Day One Agenda
Wednesday, February 7

8:00   REGISTRATION & WELCOME COFFEE

8:50   CHAIRPERSON’S OPENING REMARKS
Sean English, Director of Strategic Accounts
FRONTRUNNER HC

9:00   PANEL DISCUSSION: DEFINING CRITICAL COMPONENTS OF A HOLISTIC APPEALS STRATEGY
• Addressing the increasing volume of appeals to manage
• Methods to expedite first & second level lab-submitted appeals
• Diving further into third, fourth level appeals & more
• Potential partnerships with patients & appealing to outside entities
Julie Wiedower Kaylor, Director of Medical Affairs, Managed Care
GUARDANT HEALTH
Julia Dawson, Associate Director, Managed Care
PACIFIC EDGE DIAGNOSTICS
Heather Agostinelli, Vice President Head of Specialty RCM
XiFin, Inc.
Darla Wanitschke, Director of Customer Success, RCM Implementation
TELCOR
Anna Ogloblina, Director of Product Management
BOSTONGENE

9:45   BUILDING BLOCKS OF A SUCCESSFUL IVD REIMBURSEMENT STRATEGY
• Various pathways to securing coding, coverage & payment
• Evidence demands from payers to support diagnostic coverage
• The pivotal rule of clinical utility evidence
Eric Lam, VP, Avania Market Access
HULL ASSOCIATES, an Avania Company

10:30   COFFEE & NETWORKING BREAK

11:00   LEVERAGING DATA TO MAXIMIZE REVENUE CYCLE TEAM PRODUCTION
• Understanding the data
• Applying actionable items
• Setting team priorities
• Maximizing team output & ROI
Michael Marshall, Managing Director
e5 WORKFLOW

11:45   PANEL DISCUSSION: FUTURE OF THE FRONT-END CLAIMS PROCESS: TEST ORDERING & PRIOR AUTHORIZATION
• Improving the front end claims process & PA workflow initiation in the physician offices
• Avoiding PA management in the lab workflow, after the fact
• Automation to reduce human effort & burden on all healthcare service provider side
• Main key item: The benefits eligibility process & preventing common pitfalls
Perry Dimas, Chief Business Officer 
CAREVISO
Brittany Rambino, President of Precision Medical Revenue Solutions/VP Rev Cycle Management
AMBRY GENETICS
Chris Ho, Sr. VO Customer Operations
MYRIAD GENETICS
Rob Guigley, Chief Commercial Officer
INVITAE

12:30   LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

1:30   SMALL GROUP DISCUSSIONS: EXCHANGING STRATEGIES IN PRIOR AUTHORIZATION PROCESS STREAMLINING
A common challenge faced by most laboratories and test developers resides in managing cumbersome prior authorization processes to ultimately obtain payment for the use of a test. In small group formats, the audience is given the unique opportunity to learn from fellow participants and exchange lessons and experience pertinent to the use of third party service providers, proven strategies to create efficiencies, as well as methods to alleviate the administrative burden in handling prior authorization tasks and paperwork.
Nichole Kerr, Senior Director of Revenue Services
SONORA QUEST LABS

2:00   PANEL DISCUSSION: TRANSFORMING HEALTHCARE THROUGH TRANSPARENCY & DIALOGUE
• The crucial intersection of the patient’s financial & clinical experiences
• Breaking down silos to create transparency & dialogue across the continuum
• The impact of a “super-clean order” at the front-end & why it matters to the industry
• What it will take to disrupt healthcare & drive transformation
Mark Hiatt, Chief Medical Officer
FRONTRUNNER HC
Sean English, Director of Strategic Accounts
FRONTRUNNER HC
Anna Ogloblina, Director of Product Management
BOSTONGENE

2:45   COFFEE & NETWORKING BREAK

3:15   PANEL DISCUSSION: OPTIMIZING REIMBURSEMENT OPERATIONS FOR TESTS UNDER INCREASINGLY COMPLEX MEDICAL POLICIES
• Securing a clear understanding of payer medical policies & ensuring compliance
• Common obstacles encountered by labs amidst the growing complexity of specialized testing
• Collecting patient clinical data in a physician-friendly manner
• Effective strategies & actions to implement to optimize reimbursement processes
Chad Miles, Director, Reimbursement Management
QUADAX, INC.
Cris McMahon, Sr. Director, Payor & Customer Relations
PROMETHEUS LABORATORIES
Tim Ramirez, Head of Revenue Cycle Operations
BIOVICA, INC.
Danielle W. Scelfo, MHSA, Vice President, Market Access & Health Policy
CLEARNOTE HEALTH

4:00   PANEL DISCUSSION: CLARIFYING Z-CODES & INCREASING REQUIREMENTS FROM PAYERS
• Z-codes history & purpose in the diagnostic field
• Rationale for recent shift in UHC’s requests for Z-codes
• Implications for test developers in obtaining payment
• Managing the ripple effect & forecast of the near future
Gabriel Bien-Willner, Program Medical Director, MolDX & CMO
PALMETTO GBA
Sarah Overton, Director, Revenue Cycle Management
VELSERA
Brian Carey, Partner
FOLEY HOAG

4:45   DISSECTING THE FDA’S PROPOSED RULE GOVERNING LDTs & EFFECT ON LABORATORIES
• 21CFR part 809 amendment to clarify the definition of IVD
• Phaseout of current approach & enforcement roll-out
• Rule adoption & industry transition timelines
• Open questions pertinent to:
          » Potential grandfathering regime
          » Compliance issues relevant to the nature of LDTs
          » Phaseout program alignment with other programs
• Next steps & expectations for rule finalization
Christine P. Bump, Principal
PENN AVENUE LAW & POLICY

