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Title: Line Item Denials – Contract or CDM or Both?

Speakers: Charlotte Kohler, [RN], CPA, CVA, CRCE, CPC, CHBC, CPCO and Sara Rivenburgh, CRCR of Kohler HealthCare Consulting, Inc.

Topics:

• CDM Builds: Variances among providers.
• CDM Updates: Strategies for change in an all-payer environment.
• Payer Approach: Understanding the payer’s philosophical approach to line item denials.
• Contract Negotiations: Current trends and best practices.

Charlotte Kohler, [RN], CPA, CVA, CRCE, CPC, CHBC, CPCO is the President of Kohler HealthCare Consulting and has over 40 years of healthcare industry experience that started with Nursing on the clinical side and expanded to the business side in Finance and Compliance. She has served as the Chief Operating Officer of a hospital-based Emergency Department and a multi-specialty primary care medical practice, as well as the Compliance Officer of a five-hospital integrated delivery system, and Chief Financial Officer for ancillary services of a multi-hospital health system. She has evaluated existing hospital services and ambulatory care facilities with respect to patient flow, marketing, fee structures, compliance, use of ancillary services, and financial considerations. For the last twenty years she has provided expert testimony on behalf of providers in defense of fraud and abuse concerns.

Sara Rivenburgh, CRCR is an Associate Director with Kohler HealthCare Consulting and has over 25 years of healthcare industry experience, serving in all aspects of the revenue cycle. She has developed marketing strategies, compliance programs, business plans, and policies and procedures for various healthcare entities. With the Kohler team, Sara performs charge master coding updates, Relative Value Unit assessments, and other reimbursement activities. She incorporates her investigative skills and her ability to analyze medical and financial data to litigation matters and Independent Review Organization (IRO) engagements.