OVERVIEW:

This presentation focuses on reviewing the common areas of non-compliance with current CMS Price Transparency and the incorporation of tools to support the upcoming No Surprises Act.  Finally, we will discuss strategies to protect the hospital from a pricing and net reimbursement perspective including navigating challenges surrounding transparent pricing methodologies and payer contract management concerns.

SPEAKERS:

Peter Ripper has worked in healthcare since 1975 when he began his healthcare career as a Financial Analyst and Hospital Controller for American Medicorp, Inc. (NYSE). During 1976 and 1977 he served as a Principal Accountant at UCLA Medical Center, working in the Reimbursement Department. In 1978 he co‐founded his first healthcare consulting firm, Med‐Charge Analysis, Inc., specializing in auditing acute care hospital bills to improve the accuracy of the charge capture process. In 1982 Peter sold Med-Charge to a New York Stock Exchange listed company, (Omnicare, Inc.) and from 1982 through 1985 he managed the charge capture healthcare consulting division of Omnicare. In 1985 Peter formed his second company PARA (Peter A. Ripper & Associates, Inc.).  Since then, Peter has built PARA to become a proven resource to the hospital revenue cycle, supporting hospitals and health systems with pricing, coding, reimbursement, and compliance.  He and his team have created a powerful web-based revenue cycle tool and a comprehensive revenue integrity program complete with a chargemaster audit, pricing services, monthly departmental meetings, and ongoing pricing, coding, reimbursement, and compliance support.

Randi A. Brantner began her career in healthcare in 2002 where she spent eight years working in a variety of pharmacy settings including retail, military, hospital, narcotic control, and pharmacy purchasing. In 2010, Randi became the Charge Master Analyst for Memorial Health System in Colorado Springs, CO. There, she supported the hospital revenue cycle through maintenance of the charge description master for the health system. Over the next few years, she assisted in the implementation of operational improvement of billing processes and assisted in monitoring, auditing, and measuring the effectiveness of the revenue cycle process. Randi has a Master’s in Business Administration with a focus in HealthCare Administration and is Six Sigma Black Belt Certified. She joined PARA in 2012 and currently serves as the Vice President of Analytics.