The healthcare landscape is fraught with complexity and financial pitfalls and small-to-medium-sized health plans often find themselves vulnerable to inflated claims, hemorrhaging millions annually.
Payment integrity products like DRG Coding and Clinical Validation, Hospital Bill Audits, Data Mining, and more, can offer immediate reinforcement against dubious claims. But which products should be deployed, when should they be implemented, what are the best practices for their utilization, and how do you effectively evaluate their impact?
In this session, discover how merging clinical expertise with AI technology enhances payment integrity solutions and evaluate in-house, outsourced, or combined approaches based on reassignment and appeal overturn rates for optimal financial protection.
In a world where healthcare fraud runs rampant and financial losses mount, a strategic plan for payment integrity stands as a beacon of hope for small to medium-sized health plans, offering a formidable defense against the forces of fiscal depletion. This discussion will provide a framework for developing a strategic approach to financial stability.
Ted Pitynski
As the Chief Commercial Officer, Ted is responsible for the commercial growth of the company through his leadership of sales, marketing, and product management. Ted brings a wealth of knowledge from more than two decades of experience developing go-to-market strategies for selling complex healthcare solutions to payers, government agencies, benefit trusts and employers. Ted collaborates with sales teams, prospects, partners, and customers to capitalize on revenue-enhancing opportunities, setting new standards in the payment integrity industry.
Prior to joining MedReview, Ted transitioned from the finance sector to healthcare with a fervent commitment to revolutionizing the healthcare landscape. He was previously the Vice President of Self-Insured Solutions and Partnerships for ArmadaHealth, where he developed and executed the company’s distribution strategy. Ted also spent eight years as the Director of Health Plan Partnerships for HealthMedia, a wholly owned subsidiary of Johnson & Johnson.