
Welcome to the Medical Cost Containment Series - where healthcare finance meets innovation and impact
Join us for an all-encompassing event tailored to professionals working in healthcare finance. From payment integrity through revenue cycle management all the way to risk adjustment, we cover all aspects of the healthcare business. Our focus is on delivering actionable insights into claims optimization, value-based care, and denial management—with an emphasis on fostering payer-provider collaboration.
You'll connect with peers and vendors who can help you reduce costs, streamline operations, and boost your organization's efficiency. Expect to leave with fresh strategies, valuable contacts, and practical solutions to help your business succeed in today’s evolving healthcare landscape.

Optimizing Your Accounts Receivable Strategies
Where healthcare leaders gather to maximize revenue, exchange best practices, foster collaboration, and explore innovative solutions.
This event will bring together:
- Hospitals
- Healthcare Systems
- Physician Networks
- Clinical Practices
- Patient Access Vendors
- Accounts Receivable Management Vendors
- Medical Billing Vendors
- Denial Management Vendors

Optimizing Your Claims Management
Where healthcare leaders come to increase savings, share strategies, foster collaboration and discover innovative solutions to tackle challenges along the claims continuum and identify cost containment opportunities.
This event will bring together:
- Insurers
- Healthcare Providers
- PI Vendors
- FWA Vendors
- AI Healthcare Vendors
Speaker Faculty Includes:

Bruce Lim
Bruce Lim serves as the Deputy Director, Audits and Investigations, for the California Department of Health Care Services (DHCS) and is the designated Program Integrity Director for Medi-Cal, California’s Medicaid program. Mr. Lim is a certified public accountant (CPA) with over 32 years of audit and financial management experience in both the private and public sectors. Past employers include Kenneth Leventhal and Company, CPAs (Ernst & Young Kenneth Leventhal Real Estate Group), Packard Bell NEC, and the California Department of Food and Agriculture.

Christopher Draven
Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.

Kelly Bennett, JD, CFE, AHFI
Kelly Bennett graduated from the University of Tampa and Florida State University College of Law. She has been a member of the Florida Bar since 1997 and is a Certified Fraud Examiner and an Accredited Health Care Fraud Investigator. She has worked at the Florida Agency for Health Care Administration since 2001 and has served in several roles, including as a Senior Attorney within the Medicaid Division of the Office of the General Counsel, the Assistant Bureau Chief for the Bureau of Medicaid Program Integrity, the Agency’s Medicaid
Fraud Liaison, and is currently the Chief of Medicaid Program Integrity, where she has served since July of 2014. She is currently the President for the National Association for Medicaid Program Integrity and is an active participant in training and collaboration initiatives with the National Health Care Antifraud Association.

Cynthia Johnson

Andrew Zurick

Becky Peters

Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE
Dr. Priscilla Alfaro is a seasoned healthcare professional with extensive experience in executive medical management, fraud prevention, and healthcare analytics. A certified medical coder, fraud examiner, and auditor, she has a proven track record of improving healthcare efficiency and preventing fraud, waste, and abuse across various roles and affiliations, including the Texas HHS and Anthem.

Monique Pierce
Monique started her Payment Integrity career in COB at Oxford HealthPlans. After the merger with UnitedHealthcare, she led multiple teams and was responsible for creating innovative programs. Monique joined SCIO Health Analytics in 2014 and was responsible for system and process improvements before being promoted to VP of client engagement and business optimization In 2020, Monique joined start-up Devoted Health and created a full suite of programs from the ground up. Based on a passion for metrics and measuring performance, she centralized and standardized all programs reducing implementation time and maximizing savings. Today, Monique is driving opportunities to improve claim payment by designing and developing new prior auth and claim reconciliation products at Cohere Health.

Frank Shipp
Frank E. Shipp currently serves as Executive Director of the Johns Hopkins Clinical Alliance, the clinically integrated network of Johns Hopkins Medicine. The network includes over 3,000 providers, consisting of both employed and independent practices.
Frank transitioned to value-based care after 25 years of hospital-based operations experience in both community and academic health systems. During the past nine years, Frank has held executive positions in a Payor-Provider Organization in NYC and has built a highly successful CIN over a five-year period in Northern New Jersey. Frank speaks regular at national healthcare conferences regarding value-based care strategies and tactics.
Frank completed his MBA at Fairleigh Dickinson University, is a certified Fellow of the American College of Healthcare Executives and a trained Black Belt in Lean Six Sigma from Villanova University.

