![](https://privacy-enhancing-tech-summit-usa.com/sites/default/files/styles/panopoly_image_square/public/speakers/sean_ryder_headshot.jpg?itok=bJ0uAIMC&c=34a7aa0d7ea2ea6d53ddbdeb40255118)
Sean Ryder
Value Based Program Manager
Blue Cross Blue Shield of Arizona
101 for modernization of each step of the claims continuum. 8 separate discussion across:
- Itemized Bill Reviews
- DRG Validations
- Claim Receipts
- Clinical Review
- Provider Reviews
- Resolutions
- Formal Appeal
- The Changing World Of Payment Integrity As It Relates To VBC
- Implementing various strategies to encourage appropriate utilization of emergency outpatient facilities, such as: network management, preauthorization and utilization reviews, promoting alternative care settings, and investing in care coordination programs to prevent unnecessary readmissions.
- A look to how data analytics can be leveraged to identify patterns of overbilling or potential fraud within emergency outpatient facilities
Track 1: Payment Integrity
- Taking payment integrity solutions to the next level with clinical validation
![](https://privacy-enhancing-tech-summit-usa.com/sites/default/files/styles/panopoly_image_square/public/speakers/medreview.jpg?itok=HnlQgEca&c=fca690c28f3148226ba10bf3df52390c)
MedReview
- Unveiling the audit landscape and understanding the importance of timely responses
- Expediting audit responses through the establishment of a dedicated audit response team, implementing standardized documentation and track systems, and utilizing advanced technologies
- Discussing the value of analyzing audit findings and leveraging them as opportunities for continuous improvement in revenue cycle management
Track 2: Revenue Cycle Management & Revenue Integrity
- Investing in strategies that promote effective care transitions, care coordination, patient education, and data analysis
- Working with providers to identify patients at higher risk of readmission
- Reducing avoidable readmissions to achieve better overall quality of care and support cost savings
Track 1: Payment Integrity