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  • This session delves into prevalent billing and coding errors encountered in healthcare reimbursement postpayment and prepayent processes, shedding light on their potential to result in overpayments for payers. Through case studies and practical examples, Healthcare Fraud Shield can showcase effective strategies for identifying common errors, such as incorrect billing of maternity care services.
  • This session will walk through:
      • Appropriate coding for delivery services 
      • Proper billing practices at it relates to antepartum and postpartum care 
      • How to detect patterns of inappropriate claim submissions

Author:

Karen Weintraub

Executive Vice President
HEALTHCARE FRAUD SHIELD

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. 

... read more

Karen Weintraub

Executive Vice President
HEALTHCARE FRAUD SHIELD

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. 

HPRI developed a first of it's kind, payment integrity industry survey, in partnership with the payers that are part of the HPRI network. The survey results are aggregated to provide powerful insights from all of the PI experts across the country. The aim of the survey was to evaluate current trends in the payment integrity market, explore the payer perspective of implications related to the complexity of the market, and gain insights from payers on the introduction of disruptive technologies enabling greater analytics for unstructured data, and
opportunities for future savings in the coming year. Join us for a review of the 2024 PI survey results to help drive your PI initiatives.

- Learn about the most prominent PI trends for 2024
- Explore new innovations and their impact on driving 2024 opportunites
- Leverage survey results to asses where your program and organization fall in relation to your peers in the industry

Author:

Dave Cardelle

Chief Strategy Officer
AMS
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Dave Cardelle

Chief Strategy Officer
AMS
2024 WHIS EU Sample Attendee List
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Siamak Tavallaei

Senior Principal Engineer, System Architecture
Samsung

Siamak Tavallaei joined the CXL effort as a founding member of the CXL Consortium and co-chair of the Technical Task Force (TTF) in 2019 to develop the CXL 2.0 specification. He has served on the CXL Board of Directors and as the CXL President. In 2016, he joined Open Compute Project (OCP) as a co-lead of Server Project. He is currently the Incubation Committee Representative for the Server Project where he drives open-sourced modular design concepts for integrated hardware/software solutions.

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Siamak Tavallaei

Senior Principal Engineer, System Architecture
Samsung

Siamak Tavallaei

Senior Principal Engineer, System Architecture
Samsung

Siamak Tavallaei joined the CXL effort as a founding member of the CXL Consortium and co-chair of the Technical Task Force (TTF) in 2019 to develop the CXL 2.0 specification. He has served on the CXL Board of Directors and as the CXL President. In 2016, he joined Open Compute Project (OCP) as a co-lead of Server Project. He is currently the Incubation Committee Representative for the Server Project where he drives open-sourced modular design concepts for integrated hardware/software solutions. He has served as Chief Systems Architect at Google Cloud Platforms where he led the architecture and productization of CXL-enabled solutions. His recent focus has been the optimization of large-scale, mega-datacenters for general-purpose and tightly-connected accelerated machines built on co-designed hardware, software, security, and management. His experiences as Chief Systems Architect at Google Cloud, Senior Principal Architect at Microsoft Azure’s Hardware Architecture team, a Distinguished Technologist at HP, a Principal Member Technical Staff at Compaq, and his contributions to industry collaborations such as CXL, OCP, EISA, PCI, InfiniBand, and PCIe give Siamak a broad understanding of requirements for the Enterprise, Hyperscale, and Edge datacenters for industry-wide initiatives.