Agenda – Day 2

Day Egusquiza is President of AR Systems, Inc. and brings over 38 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance – both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA’s ANI rated her in the top 25% for each year she has presented, earning her the ‘Distinguished Speaker’ award.

Ed Norwood, President of ERN/The National Council of Reimbursement Advocacy (NCRA), Ed has first –hand experience with problematic payors and is thoroughly familiar with public policy laws designed to help participants fight unfair payment practices that impact quality of care (and reimbursement) in their facility. Ed also serves as the Chief Compliance Officer of the National Reimbursement Firm (TRAF). Multi-faceted, with a creative ability to inspire his audience, Ed combines his healthcare influence and expertise with his passion to help providers advocate for medically appropriate healthcare pursuant to federal and state laws.

After completing his residency at the University Of South Carolina School Of Medicine Dr. Baker was the founding and managing partner in Piedmont Physicians for Women an OB/GYN practice for 32 years. He has extensive background in managed care and contracting while acting as the President of an IPA and Chairman of the Board of a regional PHO. Initially serving as a part time Physician Advisor doing mainly second level reviews took on the role as a full time Physician Advisor and Medical Director for Case Management and CDI in 2014. Responsibilities also include denials management for Self Regional Healthcare a regional hospital in Greenwood, SC. Dr. Baker serves on several committees including Co-Chair of the Finance Committee for My Health First an upstate South Carolina ACO, Corporate Compliance Committee for My Health First, Governmental Affairs Committee ACPA as well as several committees at the South Carolina Hospital Association. He was also appointed to the inaugural class of “Hirsch’s Heroes” in 2015 for his work with the process to file complaints with CMS against Medicare Advantage Plans. He joined the Board of Directors for the American College of Physician Advisors in 2017.

Ms. Lamkin is a national author and speaker dedicated to improving healthcare systems. She provides consulting services on sustainable improvement in operational effectiveness with a focus on systems of utilization management, billing compliance, margin improvement, physician advisors and enterprise communication. She believes hospitals must operate as a continuum, with information sharing as a critical success factor, starting with the Mission and Vision. Her leadership and systematic methodology for organization development and improvement has proven to be successful in diverse organizations and settings.

Elizabeth served for 20 years as a hospital CEO and regional CEO in the acute and inpatient rehabilitation settings. She has broad experience in organizations spanning teaching facilities, non-profit and investor owned hospitals. Throughout her career her ability to interact and engage with physicians as team members has contributed greatly to her success.

Ms. Lamkin holds a MHA and a BA in Business Administration, University of South Carolina, Columbia, SC.

Sommer Slavin has been with the University of Rochester’s Medical Center for over 15 years. She has been involved with Utilization Management, CDI, and Appeals Management for the last 9 years.

Her educational background is in Nursing, Leadership in Healthcare, & Competitive & Organizational Strategy.

She assumed the role of Utilization Management Program Coordinator in 2016 after having been the Utilization Manager for 8 years. As a Program Coordinator, Sommer oversees and assists as a UM resource in the areas of standardization of UM practices across the URMC enterprise, integration of UM & new hospital technology systems across all affiliates, regulatory & compliance guidance as related to UM, and data analysis of CMI data across the enterprise including affiliate hospitals and HHC.

After completing his residency at the University Of South Carolina School Of Medicine Dr. Baker was the founding and managing partner in Piedmont Physicians for Women an OB/GYN practice for 32 years. He has extensive background in managed care and contracting while acting as the President of an IPA and Chairman of the Board of a regional PHO. Initially serving as a part time Physician Advisor doing mainly second level reviews took on the role as a full time Physician Advisor and Medical Director for Case Management and CDI in 2014. Responsibilities also include denials management for Self Regional Healthcare a regional hospital in Greenwood, SC. Dr. Baker serves on several committees including Co-Chair of the Finance Committee for My Health First an upstate South Carolina ACO, Corporate Compliance Committee for My Health First, Governmental Affairs Committee ACPA as well as several committees at the South Carolina Hospital Association. He was also appointed to the inaugural class of “Hirsch’s Heroes” in 2015 for his work with the process to file complaints with CMS against Medicare Advantage Plans. He joined the Board of Directors for the American College of Physician Advisors in 2017.

