Today managing high dollar claim spend is more important than ever for Health Plans, TPAs, Employers, and Reinsurers, and can pose significant financial risks.  How can these costs be managed without being a constant financial drain on your company resources? Our combination of the right people and the right technology provides an approach that ensures claims are paid right, the first time - all with unmatched turnaround times. 

  1. Ensure accuracy of payment through Hospital Bill Review services including Itemized Bill Review and Clinical Chart Review of inpatient and outpatient facility claims
  2. Learn how Zelis is bringing our prepayment expertise to our new DRG Validation product to create an innovative end-to-end technology driven solution!
  3. And hear how we’ve designed our services to collaborate, customize and provide flexibility, no matter how large or small your organization

Featured Speakers

Dr. Priscilla Alfaro, MD

Chief Medical Officer
Zelis

Dr. Priscilla Alfaro is the Chief Medical Officer for Zelis and provides clinical and coding and billing oversight of the Claims Cost Solutions team.  She is the past President of the Alumni Association for the McGovern Medical School which represents over 8,000 medical school graduates and has also served as the medical director for the Texas Office of Inspector General.

She is a Board-Certified Pediatrician and spent 20 years in clinical practice. She is also a Certified Professional Coder, Certified Professional Medical Auditor, Certified Outpatient Coder, and Certified Fraud Examiner. She is a member of AMA, AAP (National, TX, and Hawaii chapters), AAPC, NAMAS, Travis County Medical Society, Texas Medical Association, ACFE, and served as the Chairman of the Medical Advisory Board for the National Healthcare Anti-Fraud Association (NHCAA) from January 2018- July 1, 2019.

Scott Bogosian

Vice President, Sales
Zelis

Over the past 15 years, Scott has partnered with health plans and third party administrators to understand their cost management objectives and deliver strategies to assist in achieving their goals. He brings a wealth of expertise with particular strengths in cost containment, electronic payments and network management within the healthcare industry. Scott’s passion is in collaboration and service and blending them together to create lasting partnerships that continue to bring new value to clients.

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