Corella Lumpkins
Corella Lumpkins is the Manager of Coding, Compliance & Provider Education at Loudoun Medical Group (LMG) - one of the largest and most diverse physician-owned, multi-specialty Accountable Care Organizations in Northern Virginia/DC suburbs. As a subject matter expert, Corella has over 35 years of experience working in every area of the healthcare revenue cycle. Corella holds a bachelor’s degree and eleven certifications with an extensive background in auditing, billing, coding, implementing corporate compliance programs, CDI, education, denial and practice management. Prior to joining LMG, Corella has held leadership roles at Lifebridge, Medstar, Johns Hopkins and the University of Maryland health systems.
Corella is an author, adjunct faculty member and national speaker currently serving on both the AAPC National Advisory Board and Association of Clinical Documentation Integrity Specialists (ACDIS) Leadership Council. Corella works closely with providers in navigating patient-centric value-based care.

Helen Liu, Pharm.D.
Helen Liu, PharmD, brings 29 years of diverse pharmacy experience, blending clinical expertise, operational efficiency, technological innovation, and management across various healthcare settings.
Over the past four years, Helen has successfully led pharmacy operations at ATRIO Health Plans (Medicare), achieving significant milestones in PA/ST, FWA, MTM programs, resulting in over $4.5M in savings. She’s conducted formulary analyses to support actuary Medicare annual bid submissions, including IRA and M3P programs, collaborated with partners and the Pharmacy Benefit Manager (PBM) to identify cost-saving opportunities through formulary alternatives, biosimilars, and rebate strategies, and partnered in the RFP PBM selection process and resolved complex pharmacy-related issues through cross-departmental collaboration.
Before ATRIO, Helen spent seven years at Kaiser Permanente, where she served as Regional Assistant Director to implement hospitals Drug Use Management Program. Her efforts led to over $20 million in savings through inventory management, drug cost-saving initiatives, and the standardization of clinical content/practice guidelines.

Jordan Limperis
Highly motivated Data Scientist with a strong background in healthcare data and systems. Experienced in Inpatient Hospital and Laboratory Epic Systems, where I applied data-driven insights to improve clinical and operational efficiency. Currently, I am pursuing my career at L.A. Care, focusing leveraging advanced machine learning techniques to analyze noisy data, ensuring accuracy and efficiency in healthcare operations, particularly in payment integrity.
Your go-to for everything Healthcare

Bigger, better audience
With now 3 separate curated topics, we aim to unite payers and providers across everything finance. Covering the liked of payment integrity and risk adjustment from the health plan side and revenue cycle management on the provider side, we include all aspects of payer-provider collaboration across healthcare finance.

Facilitated Networking
We’re helping you keep up to date with solutions on the market and curating the conversations you have with vendors so you meet those who can really help your organizations save more. Expect trailblazing solutions in payment integrity, risk adjustment and revenue cycle management.
HEAR FROM OUR AUDIENCE

It's a unique forum that brings together providers, payors, vendors and regulators for collaboration, education and information sharing.

It was a seamless process and the intimate meeting space was ideal to allow for more collaboration

The quality of the event, sessions, speakers and Health Plan attendees scored high

Great job putting on your inaugural show. I'm certain that the show will continue to grow and get even better in the future.

I think the conference has good potential going forward. It fits a niche in the industry.

This conference filled the much needed gap in focusing on Payment Integrity issues and initiatives

We finally have a PI conference!

This PI conference was wonderful. We’d rank it 10/10 with representation from all across the industry

This was the most meaningful industry event of the year for Payment Integrity professionals

It was a great opportunity to hear from many subject matter experts over a wide topic of subjects specific to Payment/Revenue Integrity
OUR COMMUNITY OF PAYERS AND PROVIDERS

Demonstrate your tech and leadership by partnering with us
Partner with us to elevate your brand, and make valuable new connections. Subject to availability, we offer opportunities for thought leadership, branding, and facilitated networking.
Please contact our Partnerships Director, Harry Ludbrook, for more information. [email protected].

Healthcare Payers and Providers attend for free
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies.
If you are from a healthcare plan or provider organization, you can join our events for free.
TELL ME MORE
The 2nd Annual Healthcare Payment and Revenue Integrity Congress East, is an opportunity for leaders in PI and RI/RCM to come together and discuss emerging solutions to prominent issues including improving audits, resource prioritization, adjusting to new trends in healthcare demands and policy, and improving payer-provider relationships.
As a health plan, this congress will give you the resources to strengthen, redefine, or establish your own payment integrity strategies by analyzing case studies from industry peers and joining interactive discussions that span the entire claims continuum.
As a revenue cycle management expert, you can evaluate the use of intelligent automation and AI within your organisation to optimize revenue integrity, while also getting to address chargemaster integrity, understand value-based payment models and establishing strong cross functional collaboration on coding, billing, compliance and beyond.

