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Dr. Kilani is currently serving as Associate Medical Director for Cleveland Clinic Revenue Cycle Management and Medical Director of Throughput for Cleveland Clinic West Submarket. Nationally, he serves as Vice President of Operations for the American College of Physician Advisors. Dr. Kilani is board certified in Internal Medicine. Additionally, he has a Master of Business in Healthcare from Baldwin Wallace University, a Master of Legal Studies from Cleveland-Marshall College of Law, and a Master of Science in Information Technology from the University of Cincinnati. He is a Fellow of the American College of Physicians, a Fellow of the American College of Healthcare Executives, and board-certified in Healthcare Quality Management through the American Board of Quality Assurance and Utilization Review Physicians.”

Author:

Kelly Springmann

Provider Enablement & Product Development

Florida Blue

Author:

Jenny Raulerson, BSN, MSHI

Sr Clinical Consultant

Florida Blue

Read more about Panel: Strengthening Payer and Provider Relationships

Clinical Integrated Revenue Cycle

During this presentation, Dr Archer and Dr Goyal will:

Share the idea of clinically integrated revenue cycle key components
Examine the roles of the clinicians and the revenue cycle staff at each step in the revenue cycle
Analyze the effects of the clinically integrated revenue cycle in change management in its impact on clinical outcomes, experience and cost of care.

Track 2

Author:

Dr Deepak Goyal, MD, MBBS, MBA, CPE, CHCQM, CMRP, CMPC

Executive Medical Director Revenue Cycle and Supply Chain

Monument Health

Author:

Dr Brad Archer

Chief Medical Officer

Monument Health

Read more about Clinical Integrated Revenue Cycle

Effectively Assessing PI Vendors

Vendor management strategies for payment integrity are essential to ensure that your organization optimizes financial processes and ensures the recovery of overpayment. Here are some strategies that we will discuss:

Vendor Selection and Due Diligence
Stacking Vendors and multi-vendor approach
Vendor Performance Metrics
Data Sharing Protocols
Payment integrity program options

Track 1

Author:

Novelette Wallace, MPH, PMP, CSSBB

Head of Payment Integrity

Johns Hopkins Healthcare

Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve