, Michigan;
and received the Coding
Procedural
Certification—physician based
(CPC-P) from the American Health
Information Management
Association.
Tammy will
present on "Grading the
Insurance Companies." The AMA's
National Health Insurer Report
Card provides physicians a
reliable and defensible source
of metric's concerning the
timeliness and accuracy of
claims pr9ocessing by insurance
companies. Tammy will provide
insight into how the AMA ranks
payments and denials by the
major insurers and how you can
find additional tools to help
you collect more money, quicker.
Robert
W. Liles, Esq.
Website:
www.lilesparker.com
Mr. Liles is principal
shareholder of Liles Parker, PLLC, a Washington DC law firm. His
practice handles health care fraud defense and regulatory matters,
representing doctors and other health care providers both in civil
and criminal proceedings. Before entering private practice, Robert
served as Deputy Director for Leal Programs at the US Department of
Justice, Executive Office for United States Attorneys. Prior to
that, he was their first National Health Care Fraud Coordinator.
Robert has taught and lectured at more than 50 national conferences
and seminars to DOJ prosecutors, investigators, auditors, and
industry representatives on a variety of civil and criminal fraud
and regulatory issues. He serves as faculty for the Georgetown
University/National Institute of Trial Advocacy. and and serves as
the AMBA General Compliance Legal Counsel. There are a lot of new
issues for billers to deal with in 2011. Hear from Attorney Liles on
changes billers should be aware of, new compliance requirements for
physicians and get the latest on how Zpics are using predictive
modeling from data mining of claims information to identify improper
billing trends. .
Diane Marie Moulzolf
Website:
http://www.financialconsultscompany.com
Diane is the
General manager / Director of
Operations for Financial
Consultants Company, Inc
She has
been a long time trainer of
collectors in the collection
field and also in the medical
field. She has worked for the
Zimmerman, Princeton and Milaca
Clinics and was the trainer for
their office collections and
office organization, for all
three of the clinics. Diane has
29 years of collection
experience.
Diane will present "Collections
101 - Things You Need to Know to
Effectively Collect More Money"
You will learn how to protect
practices from increasing
accounts receivables, what
information is needed to collect
the account, key phrases to use
in dealing with difficult
patients and how to stop common
delay tactics delinquent
patients’ use. Diane will also
teach you how to skip trace
patients that skip out on their
bill, what to do when a patient
has passed away -- liability of
spouses and estates and how to
handle active military or
bankruptcies. She'll talk about
judgments and the statute of
limitations on collecting old
balances.
Cyndee Weston, CPC, CMC,
CMRS
Website:
http://www.ambanet.net/AMBA.htm
Cyndee Weston, CPC, CMC, CMRS is
the Executive Director of the
American Medical Billing
Association (AMBA) and has
nearly 30 years of billing,
coding, compliance and
reimbursement experience. She
works with independent and
doctor's office billers
providing support, education and
resources to AMBA members.
Weston has earned her CPC and is
a member with the AAPC.
Additionally, she is a CMC
through PMI. She chairs AMBA's
ICD10/5010 and Certifying Board
committees and has recently been
added to the Medical
Billing/Coding Program Advisory
Board for Montana State
University. Weston is a frequent
webinar speaker for AMBA, Audio
Educator, PMI and other
educational entities.
Cyndee will present
Plug Revenue
Leaks with Financial Policies
and Reimbursement Tips that
Really Work.
This session will provide good
examples of clear and concise
patient policies that should be
included in office policies but
is often overlooked.
Additionally, you'll learn easy
to use and implement
reimbursement tips that will
help you be more productive and
effective at collecting
insurance money.
Don Self, Whitehouse, TX
Website:
http://www.donself.com
Don Self has nearly 30 years of
reimbursement, coding, billing and consulting experience. He has
presented for MGMA, PAHCOM, AMBA and numerous physician groups and
professional associations. He has written many articles for newsletters
and blogs, has published his own newsletter for several years and has
assisted hundreds billers and coders on forums and news groups over the
last decade.
Don will present ERISA - A Body of Law
That All Billers Can Use to Get Claims Paid! This is an important topic
that too few billers know about, much less use to their advantage.
You'll go home with knowledge that will help you collect more claims
right away. You won't want to miss this session!
Tammy Lovely, CPC, CPMA, CMRS, Director of Coding
Website:
http://www.aisi-med.com
As Director of
Coding, Ms. Lovely oversees the Coding Department. Lovely has been
active in the medical billing field for over 15 years, she has been
a member of the Apollo team for six years. A member of both
American Medical Billing Association and the Academy of Professional
Coders and holds certificates in coding, medical auditing, medical
reimbursement, and customer service. In addition to teaching
classes in Legal Issues in Medical Billing for Apollo University.
Tammy has extensive billing experience from having previously owning
her own billing company. Tammy also is an officer on the American
Medical Billing Association National Advisory Board.