Highlights:
The Payment Integrity Vendor Landscape

Navigating the Payment Integrity Vendor landscape can be daunting for health plans and providers, given the multitude of vendors and their diverse specialties. With so many options available, it's often difficult to identify the best partners. That's why we've created this document, which showcases the top vendors tailored to your specific needs including:
- Fraud Anayltics
- Provider Networking/Contracting
- PI BPO
- Pharmacy Benefit Management
- Coordination of Benefits
- Subrogration
- Risk Adjustment/Analytics
- Data Analytics and Data Mining
- Claims Management
- Patient Experience
- Specialty Audits
- Prior Authorisation
- Payment Management
Welcome to the 2nd Annual HPRI Congress East!
The Healthcare Payment and Revenue Integrity Congress connects leading figures in PI and RI/RCM to encourage information sharing, discuss the latest solutions being leveraged to ensure the integrity of claims, nurture payer-providers relationships and support the transition to value-based payments.
Health plans use this forum to strengthen, redefine, or establish their own payment integrity strategies by analyzing case studies from industry peers and joining interactive discussions that span the entire claims continuum.
It also empowers providers to make revenue cycle decisions with confidence by leveraging intelligent automation, optimizing RCM based on value, and effectively communicating concerns around emerging payment initiatives.

Would you like to present at the upcoming event?
Showcase your work to our audience of 150+ payment integrity leaders.
If you would be interested in learning about the speaking opportunities available, please email [email protected]
Photo Gallery
HOW TO GET INVOLVED

Partner With Us
Partner with us to elevate your brand, and make valuable new connections. Subject to availability, we offer opportunities for thought leadership, branding, and facilitated networking.
Please contact our Partnerships Director, Harry Ludbrook, for more info.

Payers And Providers Attend For Free
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies.
To deliver maximum value for our community, all payers and providers are eligible for complimentary passes.
OUR COMMUNITY

FEATURED SPEAKERS

Bruce Lim
Bruce Lim serves as the Deputy Director, Audits and Investigations, for the California Department of Health Care Services (DHCS) and is the designated Program Integrity Director for Medi-Cal, California’s Medicaid program. Mr. Lim is a certified public accountant (CPA) with over 32 years of audit and financial management experience in both the private and public sectors. Past employers include Kenneth Leventhal and Company, CPAs (Ernst & Young Kenneth Leventhal Real Estate Group), Packard Bell NEC, and the California Department of Food and Agriculture.

Christopher Draven
Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.

Crystal Son
Crystal Son is an Executive Director of Enterprise Data Analytics Solutions at Healthcare Service Corporation (HCSC). She has 19 years of experience in deriving intelligence from data.
At HCSC, she leads the Strategic Initiatives & Partnerships team, a department that focuses on cross-functional, collaborative analytics delivery on key programs such as Payment Integrity and Stakeholder Engagement, enterprise data and analytics strategy and planning, as well as design and execution of HCSC’s Responsible AI program. She is passionate about real-world applications of data-driven insights, storytelling through data, and building high-performance teams.

Helen Liu, Pharm.D.
Helen Liu, PharmD, brings 29 years of diverse pharmacy experience, blending clinical expertise, operational efficiency, technological innovation, and management across various healthcare settings.
Over the past four years, Helen has successfully led pharmacy operations at ATRIO Health Plans (Medicare), achieving significant milestones in PA/ST, FWA, MTM programs, resulting in over $4.5M in savings. She’s conducted formulary analyses to support actuary Medicare annual bid submissions, including IRA and M3P programs, collaborated with partners and the Pharmacy Benefit Manager (PBM) to identify cost-saving opportunities through formulary alternatives, biosimilars, and rebate strategies, and partnered in the RFP PBM selection process and resolved complex pharmacy-related issues through cross-departmental collaboration.
Before ATRIO, Helen spent seven years at Kaiser Permanente, where she served as Regional Assistant Director to implement hospitals Drug Use Management Program. Her efforts led to over $20 million in savings through inventory management, drug cost-saving initiatives, and the standardization of clinical content/practice guidelines.