Dr. Ronald Hirsch is a Vice President of the Regulations and Education Group at R1 Physician Advisory Services. He received his medical degree from the Chicago Medical School in North Chicago, IL, and completed his internal medicine residency at Kaiser Permanente Medical Center in Hollywood, CA.

Dr. Hirsch was Medical Director of Case Management at Sherman Hospital in Elgin, IL from 2006 to 2012, and served on the Medical Executive Committee.

Dr. Hirsch is certified in Health Care Quality and Management by the American Board of Quality Assurance and Utilization Review Physicians, is a member of the American Case Management Association, on the Advisory Board of the American College of Physician Advisors, a Fellow of the American College of Physicians, and on the advisory board of the National Association of Healthcare Revenue Integrity. He is the co-author of The Hospital Guide to Contemporary Utilization Review, which was published in 2018.

Ms. Lamkin is a national author and speaker dedicated to improving healthcare systems. She provides consulting services on sustainable improvement in operational effectiveness with a focus on systems of utilization management, billing compliance, margin improvement, physician advisors and enterprise communication. She believes hospitals must operate as a continuum, with information sharing as a critical success factor, starting with the Mission and Vision. Her leadership and systematic methodology for organization development and improvement has proven to be successful in diverse organizations and settings.

Elizabeth served for 20 years as a hospital CEO and regional CEO in the acute and inpatient rehabilitation settings. She has broad experience in organizations spanning teaching facilities, non-profit and investor owned hospitals. Throughout her career her ability to interact and engage with physicians as team members has contributed greatly to her success.

Ms. Lamkin holds a MHA and a BA in Business Administration, University of South Carolina, Columbia, SC.

Ed Norwood, President of ERN/The National Council of Reimbursement Advocacy (NCRA), Ed has first –hand experience with problematic payors and is thoroughly familiar with public policy laws designed to help participants fight unfair payment practices that impact quality of care (and reimbursement) in their facility. Ed also serves as the Chief Compliance Officer of the National Reimbursement Firm (TRAF). Multi-faceted, with a creative ability to inspire his audience, Ed combines his healthcare influence and expertise with his passion to help providers advocate for medically appropriate healthcare pursuant to federal and state laws.

Sommer Slavin has been with the University of Rochester’s Medical Center for over 15 years. She has been involved with Utilization Management, CDI, and Appeals Management for the last 9 years.

Her educational background is in Nursing, Leadership in Healthcare, & Competitive & Organizational Strategy.

She assumed the role of Utilization Management Program Coordinator in 2016 after having been the Utilization Manager for 8 years. As a Program Coordinator, Sommer oversees and assists as a UM resource in the areas of standardization of UM practices across the URMC enterprise, integration of UM & new hospital technology systems across all affiliates, regulatory & compliance guidance as related to UM, and data analysis of CMI data across the enterprise including affiliate hospitals and HHC.

Day Egusquiza is President of AR Systems, Inc. and brings over 38 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance – both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA’s ANI rated her in the top 25% for each year she has presented, earning her the ‘Distinguished Speaker’ award.

Dr. Kanaparthy has completed his Internal Medicine training at Cook County Hospital, Chicago and began his hospitalist career in 2007 at Rochester General Hospital, Rochester, NY. He continues to practice as a hospitalist and also previously served as a Director for the Medical Admission and Transition unit which is a “step up and step down unit.” In that role he had overseen significant improvements in patient throughput with reduction in wait times for patients identified to be in need of a critical care bed. He has championed several quality improvement initiatives at RGH over the past decade and has received acknowledgement from the Society of Hospital Medicine as a Fellow in Hospital Medicine. In 2014, he took up the challenge as a Lead Physician Advisor where he played a key role in starting a physician Advisor Program at Rochester General Hospital with 1.3 Physician FTE and has since expanded the program system wide covering 5 hospitals with 10.9 Physician FTEs. The physician Advisor program is fully insourced with utilization review performed 365 days with 18 hours/day coverage. He currently serves as the System Medical Director for the Physician Advisor Program at Rochester General Health with CDI, Denials & Appeals, concurrent medical necessity reviews, patient throughput and revenue integrity as the key areas of focus.

