AI Summit

June 6-7, 2024 | Atlanta, GA

Renaissance Atlanta Airport Gateway Hotel

Agenda

 

Thursday, June 6th
7:00-8:30 p.m.
Welcome Networking Reception & Registration

As part of the AI Summit, we are pleased to invite attendees to a welcome reception hosted onsite at the Renaissance Atlanta Airport Gateway hotel. The reception will take place the evening prior to the kick off of the summit. Attendees will have the opportunity to network with other healthcare leaders for an evening of casual networking, drinks and great food.

Location: the reception will take place on the Magnolia Patio, an outdoor venue located at the Renaissance Atlanta Airport Gateway.

 

Friday, June 7th
8:00 a.m.
Breakfast & Registration 
9:00 a.m.
Welcome & Kick Off 

Musheer Ahmed
CEO & Founder

Codoxo

9:15 a.m.
Keynote Address: AI for Improved Healthcare Outcomes – A Unique Perspective with Congressman Schweikert

Congressman David Schweikert, a champion for healthcare reform and harnessing technology for better outcomes, will deliver a unique perspective on the role of Artificial Intelligence (AI) in the future of healthcare.

Schweikert will discuss his vision for AI-powered healthcare systems that not only advance patient care but also empower patients through easier interpretation of complex healthcare costs. He will elaborate on his support for policies that promote transparency and leverage AI technology to drive down expenses, echoing the pressing need for affordability and open access to healthcare information.

This focus on AI aligns with Schweikert’s commitment to creating a more equitable and effective healthcare system, benefiting both patients and healthcare professionals.

U.S. Representative David Schweikert
1st District, Arizona

10:15 a.m.
Leveraging AI as a Co-Pilot to Propel Payment Accuracy into the Future

Despite the increase in complexity, payment integrity has undergone dramatic transformation over the last decade. From the days when manual processes and legacy systems created vulnerabilities for fraud, errors and payment inaccuracies, to the transformative power of Artificial Intelligence (AI), unified systems, greater transparency, and streamlined processes that lead to enhanced accuracy and fostering a more transparent and reliable system for all stakeholders.

Christy Donohue, CMC
Senior Vice President Medicaid/CHIP of Mountain Health Trust

The Health Plan

10:45 a.m.
Networking Break
11:15 a.m.
Panel Session: Future-Proofing Healthcare with Disruptive Innovation

The healthcare landscape is on the cusp of a transformation. This panel discussion brings together visionary leaders to explore how cutting-edge technologies like AI and machine learning are poised to revolutionize clinical care, streamline billing and payment processing, and optimize healthcare for the future. 

Panelists will dive into:

  • The Automation Imperative: Explore how automation is streamlining workflows, reducing errors, and freeing up valuable time for healthcare professionals.
  • Unlocking Efficiency for a Sustainable FutureDiscover how innovation can improve healthcare delivery, optimize costs, and ensure long-term system viability.
  • AI and Machine Learning Powering Precision Medicine: Uncover how these technologies are personalizing treatment plans, predicting patient outcomes, and even detecting diseases earlier.
  • How is Healthcare Different: How can AI technologies be fine-tuned for healthcare and what role do standards play in enhancing transparency and ensuring accurate results. 

Panelists:

Sunil Budhrani, MD, MPH, MBA 
Chief Innovation and Medical Officer
Capital Rx

Mark Braunstein Ph.D
Professor of the Practice Emeritus
Georgia Institute of Technology

Musheer Ahmed Ph.D
CEO & Founder
Codoxo

Moderator:

Erin Demien 
Head of Business Development for Venture-backed Healthcare Startups
Amazon Web Services

12:00 p.m.
Panel Session: Navigating the Ethical Terrain of AI in Payment Integrity

The landscape of artificial intelligence (AI) is vast and continuously evolving, making it a challenge to stay abreast of the latest advancements. Just as crucial as these technological leaps are the ethical considerations they entail. Implementing AI with a strong ethical framework is key, particularly in sensitive domains like healthcare payment integrity. Ethical AI practices can revolutionize medical billing, ensuring accuracy in reimbursements and minimizing waste. Our panelists will explore the cutting-edge ethical and educational frameworks guiding AI in payment integrity. This discussion aims to chart a path for the safe and effective incorporation of AI into healthcare, focusing on fostering trust and efficiency.

Panelists:

Sheila Caulfield 
Director Corporate Recoveries
Independent Health

Nana Okyere 
Director of Operations Analytics
Health First

Chris Hammond 
Compliance and Investigations Director
BlueCross BlueShield of South Carolina

Moderator:

Rajesh Razdan 
VP of Products
Codoxo

12:45 p.m.
Networking Lunch
1:45 p.m.
Building a Scalable AI-Powered Payment Integrity Program: From Roadmap to Reality

This session dives deep into the practicalities of implementing a powerful AI system to supercharge your payment integrity efforts. We’ll explore the key business drivers pushing healthcare organizations towards AI, along with best practices for building a program that scales.