Kelly Bennett, JD, CFE, AHFI
Kelly Bennett graduated from the University of Tampa and Florida State University College of Law. She has been a member of the Florida Bar since 1997 and is a Certified Fraud Examiner and an Accredited Health Care Fraud Investigator. She has worked at the Florida Agency for Health Care Administration since 2001 and has served in several roles, including as a Senior Attorney within the Medicaid Division of the Office of the General Counsel, the Assistant Bureau Chief for the Bureau of Medicaid Program Integrity, the Agency’s Medicaid
Fraud Liaison, and is currently the Chief of Medicaid Program Integrity, where she has served since July of 2014. She is currently the President for the National Association for Medicaid Program Integrity and is an active participant in training and collaboration initiatives with the National Health Care Antifraud Association.

Cynthia Johnson
AGENDA HIGHLIGHTS
Step into interactive discussions and engaging presentations on the key challenges and opportunities presented by payment companies today:
OUR PARTNERS

OUR SELECTION COMITTEE

Brannon Morisoli
Mr. Morisoli joined SWK Holdings as a Senior Analyst in March 2016. Prior to joining SWK, he was an Investment Analyst and Portfolio Manager for a family office that invested in equities, fixed income, real estate, and alternative investments. Prior to that, he was an Investment Analyst for Presidium Group, a real estate private equity firm, where he played an integral role in closing over $100mm in transactions. Mr. Morisoli began his career at Neurografix, a startup medical technology company in Santa Monica, CA that was doing groundbreaking work in the MRI imaging of peripheral nerves. While with Neurografix, he was published in two leading neurology journals. Brannon graduated from UCLA with a B.S., was awarded a fellowship and graduated from the University of Notre Dame with an M.B.A, and was awarded a Samson Fellowship from the University of Wisconsin Law School, where he graduated with a J.D. Mr. Morisoli is an inactive member of the State Bar of Wisconsin

Thomas Busby
Thomas Busby is a Vice President and has been with Outcome Capital since 2015. He focuses on medical technology, digital health and life science services segments with particular interest in innovative life science companies that deliver patient impact by leveraging novel approaches. Thomas is driven by the desire to identify disruptive technologies and services that require unique strategic thought and assistance to realize their full market potential. Thomas has been published in leading life science journals Life Science Leader and The Pharma Letter, and also serves on the board of HealthTech Build, a Boston-based digital health innovation group.
Prior to his career in life-science investment banking, Thomas pursued his passion for the public service and non-profit sectors working in a variety of leadership and management positions, and at one time held a Massachusetts teaching license.
Thomas completed his MBA at Suffolk University’s Sawyer Business School on full academic scholarship where he was President of the school’s Graduate Business Association and class speaker at graduation. Prior, he completed a BS in Philosophy with Honors from Suffolk’s College of Arts & Sciences. Committed to giving back, Thomas is currently the President of the College of Arts & Sciences Alumni Board of Directors. Thomas is a FINRA Registered Securities Representative holding his Series 79 and 63.

Robert Crousore
Robert has 28 years of experience in the health care products and
services industry. Crousore is a serial entrepreneur with multiple
successful product and services company exits. His experience spans
the entire business enterprise including Sales, Marketing, Operations,
Product Innovation and, most recently M & A.
Highlights Include:
- Has successfully managed a global commercial organization in the wound care business.
- Has a number of patent credits for products in the wound care industry.
- Sits on multiple boards of healthcare technology companies.
- His passion is creating meaningful changes in patient care by combining great products with great teams that are focused on empowering improved clinical and financial outcomes.

Brannon Morisoli
Mr. Morisoli joined SWK Holdings as a Senior Analyst in March 2016. Prior to joining SWK, he was an Investment Analyst and Portfolio Manager for a family office that invested in equities, fixed income, real estate, and alternative investments. Prior to that, he was an Investment Analyst for Presidium Group, a real estate private equity firm, where he played an integral role in closing over $100mm in transactions. Mr. Morisoli began his career at Neurografix, a startup medical technology company in Santa Monica, CA that was doing groundbreaking work in the MRI imaging of peripheral nerves. While with Neurografix, he was published in two leading neurology journals. Brannon graduated from UCLA with a B.S., was awarded a fellowship and graduated from the University of Notre Dame with an M.B.A, and was awarded a Samson Fellowship from the University of Wisconsin Law School, where he graduated with a J.D. Mr. Morisoli is an inactive member of the State Bar of Wisconsin