Michael Salvatore, MD, FACP received his MD from the University of Arizona in 1977. His post-graduate training 1977 – 1982 was at Duke University. He practiced Critical Care Medicine for 30 years before becoming a full time PA at Beebe Healthcare in 2012. He has been married for 47 years and has 2 daughters. When not working as a PA, he is watching birds or walking the dog with his wife.

Donnah Mathews, MD, FACP, Assistant Professor of Medicine at the Alpert School of Medicine for Brown University, is a board-certified physician in both internal medicine and hospice and palliative medicine. She is an attending internist at Rhode Island Hospital, overseeing internal medicine residents on inpatient medicine wards and consultation services. She is the Medical Director of Clinical Management, serving as a physician advisor for Rhode Island Hospital. She also is an Associate Medical Director for Hope Hospice, overseeing a hospice team, performing long term care and home visits for patients, and supervising residents and fellows. She additionally serves at the Chief Compliance Officer for Brown Medicine.

Her undergraduate degree is from Case Western Reserve University in Cleveland, Ohio, where she studied English, chemistry, and modern dance. She attended George Washington Medical School in Washington, D.C., and did her residency at Brown University in Providence, RI. She currently resides in East Greenwich, RI.

After completing his residency at the University Of South Carolina School Of Medicine Dr. Baker was the founding and managing partner in Piedmont Physicians for Women an OB/GYN practice for 32 years. He has extensive background in managed care and contracting while acting as the President of an IPA and Chairman of the Board of a regional PHO. Initially serving as a part time Physician Advisor doing mainly second level reviews took on the role as a full time Physician Advisor and Medical Director for Case Management and CDI in 2014. Responsibilities also include denials management for Self Regional Healthcare a regional hospital in Greenwood, SC. Dr. Baker serves on several committees including Co-Chair of the Finance Committee for My Health First an upstate South Carolina ACO, Corporate Compliance Committee for My Health First, Governmental Affairs Committee ACPA as well as several committees at the South Carolina Hospital Association. He was also appointed to the inaugural class of “Hirsch’s Heroes” in 2015 for his work with the process to file complaints with CMS against Medicare Advantage Plans. He joined the Board of Directors for the American College of Physician Advisors in 2017.

Jennifer Bartlett has served at Infirmary Health for 18 years. She has vast knowledge and expertise in patient access, revenue cycle, payer contracts, payer processes and denials management. Her many years of extensive research and study of payer practices and behaviors have been instrumental in holding payers to a greater level of accountability. She manages all prepay and postpay clinical audits including RAC, KePro 2MN, CERT, MAC, Part C audits. In her organization, she’s a member of the Information Governance/HIPAA Steering Committee. In her state, she’s an active member of the Alabama Hospital Association’s Revenue Integrity/Recovery Audit Steering Committee and the Palmetto GBA Provider Outreach and Education Advisory Board, (CMS JJ MAC region) and was a presenter in 2016 and 2017 at the AlaHA/HFMA Alabama Audit Summit. As well, she served on the faculty for the 2016 & 2017 PA UR Boot Camp events.

After completing his residency at the University Of South Carolina School Of Medicine Dr. Baker was the founding and managing partner in Piedmont Physicians for Women an OB/GYN practice for 32 years. He has extensive background in managed care and contracting while acting as the President of an IPA and Chairman of the Board of a regional PHO. Initially serving as a part time Physician Advisor doing mainly second level reviews took on the role as a full time Physician Advisor and Medical Director for Case Management and CDI in 2014. Responsibilities also include denials management for Self Regional Healthcare a regional hospital in Greenwood, SC. Dr. Baker serves on several committees including Co-Chair of the Finance Committee for My Health First an upstate South Carolina ACO, Corporate Compliance Committee for My Health First, Governmental Affairs Committee ACPA as well as several committees at the South Carolina Hospital Association. He was also appointed to the inaugural class of “Hirsch’s Heroes” in 2015 for his work with the process to file complaints with CMS against Medicare Advantage Plans. He joined the Board of Directors for the American College of Physician Advisors in 2017.