Compliance is one of the most
integral responsibilities of a
successful and lawful billing
company or medical practice.
Tammy will help attendees
understand all the important
elements of a
billing compliance plan. She'll
cover simple and effective
policies and procedures you can
easily implement that will help
you comply with fraud and abuse
detection and prevention. Get
documentation strategies, learn
about key issues that are
considered problematic, and how
you can ensure your policies
stand up to scrutiny of
government investigators.
Cyndee Weston, CPC, CMC,
CMRS
Website:
http://www.ambanet.net/AMBA.htm
Cyndee Weston, CPC, CMC, CMRS is
the Executive Director of the
American Medical Billing
Association (AMBA) and has
nearly 30 years of billing,
coding, compliance and
reimbursement experience. She
works with independent and
doctor's office billers
providing support, education and
resources to AMBA members.
Weston has earned her CPC and is
a member with the AAPC.
Additionally, she is a CMC
through PMI. She chairs AMBA's
ICD10/5010 and Certifying Board
committees and has recently been
added to the Medical
Billing/Coding Program Advisory
Board for Montana State
University. Weston is a frequent
webinar speaker for AMBA, Audio
Educator, PMI and other
educational entities.
In today's economic times, it is
important for practices and
independent billers to utilize
and provide cutting edge
technologies and services in
ways that will ensure better
patient experiences and enhance
productivity and collections
effectiveness. Weston will
present "Reinvent Your Services
or Your Practice for Optimum
Results" in an effort to assist
medical billers and practices in
learning how to utilize existing
and new technologies such as
social networking and twitter to
market and communicate with
patients in ways patients are
using those technologies. She
will also provide tips and
strategies for optimum
productivity and collections of
insurance payments.
Weston will also present on the
Latest on Regulations, RACs,
CERT and ICD10/5010 by providing
you with updated information and
last minute tips on implementing
5010 successfully.
Cheri Freeman
Website:
http://www.cherifreeman.com
Cheri Freeman is a Certified
Medical Reimbursement Specialist
with over 12 years of experience
billing for providers in the
Physical Medicine & Rehab
specialties. She has owned and
operated her own billing company
and currently works at Virginia
College as the manager of
account services in their
billing agency. Cheri has served
on the AMBA National Advisory
Board and currently serves on
the Certifying Board of the
AMBA.
With an extensive LCD in Texas
for for Physical Medicine and
Rehab specialties, Cheri has
learned to properly utilize the
LCDs to not only get her
providers paid accurately and in
full the first time around, but
how to work old A/R for new
clients and recover thousands of
dollars in previously denied
Medicare claims. She has been
teaching others how to use the
LCDs not only in Rehab
specialties, but in other
specialties as well. Cheri will
present on how to effectively
use and understand LCDs to
maximize reimbursement. She'll
also explain how to use ABNs for
non-covered services and how to
get previously denied claims
paid using LCDs correctly.
Bonnie J. Flom, CMRS
Website:
http://www.billingbuddies.com
Bonnie J. Flom began her healthcare career by working in the
accounts receivables department at St. Joseph’s Medical Center on
February 13, 1984. While working there, she served on the Blue
Shield EDI committee, United Way Committee and Benedictine Mission
Committee. After starting her billing agency, Rapid Return Medical
Billing in 1994 quickly grew to employ 17 people at one time. In
2000, Bonnie J. Flom served Blue Cross Blue Shield of Minnesota in
testing their Optical Character Reader (OCR) which automatically
converted paper claims to NSF files. In 2006, Bonnie J. Flom sold
her shares of the Rapid Return Medical Billing, and spent two years
writing the book Mastering Medisoft, which is used today in colleges
to teach new medical billing students. In 2008, Bonnie joined a new
company named Billing Buddies and a unique concept was born that
allowed clinics and billers to become “buddies” in the billing
processes. In 2009, Bonnie spoke for AMBA on the Daily Basics of
Medical Billing. Bonnie is also a speaker for Senior Community
Services presenting Navigating Medicare to the elderly. Bonnie
recently earned her CMRS through AMBA.
Bonnie will present
"Our Future, the Affect
of EHR on Billing Services." We
are facing some major changes in
the billing service industry --
most notably implementation of
EHRs. How will these changes
affect billing services? Bonnie
will review what EHR is and when
and how it will affect billing
services. She'll demonstrate how
billing companies can help
doctors and other healthcare
providers earn the stimulus
incentive bonus. Bonnie will
provide you with the tools and
information you need to
successfully assist providers.
Bonnie will also present "5010 -
What You Need to Know to be
Ready Jan. 1, 2011." This
session will focus on the least
you need to know so that your
office can be ready to make the
change in January. Payments
could be delayed if you're not
prepared - learn what you need
to focus on to get paid in 2012.