Thomas Busby
Thomas Busby is a Vice President and has been with Outcome Capital since 2015. He focuses on medical technology, digital health and life science services segments with particular interest in innovative life science companies that deliver patient impact by leveraging novel approaches. Thomas is driven by the desire to identify disruptive technologies and services that require unique strategic thought and assistance to realize their full market potential. Thomas has been published in leading life science journals Life Science Leader and The Pharma Letter, and also serves on the board of HealthTech Build, a Boston-based digital health innovation group.
Prior to his career in life-science investment banking, Thomas pursued his passion for the public service and non-profit sectors working in a variety of leadership and management positions, and at one time held a Massachusetts teaching license.
Thomas completed his MBA at Suffolk University’s Sawyer Business School on full academic scholarship where he was President of the school’s Graduate Business Association and class speaker at graduation. Prior, he completed a BS in Philosophy with Honors from Suffolk’s College of Arts & Sciences. Committed to giving back, Thomas is currently the President of the College of Arts & Sciences Alumni Board of Directors. Thomas is a FINRA Registered Securities Representative holding his Series 79 and 63.

Robert Crousore
Robert has 28 years of experience in the health care products and
services industry. Crousore is a serial entrepreneur with multiple
successful product and services company exits. His experience spans
the entire business enterprise including Sales, Marketing, Operations,
Product Innovation and, most recently M & A.
Highlights Include:
- Has successfully managed a global commercial organization in the wound care business.
- Has a number of patent credits for products in the wound care industry.
- Sits on multiple boards of healthcare technology companies.
- His passion is creating meaningful changes in patient care by combining great products with great teams that are focused on empowering improved clinical and financial outcomes.
SPEAKERS

Bruce Lim
Bruce Lim serves as the Deputy Director, Audits and Investigations, for the California Department of Health Care Services (DHCS) and is the designated Program Integrity Director for Medi-Cal, California’s Medicaid program. Mr. Lim is a certified public accountant (CPA) with over 32 years of audit and financial management experience in both the private and public sectors. Past employers include Kenneth Leventhal and Company, CPAs (Ernst & Young Kenneth Leventhal Real Estate Group), Packard Bell NEC, and the California Department of Food and Agriculture.

Christopher Draven
Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.

Crystal Son
Crystal Son is an Executive Director of Enterprise Data Analytics Solutions at Healthcare Service Corporation (HCSC). She has 19 years of experience in deriving intelligence from data.
At HCSC, she leads the Strategic Initiatives & Partnerships team, a department that focuses on cross-functional, collaborative analytics delivery on key programs such as Payment Integrity and Stakeholder Engagement, enterprise data and analytics strategy and planning, as well as design and execution of HCSC’s Responsible AI program. She is passionate about real-world applications of data-driven insights, storytelling through data, and building high-performance teams.

Helen Liu, Pharm.D.
Helen Liu, PharmD, brings 29 years of diverse pharmacy experience, blending clinical expertise, operational efficiency, technological innovation, and management across various healthcare settings.
Over the past four years, Helen has successfully led pharmacy operations at ATRIO Health Plans (Medicare), achieving significant milestones in PA/ST, FWA, MTM programs, resulting in over $4.5M in savings. She’s conducted formulary analyses to support actuary Medicare annual bid submissions, including IRA and M3P programs, collaborated with partners and the Pharmacy Benefit Manager (PBM) to identify cost-saving opportunities through formulary alternatives, biosimilars, and rebate strategies, and partnered in the RFP PBM selection process and resolved complex pharmacy-related issues through cross-departmental collaboration.
Before ATRIO, Helen spent seven years at Kaiser Permanente, where she served as Regional Assistant Director to implement hospitals Drug Use Management Program. Her efforts led to over $20 million in savings through inventory management, drug cost-saving initiatives, and the standardization of clinical content/practice guidelines.

Kelly Bennett, JD, CFE, AHFI
Kelly Bennett graduated from the University of Tampa and Florida State University College of Law. She has been a member of the Florida Bar since 1997 and is a Certified Fraud Examiner and an Accredited Health Care Fraud Investigator. She has worked at the Florida Agency for Health Care Administration since 2001 and has served in several roles, including as a Senior Attorney within the Medicaid Division of the Office of the General Counsel, the Assistant Bureau Chief for the Bureau of Medicaid Program Integrity, the Agency’s Medicaid
Fraud Liaison, and is currently the Chief of Medicaid Program Integrity, where she has served since July of 2014. She is currently the President for the National Association for Medicaid Program Integrity and is an active participant in training and collaboration initiatives with the National Health Care Antifraud Association.

Cynthia Johnson

Andrew Zurick

Becky Peters

Betye Ochoa

Ebrahim Barkoudah

Jordan Limperis
Highly motivated Data Scientist with a strong background in healthcare data and systems. Experienced in Inpatient Hospital and Laboratory Epic Systems, where I applied data-driven insights to improve clinical and operational efficiency. Currently, I am pursuing my career at L.A. Care, focusing leveraging advanced machine learning techniques to analyze noisy data, ensuring accuracy and efficiency in healthcare operations, particularly in payment integrity.