Jennifer Bartlett has served at Infirmary Health for 18 years. She has vast knowledge and expertise in patient access, revenue cycle, payer contracts, payer processes and denials management. Her many years of extensive research and study of payer practices and behaviors have been instrumental in holding payers to a greater level of accountability. She manages all prepay and postpay clinical audits including RAC, KePro 2MN, CERT, MAC, Part C audits. In her organization, she’s a member of the Information Governance/HIPAA Steering Committee. In her state, she’s an active member of the Alabama Hospital Association’s Revenue Integrity/Recovery Audit Steering Committee and the Palmetto GBA Provider Outreach and Education Advisory Board, (CMS JJ MAC region) and was a presenter in 2016 and 2017 at the AlaHA/HFMA Alabama Audit Summit. As well, she served on the faculty for the 2016 & 2017 PA UR Boot Camp events.

Dr. Kanaparthy has completed his Internal Medicine training at Cook County Hospital, Chicago and began his hospitalist career in 2007 at Rochester General Hospital, Rochester, NY. He continues to practice as a hospitalist and also previously served as a Director for the Medical Admission and Transition unit which is a “step up and step down unit.” In that role he had overseen significant improvements in patient throughput with reduction in wait times for patients identified to be in need of a critical care bed. He has championed several quality improvement initiatives at RGH over the past decade and has received acknowledgement from the Society of Hospital Medicine as a Fellow in Hospital Medicine. In 2014, he took up the challenge as a Lead Physician Advisor where he played a key role in starting a physician Advisor Program at Rochester General Hospital with 1.3 Physician FTE and has since expanded the program system wide covering 5 hospitals with 10.9 Physician FTEs. The physician Advisor program is fully insourced with utilization review performed 365 days with 18 hours/day coverage. He currently serves as the System Medical Director for the Physician Advisor Program at Rochester General Health with CDI, Denials & Appeals, concurrent medical necessity reviews, patient throughput and revenue integrity as the key areas of focus.

Donnah Mathews, MD, FACP, Assistant Professor of Medicine at the Alpert School of Medicine for Brown University, is a board-certified physician in both internal medicine and hospice and palliative medicine. She is an attending internist at Rhode Island Hospital, overseeing internal medicine residents on inpatient medicine wards and consultation services. She is the Medical Director of Clinical Management, serving as a physician advisor for Rhode Island Hospital. She also is an Associate Medical Director for Hope Hospice, overseeing a hospice team, performing long term care and home visits for patients, and supervising residents and fellows. She additionally serves at the Chief Compliance Officer for Brown Medicine.

Her undergraduate degree is from Case Western Reserve University in Cleveland, Ohio, where she studied English, chemistry, and modern dance. She attended George Washington Medical School in Washington, D.C., and did her residency at Brown University in Providence, RI. She currently resides in East Greenwich, RI.

Michael Salvatore, MD, FACP received his MD from the University of Arizona in 1977. His post-graduate training 1977 – 1982 was at Duke University. He practiced Critical Care Medicine for 30 years before becoming a full time PA at Beebe Healthcare in 2012. He has been married for 47 years and has 2 daughters. When not working as a PA, he is watching birds or walking the dog with his wife.

Day Egusquiza is President of AR Systems, Inc. and brings over 38 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. During her 20 years as Director of Revenue and Reimbursement at a community hospital in Idaho, she also was Director of a Physician Medical Management billing service, where she completed an integrated business office between a hospital and a large physician clinic. Her work includes providing guidance as a compliance & APC educator while providing operational insight on the revenue cycle impacts of RAC/Medicare Recovery Audit Contractors. Ms Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance – both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, and is a past President of the Idaho HFMA Chapter & recently received the Lifetime Achievement Award. Attendees at HFMA’s ANI rated her in the top 25% for each year she has presented, earning her the ‘Distinguished Speaker’ award.