Stacy Borans

Founder &
Chief Medical Officer

Dr. Borans is the Founder and Chief Medical Officer of AMS (Advanced Medical Strategies), the leader in strategic intelligence software for clarity into complex claims.

AMS was founded with the purpose of combining technology, clinical expertise, financial insight, and data science to help manage and mitigate the disproportionate impact catastrophic claims, specialty pharmaceuticals, and implant costs have on overall medical cost trend increases. Through AMS, Dr. Borans has streamlined the way payers all across the healthcare spectrum can better understand and address the most costly and complex claims problems they encounter every day.

Dr. Borans is a respected and much in-demand speaker at seminars worldwide for claims professionals. She has appeared on a multitude of educational panels, workshops, and podcasts, in addition to hosting webinars on a regular basis.

Prior to forming AMS, Dr. Borans was Medical Director at Executive Health Resources, where she oversaw insurance denial management, appropriateness of care, and length of stay programs in over 50 hospitals spanning 15 states. She began her professional career in medicine as a private practice physician at Fountainville Medical Specialists in Doylestown, PA.

Dr. Borans earned her medical degree from Hahnemann University in Philadelphia, PA. She completed an internal medicine residency at Thomas Jefferson University Hospital, also in Philadelphia. She holds a BA in Biology from Brandeis University.

Away from AMS duties Dr. Borans is the volunteer President of the Board for a no-kill cat shelter and rescue non-profit organization.


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Opening Remarks

Stephanie Belschner, Vice President, Client Relations


10:30 - 11:30


Price Transparency, Health Care Cost, and the Political Landscape

Ryan Work, Vice President, Government Relations | Self-Insurance Institute of America, Inc.


This session will offer an overview of current and upcoming regulations surrounding surprise billing and price transparency and offer insights into how the current political environment is impacting health care policy. From drug pricing to the Medicare for All debate, find out what Congress and the new Administration are doing in the first 100 days and beyond.


11:30 - 11:45


Open Snack 1


11:45 - 12:30


Session 1 | Leveraging Big Data to Assess Small Group Risk

Peter Borans, CEO & Co-Founder

Derek Moore, Chief Growth Officer


Self-insurance has long been a cost-management strategy for large employers. Recently, more and more smaller companies are beginning to see the potential benefits of not paying high monthly premiums to traditional insurance carriers. Many brokers and stop-loss carriers are looking to offer partially self-funded products that address this growing market need. But industry and regulatory barriers (including lack of claim experience) make selling and underwriting these products challenging. Common questions include: “Is there any way to avoid the hassle of health questionnaires?”; “Is there an automated tool for brokers and underwriters to quickly identify which groups are the best candidates?”; “How can I preview anticipated risk and variable risk to win or lose early?”

If you are asking these questions and want to learn more, join this session as we will:

  • Guide you through how to assess risk by leveraging Big Data and predictive analytics
  • Demonstrate how to eliminate health questionnaires by using only a current member census
  • Benchmark risk with actual claims from similar-sized groups with comparable demographic profiles by state and nationally
  • Adjust risk tolerances and claim rates to project claims costs
  • Discuss how to evaluate the financial risk of catastrophic diagnoses as it pertains to underwriting small groups


Session 2 | The Stop Loss Intersection: Where Underwriters, Advisors, and TPAs Meet

Vlad Cadet, EVP Business Development & Partnerships

Nic Andre, Vice President of Product Development

Heather Fox, RN, Vice President FACS


Though all three players generally work towards the same goal, the current infrastructure at the stop loss intersection can sometimes be at an impasse.

In this session the AMS Team will help to relieve the gridlock to get communications, oversight, and transparency flowing again.

Come meet up in this session to learn more!


Session 3 | Implant Billing: The Untold Stories

David Cardelle, RPh, Chief Strategy Officer

Stephanie Belschner, Vice President, Client Relations

Jason Sinatra, PredictIx Account Manager


When it comes to claims billing for medical implants and surgical bundled procedures, we all have stories. These tales include hidden costs, inappropriateness, and withheld data to name a few. During this session we have new stories to tell. Ones that have to do with insight, transparency, clarity, and real data. We will separate the fact from the fiction pertaining to implant claims, revealing:

  • Erroneous and inappropriate billing of common supplies as implants under carveout language
  • Implant billing where no diagnosis or procedure codes indicate an implant should have been used
  • Instruments being billed as implants
  • Egregious pricing of implants
  • Excessive units of implants being billed
  • Poor contract language or policies with loopholes allowing Providers to bill in excess of industry standard reimbursement

If you’re a payer who is tired of the on-going saga of implant billing, join this session and close this chapter of your work life.


Session 4 | The Predict Suite: A Guided Tour

Alice Jamba, RN, Vice President of Clinical Services

Lee Patrick, RN, Vice President of Clinical Informatics

Jackie Clingman, RN, Clinical Review Nurse

Karen Giroux, RN, Clinical Review Nurse


The Predict Suite is home to many features you are familiar with, and possibly some you are not. Come and take a tour guided by members of the AMS clinical team. In this session the team will discuss PredictDx's offerings beyond its neoplastic disease directory. They will also demonstrate how PredictRx illuminates the differences between drugs, biologics, generics, and biosimilars. And did you know that some generic drugs are branded? PredictRx does! Join this session for a guided tour of PredictDx and PredictRx features.


12:45 - 1:45



Come and take a break with AMS Founders Stacy Borans, MD & Peter Borans in the Networking Café!


1:45 - 3:15


Gene Therapies: The Future is… Now?

Stacy Borans, MD, Founder & Chief Medical Officer


Gene therapies are truly groundbreaking treatments. The few that have already been FDA approved are rousing success stories. Yet for some time now we’ve been promised that the dam will burst, ushering in a virtual tidal wave of cutting-edge medicines. That has not happened. It seems the future has been put on hold.

Please join Dr. Borans as she does a deep dive into the gene therapies currently on the market, those whose approvals seems imminent, and the many others still in development. Find out if the future is worth waiting for—and who pays for that bright new tomorrow.


3:15 - 3:30


Closing Remarks / Open Snack 2

Stacy Borans, MD, Founder & Chief Medical Officer

Stephanie Belschner, Vice President of Client Relations

A recap of the day’s events and information on how to navigate through the conference platform following the event.