Monique Pierce
Monique started her Payment Integrity career in COB at Oxford HealthPlans. After the merger with UnitedHealthcare, she led multiple teams and was responsible for creating innovative programs. Monique joined SCIO Health Analytics in 2014 and was responsible for system and process improvements before being promoted to VP of client engagement and business optimization In 2020, Monique joined start-up Devoted Health and created a full suite of programs from the ground up. Based on a passion for metrics and measuring performance, she centralized and standardized all programs reducing implementation time and maximizing savings. Today, Monique is driving opportunities to improve claim payment by designing and developing new prior auth and claim reconciliation products at Cohere Health.

Dr Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE
Dr. Priscilla Alfaro is a seasoned healthcare professional with extensive experience in executive medical management, fraud prevention, and healthcare analytics. A certified medical coder, fraud examiner, and auditor, she has a proven track record of improving healthcare efficiency and preventing fraud, waste, and abuse across various roles and affiliations, including the Texas HHS and Anthem.

Simi Binning
Simi Binning is an accomplished healthcare professional with over a decade of experience in developing and executing successful strategies that drive business growth. Currently serving as a Responsible AI lead at HCSC, her focus is on AI governance and innovative problem solving.

Edward Thomas

Frank Shipp
Frank E. Shipp currently serves as Executive Director of the Johns Hopkins Clinical Alliance, the clinically integrated network of Johns Hopkins Medicine. The network includes over 3,000 providers, consisting of both employed and independent practices.
Frank transitioned to value-based care after 25 years of hospital-based operations experience in both community and academic health systems. During the past nine years, Frank has held executive positions in a Payor-Provider Organization in NYC and has built a highly successful CIN over a five-year period in Northern New Jersey. Frank speaks regular at national healthcare conferences regarding value-based care strategies and tactics.
Frank completed his MBA at Fairleigh Dickinson University, is a certified Fellow of the American College of Healthcare Executives and a trained Black Belt in Lean Six Sigma from Villanova University.

Garland Goins Jr

Jill Sell-Kruse

Corella Lumpkins
Corella Lumpkins is the Manager of Coding, Compliance & Provider Education at Loudoun Medical Group (LMG) - one of the largest and most diverse physician-owned, multi-specialty Accountable Care Organizations in Northern Virginia/DC suburbs. As a subject matter expert, Corella has over 35 years of experience working in every area of the healthcare revenue cycle. Corella holds a bachelor’s degree and eleven certifications with an extensive background in auditing, billing, coding, implementing corporate compliance programs, CDI, education, denial and practice management. Prior to joining LMG, Corella has held leadership roles at Lifebridge, Medstar, Johns Hopkins and the University of Maryland health systems.
Corella is an author, adjunct faculty member and national speaker currently serving on both the AAPC National Advisory Board and Association of Clinical Documentation Integrity Specialists (ACDIS) Leadership Council. Corella works closely with providers in navigating patient-centric value-based care.

Ankur Verma
Ankur Verma is a member of the Business Process Services team and assists clients on topics related to optimizing business process service delivery models, with an emphasis on Healthcare (payers and providers) and Life Sciences. Ankur’s responsibilities include assisting in managing Everest Group’s Healthcare and Life Sciences Outsourcing subscription offerings and providing outsourcing advisory services to clients on an ad hoc basis.
Prior to joining Everest Group, Ankur was a Senior Analyst with The Smartcube. He holds a bachelor’s degree in technology from Netaji Subhas Institute of Technology, Delhi.

Lisa Meredith

Paul LePage

Paul Schmitz

Richelle Marting

Sandy Giangreco Brown

Willie Brown

Rae A. McIntee, DDS, MD, MBA, FACS, CPE

Eric Branson
Eric Branson is a special agent with the Department of Health and Human Services Office of Inspector General. Eric started investigating healthcare fraud in August 2011, spending time at both a Medicare and Medicaid contractor as well as working for the US Attorney's Office in the Middle District of Tennessee prior to becoming an agent. During that time, he has investigated fraud committed against both government and commercial insurance payors perpetrated by doctors, laboratories, pharmacies, home health agencies, durable medical equipment suppliers, and other healthcare providers. Eric graduated from Middle Tennessee State University with a Master's degree in Criminal Justice.