5:30   CLOSING REMARKS AND END OF DAY 1  

Day Two Agenda
Thursday, February 8

8:00   REGISTRATION & WELCOME COFFEE

8:20   CHAIRPERSON’S OPENING REMARKS
Patti Grey, Assoc. Vice President, Client Implementations & Support, Partner
QUADAX, INC

8:30  EFFECTIVE GROWTH STRATEGIES FROM MARKET ACCESS THROUGH REIMBURSEMENT: PROVEN METHODS TO MAXIMIZE REVENUE & CASH FLOW
• Better understand how investing in market access is a key growth strategy to solidify & expand payor coverage
• Learn valuable strategies to overcome common revenue cycle management (RCM) challenges including:
          » Achieving accurate medical coding
          » Ensuring complete reimbursement
          » Effectively applying artificial intelligence to streamline complex processes & accelerate reimbursement
          » Upholding billing compliance standards amidst changing payor policies and behavior
Clarisa Blattner, Senior Director, Revenue & Payor Optimization
XiFin, Inc.

9:15   PANEL DISCUSSION: UNDERSTANDING THE PSYCHOLOGY OF THE PAYER & CLINICIAN TO PURSUE MARKET ACCESS EFFECTIVELY
• Appealing to what matters most to the payer
• Addressing Medical Directors as Clinicians
• Elaborating upon payers’ mindset, mission & vocabulary
• Targeting the payer’s primary focus: Patients/members
Mark Hiatt, Chief Medical Officer
FRONTRUNNER HC
Brent Gibbs, Vice President, Market Access & Health Policy
CAREDX
Greg Stein, Founder & CEO
SHADOWBOX
Eugean Jiwanmall, Sr Research Analyst; Medical Policy & Technology Evaluation
INDEPENDENCE BLUE CROSS

10:00   COFFEE & NETWORKING BREAK

10:30  CLARIFYING PAYER METHODOLOGIES TO MAKE INFORMED COVERAGE DECISIONS
• Technology evaluation process walkthrough
• Preferences towards clinical testing methodologies
• Expectations towards evidence to demonstrate:
           » Clinical utility
           » Economic value
• Positive decision criteria: Key data to secure coverage
• Policy development & updating mechanisms & influences
Paige Nardi, VP Market Access, Reimbursement & Billing
HEPQUANT
Gabriel Bien-Willner, Program Medical Director, MolDX & CMO
PALMETTO GBA
Eugean Jiwanmall, Sr Research Analyst; Medical Policy & Technology Evaluation
INDEPENDENCE BLUE CROSS
Sarah Kurley, Associate Director – Molecular Diagnostics Evidence
OPTUM GENOMICS 

11:15  DISSECTING STATE BIOMARKER COVERAGE LAWS & IMPACT
Part 1 – LEGAL PERSPECTIVE:
• Discuss the rationale for biomarker coverage legislation
• Landscape of enacted state biomarker laws
• Considerations for implementation of biomarker laws
• Lab experience to date working with payers & prospects for working with payers & policymakers
Erik Schulwolf, Associate
FOLEY HOAG

12:00   DISSECTING STATE BIOMARKER COVERAGE LAWS & IMPACT
Part 2 – LAB PERSPECTIVE:
• Biomarker Legislation in the real world & impact on non-oncology diagnostics
• Solutions to solve prior authorization, medical records & other items to increase paid claims
• Challenges in obtaining medical records & lack of quality information in medical records
Brent Gibbs, Vice President, Market Access & Health Policy
CAREDX
Kaitlyn Mouton, Associate Director, Reimbursement and Strategic Planning
CAREDX

12:45   LUNCHEON FOR ALL SPEAKERS, SPONSORS & ATTENDEES

1:45   FIRESIDE CHAT: PAYERS’ PERSPECTIVES ON AUTOMATED & AI-POWERED TECHNOLOGIES
As artificial intelligence (AI) has become increasingly integrated into the diagnostic offerings of labs — helping, for example, to identify biomarkers for panels, patients for trials, and therapies for patients — how will payers respond in terms of coverage and reimbursement? In policy and payment, will AI be integrated with, or separate from, the technologies it powers?
Mark Hiatt, Chief Medical Officer
RADSITE
Orest Boyko, Chief Scientific Officer & Founding Member
AMERICAN BOARD OF AI IN RADIOLOGY (ABAIR)
Navid Alipour, CEO
CUREMETRIX

2:15   MASTERING & ENHANCING STRATEGIES TO OPTIMIZE EVIDENCE PRODUCTION
Given the critical importance of demonstrating clinical utility, scientific validity, and economic value to healthcare payer organizations in order to secure coverage and reimbursement, teams must ensure a sound evidence generation strategy is in place. Working off of each participant’s personal experience, this session enables attendees to discuss with peers in a small group format, and share valuable lessons learned relevant to methods aiming at enhancing evidence generation in the clinical setting.
Part 1 – Case Study: Practical Approach to Analyze Evidence Needs & Reach Targeted Goals
Anna Ogloblina, Director of Product Management
BOSTONGENE

3:00   Part 2 – Small Group Discussions: Sharing Experience & Lessons Learned
Julie Wiedower Kaylor, Director of Medical Affairs, Managed Care
GUARDANT HEALTH
Anna Ogloblina, Director of Product Management
BOSTONGENE

3:45   Closing Remarks & Conference Conclusion

A Special Thanks to Our Sponsors