With change and uncertainly brought on by health reform, including the need to minimize administrative costs because of the medical loss ratio, can you afford to lose money to an inefficient and out-of-date claims management administration?

The claims adjudication process must be timely and accurate, not only to cut administrative costs and reduce payment errors, but also to maximize the satisfaction of the provider networks. This includes achieving automation, rules-driven processes and other efficiency gains to optimize workflow and operational efficiency and performance.

World Congress is excited to present the National Executive Forum on Healthcare Claims Management for health plans. This conference equips health plans with the latest strategies to implement time-saving and money-saving solutions to adapt to increased scrutiny on the costs of claims processing as a result of health reform, prepare for an influx of new members, advance efficiency with new technology and processes and achieve compliance with 5010 and ICD-10 implementation. 

The Conference Goal

This congress brings together health plan executives to discuss the challenges and solutions in claims processing and management. Attendees leave this conference with a better understanding of:

• Prevention and detection of inappropriate, unnecessary billing or falsification of medical records
• Claims processing components to outsource receive the best ROI
• Transitioning to ICD-10 and 50/10
• The impact of healthcare reform and Medical Loss Ratio (MLR) on claims management
• The right level of auto-adjudication to lower expenses while ensure claims processing quality
• High cost transactions to speed up processes and reduce cost
• Eliminating overpayments up-front to drive down costs

Learn Directly from the Leaders

• UPMC HEALTH PLAN on cost cutting strategies and improve provider satisfaction
• LOVELACE HEALTH PLAN on capturing and processing claims correctly to avoid overpayments
• BLUECROSS BLUESHIELD OF DELAWARE on outsourcing claims services for the best ROI
• HIGHMARK BLUECROSS on detecting fraudulent and inappropriate claims
• CONNECTICARE on controlling administrative costs for MLR compliance
• MARTIN’S POINT HEALTH CARE on increasing electronic data interchange utilization