Regulator Strategies for Improving Provider Directory Accuracy, Eliminating Ghost Providers and Encouraging Provider Engagement
Why attend:
- Understand the challenges and solutions in maintaining accurate provider directories.
- Learn about the transition from static reports to dynamic claims analysis for identifying active providers.
- Discover the importance of accurate data for legislative compliance and member services.
- Explore the impact of new administration support on data cleanup projects and MCO engagement.
- Gain insights into the practical steps for conducting provider directory audits and the implications for healthcare networks.
- Hear firsthand experiences and lessons learned from the Louisiana Department of Health in managing data and audits.
- Discuss the significance of geographic distance calculations and realistic expectations for member access.
- Find out how to quantify the quality of providers and networks to address Network Adequacy anomalies and constituent complaints.
WHO IS INVITED: Federal and State Directors, Commissioners, and Staff
WHEN: July 16, 2024, Noon – 1 p.m. CST
MEET THE PRESENTERS
Guest: Whitney Martinez, Medicaid Provider Services Manager, Louisiana Department of Health
Moderator: Scott Westover, Chief Network Solutions Officer, Quest Analytics®
Meet Whitney Martinez:
Whitney is the Medicaid Provider Services Manager with the Louisiana Department of Health, responsible for provider networks, provider relations, and provider enrollment. Her professional employment history in the medical field spans over twenty-five years as a Clinic Administrator, Reimbursement Manager and Operations Manager for pediatric and multi-specialty physician groups. She is a certified professional coder through the American Academy of Professional Coders and taught medical coding and medical management for five years at Louisiana State University. Whitney currently chairs the Administrative Simplification Committee and is a speaker for other organizations. She has received several awards from provider associations recognizing the work performed at the Louisiana Department of Health.
Meet Scott Westover:
Scott is a seasoned executive with deep experience across the payer, provider and regulatory space. Most recently, he served as market president for AmeriHealth Caritas New Hampshire, where he was responsible for the plan’s strategic direction, growth, and leadership. His prior experience includes working at Anthem, Inc. as a vice president of provider joint ventures and national accounts, and he has also held senior roles within leading healthcare providers, directing a Medicaid health plan, and driving national health strategy for multiple Fortune 50 corporations.
This is your opportunity to be at the forefront of implementing meaningful change in mental health and behavioral health access. Register now to be part of the conversation.
By invitation only, contact us for more information.