Thomas Ricketts
Thomas is an accomplished professional with 18 years of experience in the healthcare industry, specializing in the Coordination of Benefits. Currently serving as the Manager of Reporting and Data Analysis at Elevance/Carelon. His career is marked by a commitment to leveraging data-driven insights to enhance efficiencies and drive strategic decision-making.

Dutch Noss
Dutch Noss is a seasoned leader with over 25 years of expertise in Payment Integrity and Claims Processing, renowned for his pioneering approach to integrating responsible AI and machine learning into operational strategies. As Chief Product & Strategy Officer at Alivia Analytics, he drives innovations that improve accuracy within claims platforms. Dutch has held key leadership roles at various vendors and healthcare plans. A respected speaker at major healthcare conferences, he is recognized for blending deep industry knowledge with cutting-edge technology to shape the future of payment integrity.

Prasanna Ganesan

Karen Weintraub
With 25 years of data and 20 years of healthcare experience, Ms. Weintraub is currently responsible for the design and development of the company’s healthcare fraud detection software products and services. She provides subject matter expertise on system design and workflow, business rule development, data mining and fraud outlier algorithms as well as SIU policies and procedures. Prior to joining Healthcare Fraud Shield, managed SIUs on various healthcare investigations for all commercial, Medicaid and Medicare business and claims of fraudulent activity. Ms. Weintraub received a BA in Criminal Justice from the University of Delaware and an MA in Criminal Justice from Rutgers University. Ms. Weintraub is a Certified Professional Coder for Payers (CPC-P), a Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders, a Certified Dental Coder (CDC) from the American Dental Association, and the founder of the Hamilton, NJ AAPC chapter. She is also an Accredited Healthcare Fraud Investigator (AHFI) from the National Healthcare Anti-Fraud Association (NHCAA). Ms. Weintraub Taught CPT Coding, Fraud & Audits, and Medical Billing, Laws and Ethics and the local community college.