Ann Marie Brunk, CPC, CMRS
Website:
http://www.hcarebills.com
Ann Marie Brunk
opened her full
service Medical
Billing company
in Loveland
Colorado in
December 2006.
She has served
as Vice Chair
and then
Commissioner of
the Human
Services
Commission for
the City of
Loveland in the
state of
Colorado. Prior
to starting her
billing company
in 2006, Ann had
30 years of
management
responsibility
at a major
communications
company. She has
quickly become
an expert in
medical billing.
She is a member
of the AAPC and
is a CPC and is
also the
President of the
Rocky Mountain
AMBA local
chapter.
Ann works
closely with
fellow AMBA
member, Terri
Marohn. They
collaborate and
share resources
and are
continuously
looking for
better processes
to utilize in
their billing
companies. As a
result of all
their research
and
implementations,
they have
improved
performance and
cost savings.
Ann and Terri
have implemented
several
effective
methods and processes that
allow them to
easily work with
and manage
remote workers,
remote backup of
data, dual
monitor and
computers,
document
management,
electronic EOBs
and statements
and much more .
Ann and Terri
will co-present
on "Processes
Used by
Successful
Billing
Companies That
You Can Easily
Duplicate."
They'll share
their secrets
for quickly
researching and
implementing new
processes that
save them time
and money.
They'll provide
you with a list
of the processes
they have
implemented as
well as giving
you tips on
implementing
your own
processes that
will save you
time and money.
They'll show you
how to simplify
your daily
administrative
tasks using
affordable and
compliant tools
and processes.
Terri Marohn, CMRS
Website:
http://www.termarbilling.com
Terri Marohn has
been in the
medical billing
field for over
13 years and is
president of
TerMar Billing,
Inc. a Michigan
company,
specializing in
Mental Health
Billing. Terri
recently became
a CMRS and is a
moderator for
the AMBA
Forum. She is a
current member
of AMBA’s
National
Advisory Board
and has
represented AMBA
at the Michigan
Medical Billers
Association 2011
Conference.
Terri works
closely with
fellow AMBA
member, Ann
Brunk. They
collaborate and
share resources
and are
continuously
looking for
better processes
to utilize in
their billing
companies. As a
result of all
their research
and
implementations,
they have
improved
performance and
cost savings.
Ann and Terri
have implemented
several
effective
methods and processes that
allow them to
easily work with
and manage
remote workers,
remote backup of
data, dual
monitor and
computers,
document
management,
electronic EOBs
and statements
and much more .
Terri and Ann
will co-present
on "Processes
Used by
Successful
Billing
Companies That
You Can Easily
Duplicate."
They'll share
their secrets
for quickly
researching and
implementing new
processes that
save them time
and money.
They'll provide
you with a list
of the processes
they have
implemented as
well as giving
you tips on
implementing
your own
processes that
will save you
time and money.
They'll show you
how to simplify
your daily
administrative
tasks using
affordable and
compliant tools
and processes.
Sheila Hokes,
CMRS
Ann Brunk, CPC,
CMRS
Tammy Lovely,
CPC, CPMA, CMRS
Robert Liles,
Esq.
Leah Sees, CMRS
Leah Sees, CMRS
Website:
http://www.taylorbilling.com
Leah is a CMRS
with broad and
extensive
experience in
all phases of
the
reimbursement
cycle for all
provider types
and all payor
types. She has
direct
experience with
provider
start-ups and
aged claims
recovery. She
has extensive
experience in
Medicare and TX
Medicaid, DME
billing,
transport
services,
hospice, CORF
and dialysis
facility
billing.
Additionally,
she has
experience in
billing
professional
charges for
rehabilitative
services and
psychiatric
services as well
as experience in
IDTF billing.
She also has
experience in
credentialing
new providers.
Leah is an AMBA
National
Advisory Board
member and has
written several
advisory
articles for the
AMBA. Leah will
share her
experience with
members by
participating in
the Guest Panel
on Friday, Day
2.
Shelia Hokes, CMRS
Sheila Hokes is the
President of Advanced Insurance Management, LLC, in Columbus, Ohio.
She is a consultant providing billing, auditing, practice
management, compliance, credentialing, and continuing education for
healthcare providers in numerous states for over 17 years. She has
served as an expert witness in the medical billing and consulting
field. She has reviewed numerous cases and written expert witness
letters, been deposed on several occasions, and has testified in
court regarding various issues pertaining to the medical field. She
is a CMRS and has been a member of AMBA since 2005. She is currently
the President of the Central Ohio AMBA
local chapter, and serves on the National
Advisory Board for AMBA. Sheila also has a health and life insurance
license in the State of Ohio and is currently a member of the
Columbus Association of Health Underwriters (CAHU), the Ohio
Association of Health Underwriters (OAHU), and the National
Association of Health Underwriters (NAHU). She is a co-chair for
the OAHU PAC legislative committee.
Sheila will participate in the
Guest Panel on Friday, Day 2.
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