NEW YORK, Nov. 27, 2023 — MedReview, Inc., a leading provider of payment integrity, utilization management, and quality surveillance services, today announced that Kathy Gonzales, Chief Strategy Officer, has been selected as a featured presenter at the Healthcare Payment and Revenue Integrity Congress (HPRI) West. Gonzales will be joined by 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 Nov. 30 at 11:30 am PST at the Sheraton Grand Los Angeles.
Data mining applies algorithms, or “concepts,” that efficiently identify claim overpayments. In addition to recouping the overpaid funds these concepts uncover, payors can apply the information to adjust their workflows and prevent similar overpayments in the future.
MedReview currently uses more than 400 concepts tailored to each client, as well as unique concepts developed for specific clients. “The secret to finding claim leakage is knowing where to look and going there first,” said Michael Brown, senior director of data mining at MedReview. The data-mining team “works with clients to make sure we’re in alignment with their goals and determine the best way to find the most overpayments for them as quickly as possible.”
“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.
HPRI West connects leading figures in payment integrity and revenue cycle management to encourage information sharing, nurture payor-provider relationships, and support the transition to value-based payments. Learn more about the conference.
Read the full press release
DON'T MISS AN UPDATE
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.