Join us for an interactive session and gain valuable perspectives on:

  • Understanding the “Why”: We’ll break down the compelling business drivers motivating healthcare payers to leverage AI in payment integrity.
  • Building for Success: Learn best practices for establishing a strong foundation for your AI program, including stakeholder alignment and internal buy-in.
  • Demystifying the Tech Stack: Uncover the essential capabilities and features you should look for in a potential AI solution to ensure seamless integration with your existing systems.
  • Charting the Course: We’ll discuss the expected outcomes you can achieve with a successful AI implementation, along with strategies for developing a clear roadmap to reach your goals.

Panelists:

Priscilla Alfaro, MD, FAAP, CPC, CPMA, COC, CIC, CFE, CRC
VP Payment Integrity
Blue Cross NC

Rae McIntee, DDS, MD, MBA, FACS, CPE
Medical and Dental Director, Fraud, Waste and Abuse, Payment Integrity and Utilization Management

Blue Cross and Blue Shield of Louisiana

Bryan Childress
Enterprise Business Operations Services (EBOS) Director, COB-TPL Operations

Centene Corporation

Moderator:

Jim Brady
Staff VP Payment Integrity

Elevance Health (Carelon)

2:30 p.m.
Fireside Chat: Masterful Approaches to Avoid Healthcare Payer AI Adoption Pitfalls

During this session, AI experts from Highmark Health will delve into the critical aspects of applying artificial intelligence safely and responsibly while avoiding common pitfalls. Panelists will explore the security landscape surrounding AI in healthcare, including potential threats, industry regulations, and best practices for securing sensitive data within AI-powered systems. They will also shed light on how AI empowers healthcare analytics and will explore the use of AI for data analysis, pattern recognition, and generating actionable insights to contain costs.

Panelists:

Sean Kelly
Director – Cyber Governance, Risk, and Controls
Information Security and Risk Management 

Highmark Health

Shashank Suresh
Director – Analytic Enablement  

Highmark Health

Moderator:

Patrick Stamm
Former COO of Shared Services at United Healthcare

3:15 p.m.
Networking Break
3:30 p.m.
Unleashing Synergy: How AI & Tech Vendors Can Partner to Deliver Cost-Saving Solutions for Healthcare Organizations

While AI and technology hold immense potential for cost containment, fragmented solutions and siloed development often hinder progress. This panel brings together leading AI and technology vendors to explore collaborative strategies to advance cost containment outcomes, including: 

  • Identifying key cost drivers in healthcare and how AI can address them. 
  • Fostering open communication and data sharing between vendors and payers. 
  • Building interoperable AI solutions that integrate seamlessly with existing operations. 
  • Defining clear ROI metrics for AI implementation to ensure value for payers. 
  • Exploring innovative partnership models that incentivize cost-saving solutions. 

Sunil Venkataram
Director  

HealthEdge

Musheer Ahmed
Founder & CEO  

Codoxo

4:00 p.m.
Closing 

Musheer Ahmed
CEO & Founder

Codoxo

7:00 – 8:30 p.m.
Welcome Networking Reception & Registration

As part of the AI Summit, we pleased to invite attendees to a welcome reception hosted onsite at the Renaissance Atlanta Gateway Hotel. The reception will take place the evening prior to the kick off of the summit. Attendees will have the opportunity to network with other healthcare leaders for an evening of casual networking, drinks and great food.

The reception will take place on the Magnolia Patio, an outdoor venue located at the Renaissance Atlanta Airport Gateway.

8:00 a.m.
Breakfast & Registration 
9:00 a.m.
Welcome & Kick Off 

Musheer Ahmed
CEO & Founder

Codoxo

9:15 a.m.
Keynote Address: AI in Healthcare – A Unique Perspective with Congressman McCormick

As an advocate for greater healthcare price transparency and reduction, Congressman McCormick will detail the imperative for legislation aimed at injecting transparency into healthcare pricing and reducing costs for patients. By integrating AI, he envisages a healthcare system that not only advances patient care but also facilitates the easy interpretation of complex healthcare costs. McCormick emphasized the commitment to develop and support policies that promote transparency and leverage AI technology to drive down expenses, an approach that resonates with the pressing need for affordability and open access to healthcare information for all patients. This inclusive approach, which harnesses technology to benefit both patients and healthcare professionals, is a step towards creating an equitable and effective healthcare system.

U.S. Representative Rich McCormick, MD, MBA
6th District, Georgia

10:15 a.m.