Katherine Brant

Clay Wilemon
Clay serves as CEO at 4L Data Intelligence™. He has launched over 500 new healthcare brands and holds patents in artificial intelligence and medical technologies. Clay is on the Board of Directors at Octane, a Southern California non-profit economic development organization that has helped hundreds of technology and med-tech companies get started. He a graduate of Vanderbilt University.
AGENDA
DOWNLOAD YOUR COPY OF THE BROCHURE
REGISTRATION
- Monday, February 17, 2025 to Friday, September 12, 2025Healthcare Payers (HPRI)COMPLIMENTARY PASSIncludes Access to all sessionsTailored networking for decision makers from provider and payer organizationsParticipate in 8+ double opt-in meetings with participating sponsors based on your interestsFood & Drink throughout the conference including access to Payer/Provider Party
- Friday, November 8, 2024 to Friday, September 12, 2025Healthcare Providers (RCM)COMPLIMENTARY PASSIncludes Access to all sessionsTailored networking for decision makers from provider and payer organizationsParticipate in 8+ double opt-in meetings with participating sponsors based on your interestsFood & Drink throughout the conference including access to Payer/Provider Party
- Monday, October 30, 2023 to Friday, September 12, 2025Payment Integrity Vendors (HPRI)$5,499Includes Access to all sessionsNetworking App with match making for decision makers from provider and payer organizationsFood & Drink throughout the conference
- Friday, November 8, 2024 to Friday, September 12, 2025Revenue Integrity Vendor - RCM Event$5,499Includes Access to all sessionsNetworking App with match making for decision makers from provider and payer organizationsFood & Drink throughout the conference
Headline
AMS Intelligent Analytics
Website: http://www.amspredict.com/
Advanced Medical Strategies (AMS) is the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.
Platinum Partner
Machinify
Website: https://www.machinify.com/
Machinify is the trusted AI partner for healthcare admin, providing software and services that enable health plans to accurately and efficiently pay claims, leading to a reduction in provider abrasion. With safe, transparent AI and deep clinical expertise, Machinify brings a unique blend of speed, accuracy, and intelligence health plans need to make healthcare admin more efficient.
The company serves partners of all sizes with its two products:
● Machinify Audit - Medical AI system identifying erroneous claims and performing record review.
● Machinify Pay - AI models and SME expertise to process claims at wire speed, ensuring accurate coding and pricing.
Gold Partners
Alivia Analytics
Website: https://www.aliviaanalytics.com/
Your most expansive Payment Integrity and FWA partner for medical, pharmacy, vision, and dental claims. This features our powerful, configurable Alivia 360™ Platform that provides pre- and post-payment flexibility and considerable cost savings across the healthcare claims management process. It seamlessly transitions between FWA detection and Payment Integrity solutions including clinical and non-clinical audit scenarios, first- and second-pass claims editing, and COB/TPL. Alivia 360™ not only ensures comprehensive financial oversight but full adaptability to operational needs. Alivia integrates AI as an assistant, not a replacement, prioritizing ethical use, human oversight, and compliance with industry standards. Our solutions are offered as SaaS or tech-enabled services that build strong cases against inappropriate billing practices, identify new recoveries missed by legacy vendors, deliver actionable analytics, and offer automated corrections. Alivia enables healthcare payers to streamline vendor management, improving control and strategic decision-making. Schedule a discovery meeting and demo.
Rialtic
Website: https://www.rialtic.io/
Rialtic is a next-generation platform that equips and enables players with the technology to take control of and execute their payment accuracy strategy. Rialtic’s first solution on the platform is a comprehensive code editing capability that combines the scope of editing typically found with both primary and secondary editors and merges it into a single platform supported by a modern user experience for managing policies, deviations, reporting, and provider inquiries. Our solution champions transparency — enabling greater understanding and control of your payment accuracy program and empowering payment accuracy teams to collaborate more effectively within their organization and with provider partners and employer groups.
Exhibitors
Penstock
Website: https://www.penstockgroup.com/
Penstock is a service partner and SaaS builder for forward-thinking health plans, arming recovery, audit and regulatory teams with the tools and insights to enhance payment and regulatory accuracy. Our mission is to create lasting systemic change that removes wasted spend from our healthcare system, returning dollars to payers, lowering the cost of care and improving access for all.
Penstock is powered by industry veterans who are some of the most sought-after payment integrity and regulatory experts in the industry. Our business model is rooted in transparency and the drive to reinstate true integrity in payment integrity—even if it defies traditional business sense.
Our audit workflow SaaS platform, ClearBridge gives health plans the tools and insights they need to identify overpayments, correct them and implement their own edits with ease, ensuring correct payments and mitigating future discrepancies.
When you partner with Penstock, you reclaim time and control with an end-to-end partnership that beautifully and seamlessly connects human and machine intelligence—to prevent recurring issues at the source.
When you partner with Penstock, you reclaim time and control with an end-to-end partnership that beautifully and seamlessly connects human and machine intelligence—to prevent recurring issues at the source.
PARTNER WITH US
Based on your objectives, we can create bespoke packages designed specifically for you – from presenting your expertise on the main stage, to hosting a private dinner. You can partner with us showcase your brand and make valuable new connections. Opportunities predominantly lie in 3 main categories: Thought Leadership, Branding & Networking.
To discuss your objectives and partnership opportunities please contact Harry Ludbrook, Sales Director [email protected]
Interested in a media partnership?
We'd love to hear from you and how we can support one another to connect with the industry. Contact Jodie Purser, Marketing Manager, [email protected]
PARTNER WITH US
Based on your objectives, we can create bespoke packages designed specifically for you. Opportunities predominantly lie in 3 main categories: Thought Leadership, Branding, and Networking.
Interested in a media partnership?
We'd love to hear from you and how we can support one another to connect with the industry. Contact [email protected]
Delivering scalable and flexible solutions which ensure accuracy and integrity of claims
The Healthcare Payments and Revenue Integrity Congress is the only summit focused on addressing healthcare waste and ensuring that claims are paid correctly, reflecting current healthcare needs. You will join key decision-makers, within health insurers and providers, who are responsible for payment and revenue integrity, value-based payment, and networking relations.
At a time when both payers and providers are evaluating and streamlining internal payment and revenue integrity processes, this networking conference has been established to breakdown silos, by promoting discussion between clinical, coding, revenue cycle and payment departments to facilitate the development of efficient, value-based healthcare systems.
MEDIA KIT
For more information on webinars, roundtables, content marketing packages, interviews and marketing solutions opportunities, download the Media Kit.
If you have any questions, please contact Harry Ludbrook, Sales Director, [email protected].
About Kisaco Research
Kisaco Research produces, designs and hosts B2B industry conferences, exhibitions and communities – focused on a specialized selection of topic areas.
Meet industry peers that will help build a career-changing network for life.
Learn from the mistakes of your peers as much as their successes—ambitious industry stalwarts who are happy to share not just what has made them successful so far but also their plans for future proofing their companies.
Note down the inspired insight that will form the foundation for future strategies and roadmaps, both at our events and through our online communities.
Invest both in your company growth and your own personal development by signing up to one of our events and get started.
We'd love to hear from you.
Contact us at +44 (0)20 3696 2920 and email [email protected], or let us know what subject area you're interested in below.