KEYNOTE SPEAKERS

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.

 

Marshall Allen

Author/Journalist/Educator

Marshall Allen has spent more than 16 years as an investigative reporter covering health care, including more than a decade at ProPublica. He specializes in investigating why we pay so much for health care in the United States and get so little in return, and in issues related to patient safety. He is the author of the new book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.” He is also the founder of Allen Health Academy, which produces a curriculum of short on-demand videos to equip and empower employees to navigate the health care system. Please go to marshallallen.com for more information, and sign up for his newsletter at marshallallen.substack.com. Marshall now works for the Dallas region of the OIG-HHS, but he is speaking here as an author and educator, not on behalf of the federal government.

PRESENTERS

Click on a name to view bio

 

AGENDA

 

June 15, 2022 | 10:15 am - 3:30 pm EST

 

10:15 - 10:30

Welcome

Stephanie Belschner, Vice President, Client Relations

 

10:30 - 11:30

The Policies Shaping Healthcare Price Transparency: Surprise Billing, Drug Costs and Where We Go From Here

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

Stacy Borans, MD, Founder & Chief Medical Officer | AMS

 

Ryan Work of SIIA and AMS’ very own Dr. Stacy Borans will provide an interactive discussion on the latest activities related to the implementation of surprise billing protections, SIIA’s recently release Drug Pricing Best Practice Guide and federal proposals to curb drug prices and bring out a crystal ball to talk about what is on the horizon for healthcare transparency and reform.

 

11:30 - 11:45

Break

 

11:45 - 12:30

Breakout Sessions

Session 1 | The Payment Integrity Digital Transformation

Dave Cardelle, Chief Strategy Officer | AMS

Stephanie Belschner, Vice President of Client Relations

 

Traditional post-payment and pre-payment Payment Integrity solutions have evolved organically in the past 35 years by adding patchwork ‘enhancements’ to traditional methodologies and workflows. While these solutions provide some short-term benefits, they do not address the core issue facing payers today and, in the future… scalability. Only by leveraging modern technology such as Artificial Intelligence, Natural Language Processing and Machine Learning, can organizations evolve to stay on pace with their expanding fiduciary responsibilities.

 

Session 2 | FACS: The Next Step Forward In Payment Integrity

Nic Andre, Vice President of Product

Heather Fox, RN, Vice President FACS

 

AMS doesn’t see “Payment Integrity” as just another industry buzzword; it’s what our systems do to yield our clients concrete results every single day. We’ve spent years building a unique, scalable SaaS solution that allows payers to forensically review clinical and financial flags on high-dollar claims in-house. Those that have integrated FACS into their payment integrity processes are now realizing exponential cost-savings on nuanced issues completely missed by other claims surveillance systems. After all…Knowledge Is Power. Take a look under the hood of FACS in this deep-dive with the product team.

 

Session 3 | Creating Local Partnerships To Reduce The Cost Of Cancer Treatment

Pete Scruggs, AIL Innovator of the Year | Founder benefitSMART Cancer Solutions | Best Selling Author

Eric Morrow, Predict Suite Account Specialist| AMS

 

Join this session as Pete Scruggs describes the problem of increased hospital control of cancer procedures elevating the cost of cancer treatment. Uncover real-world solutions to the financial toxicity of cancer through strategic partnerships between stop loss carriers, employer groups and local cancer providers.

 

Session 4 | Anticipate High-Cost Claims with Accuracy

Peter Borans, President & Co Founder | AMS

Alice Jamba, Vice President, Clinical Integration

Vlad Cadet, E. Vice President, Sales

 

Accurately predicting the financial impact of high-cost claims 12 months ahead of time is more complex than a single financial algorithm. To effectively, and accurately, predict future high-cost claims, member-level clinical data needs to be evaluated and courses of treatment need to be integrated into the analysis. Join this session as Peter and team shows how it is done!

 

12:45 - 1:45

Lunch

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

 

1:45 - 3:15

Keynote Presentation

Stacy Borans, MD, Founder & Chief Medical Officer

 

Be on the lookout for full details on Dr. Stacy’s Keynote! We wanted this session to be all about you, the AMS Virtual Conference attendees, so we're gathering your feedback to address those topics. It'll be a fantastic, tailor-made talk just for you hosted by Dr. Stacy.

 

3:15 - 3:30

Closing Remarks

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.

 

June 16, 2022 | 10:15 am – 1:45 pm EST

 

10:15 - 10:30

Welcome

Stephanie Belschner, Vice President, Client Relations

 

10:30 - 11:30

Keynote - Patient Empowerment: The Secret to Reducing Health Care Costs

Marshall Allen, Author - “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win”

 

Working Americans are being afflicted by unjustified and out-of-control health care costs. With proper education, they can be empowered to lower health care costs for themselves, their families – and their employer sponsored health plans. Journalist Marshall Allen will show how it’s already happening. His book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win,” is a field guide that’s helping patients save hundreds and even thousands of dollars per health care interaction.

 

11:30 - 11:45

Break

 

11:45 - 1:00

AMS IQ – Insight & Questions

AMS IQ is filled with a panel of industry executives who will share their industry INSIGHT with conference attendees. Each panelist will give an intro into their business, what is impacting the industry from their perspective and how they are overcoming challenges. Attendees will have the opportunity to ask QUESTIONS by submitting them before the conference and live during the session.

 

Panelists

  • Stacy Borans, M.D., Founder & Chief Medical Officer | Advanced Medical Strategies
  • Brooks Goodison, President | Diversified Group
  • Christine M. Hale, MD, MBA VP Clinical Consulting | Lockton Dunning Benefits
  • Marien Diaz, VP Stop-Loss Claims and Medical Management | Symetra
  • Rodger Smith, VP, Strategic Accounts | EXL
  • Robert Gaudette, Pharm.D., M.B.A. Staff Vice President, Complex & Clinical Audit and Provider Education | Anthem

 

1:00

Closing Remarks

Stephanie Belschner, Vice President Client Relations

 

A recap of the day’s events and information on how to navigate through the conference platform following the event. And most importantly, the presentation of conference prizes.

 

1:00 - 2:00

Demo Hall Demonstrations

Interested in an AMS module that you have seen during the virtual conference? Come on over to the demo hall to watch on demand demos of the Predict Platform modules. PredictDx, PredictRx, PredictIx/AI-Bill, FACS and Profiler will all be on display. Have a question? Want to learn more during a private demonstration? You may do so by signing up via the calendar!