Leveraging AI as a Co-Pilot to Propel Payment Accuracy into the Future

Despite the increase in complexity, payment integrity has undergone dramatic transformation over the last decade. From the days when manual processes and legacy systems created vulnerabilities for fraud, errors and payment inaccuracies, to the transformative power of Artificial Intelligence (AI), unified systems, greater transparency, and streamlined processes that lead to enhanced accuracy and fostering a more transparent and reliable system for all stakeholders. 

Christy Donohaue
Senior Vice President Medicaid/CHIP

The Health Plan

11:00 a.m.
Networking Break
11:15 a.m.

Panel Session: Future-Proofing Healthcare with Disruptive Innovation 

The healthcare landscape is on the cusp of a transformation. This panel discussion brings together visionary leaders to explore how cutting-edge technologies like AI and machine learning are poised to revolutionize clinical care, streamline billing and payment processing, and optimize healthcare for the future. 

Panelists will dive deep into:  

  • The Automation Imperative: Explore how automation is streamlining workflows, reducing errors, and freeing up valuable time for healthcare professionals.  
  • Unlocking Efficiency for a Sustainable Future: Discover how innovation can improve healthcare delivery, optimize costs, and ensure long-term system viability.  
  • AI and Machine Learning Powering Precision Medicine: Uncover how these technologies are personalizing treatment plans, predicting patient outcomes, and even detecting diseases earlier.

Mark Braunstein Ph.D. 
Scientist
Australian eHealth Research Centre

12:00 p.m.
Fireside Chat: Ethical Applications of AI for Payment Integrity

Applications of AI are massive, and it is hard to keep track of the advancements in the technology. However, the ethical implications that come with them are as important as their educational and technological advancements. Ethical AI can guide medical billing and payment integrity guidelines, ensuring that healthcare payers reimburse accurately and reduce waste. Fireside chats on such topics can ensure that healthcare payers and decision-makers stay abreast of the latest ethical and educational standards in AI applications for payment integrity. Such discussions create a mutual understanding, and ethical taxonomies can facilitate the safe and robust adoption of AI in the healthcare world.

Sheila Caulfield
Director, Corporate Recoveries

Independent Health

Nana Okyere
Director of Operations Analytics

Health First

Chris Hammond
Compliance and Investigation Director

BlueCross BlueShield of South Carolina

12:45 p.m.
Networking Lunch
1:45 p.m.
An MD Perspective: Ethical Considerations of Applying AI for More Effective Payment Integrity

A Doctor of Medicine can contribute valuable insights and perspectives to helping healthcare payer executives understand the potential benefits and challenges associated with using AI for payment integrity while ensuring ethical and patient-centered approaches.

Hear these MDs perspectives on:

  • Balancing patient privacy and data security with fraud detection needs
  • Ensuring fairness and mitigating bias in AI algorithms used for payment reviews
  • The role of the physician in the AI-driven payment review process and ensuring transparency and accountability
  • Fostering collaboration and communication between physicians and payers

Priscilla Alfaro, MD, FAAP CPC CPMA COC CIC CFE
VP Payment Integrity

Blue Cross NC

Rae McIntee, DDS, MD, MBA, FACS, CPE
Medical and Dental Director, Fraud, Waste and Abuse, Payment Integrity and Utilization Management

Blue Cross and Blue Shield of Louisiana

2:30 p.m.
Fireside Chat: Masterful Approaches to Avoid Healthcare Payer AI Adoption Pitfalls

Implementing AI technology without proper preparation can lead to various pitfalls such as data bias and misinterpretation of results. This Fireside Chat includes healthcare leaders who have mastered the art of successful AI adoption and overcome these challenges. Experts will share their insights on best practices for evaluating AI solutions, overcoming data challenges, and ensuring a seamless transition to AI-powered decision-making. Gain insights and practical strategies to help your organization avoid the common pitfalls of healthcare payer AI adoption and emerge as a trailblazer in the industry.

Kurt Spear
VP of Financial Investigations and Provider Review

Highmark, Inc.

3:15 p.m.
Networking Break (30 min)
3:30 p.m.
A PBM’s View: Applying AI across a PBM’s Payment Integrity Spectrum

Pharmacy Benefit Managers (PBMs) have become an integral part of the healthcare industry by processing prescription drug claims for health plans. However, with millions of claims being processed every day, the chances of errors occurring is not negligible. This is where Artificial Intelligence (AI) comes in – PBMs can now leverage AI to automate their payment integrity processes, ensuring that every claim is accurate and equitable. AI can help PBMs detect fraudulent claims, predict payer variability, and identify pharmaceutical trends, among others. In this era where there is increased pressure to reduce healthcare costs, applying AI across a PBM’s payment integrity spectrum is an innovative and promising solution.

Speakers coming soon

4:00 p.m.
Closing 

Musheer Ahmed
CEO & Founder

Codoxo