NEW YORK, Aug. 30, 2023 /PRNewswire-PRWeb/ —
MedReview, Inc., a leading provider of payment integrity, utilization management, and quality surveillance services, today announced that Chief Strategy Officer Kathy Gonzales has been selected as a featured presenter at the Healthcare Payment and Revenue Integrity Congress (HPRI) East. Gonzales will be joined by Timothy Wilson, Senior Vice President of Population Health Management at P3 Health Partners, a MedReview client, and MedReview data mining expert Michael Brown for a presentation titled “Better Manage What You Are Missing: Collaborate with Data Mining Expertise.” The presentation will take place Sept. 14 at 11:30 at The Colonnade in Boston.
Data mining is one of several analytical tools used in payment integrity to identify fraudulent, erroneous, or abusive claims. Unlike a DRG coding review, data mining does not require medical records or look at DRG codes. Instead, data-mining experts use such techniques as association rules, classification and clustering to locate claim overpayments that might otherwise remain hidden.
“Data mining is a powerful tool, as it can curtail claim leakage, identify new savings opportunities and improve medical loss ratios by returning claim dollars to payors,” said Gonzales, who focuses on organizational effectiveness and oversees new client implementations for MedReview.
“Implementing MedReview’s data-mining process has resulted in real savings for P3,” said Wilson. “We’re excited to share our story at HPRI East so that other companies can see a path to the results we have discovered.”
HPRI East connects leading figures in payment integrity and revenue cycle management and is the only conference focusing on breaking down payor and provider silos. Learn more about the conference here.
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Headquartered in the financial district of New York City and serving all U.S. states and territories, MedReview has been a leading provider of payment integrity, utilization management and quality surveillance services for more than 40 years. A physician-led organization with a passion for ensuring that health care claims fairly represent the care provided, MedReview provides timely independent hospital billing audits and clinical validation reviews on behalf of health plans, government agencies and Taft-Hartley organizations, saving millions of dollars for its clients each year.