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S AV E U P TO $ 6 0 0 — S ee i n s i d e f o r d eta i l s
Earn CME & Nursing Contact Hours. See website for details!
The National Association of Physician Advisors presents The12th Annual
Physician Advisor Summit
Strengthening the Roles of Medical Directors, Case Managers, and Physician Advisors NAPA
March 16-17, 2015 • Buena Vista Palace Hotel and Spa • Lake Buena Vista, FL
Bernard M. Bettencourt, Jr.
DO, MPH, FACEP, FACOEM
Medical Director, Lahey Accountable
Care Unit, Senior Staff Physician,
Department of Emergency Medicine
Lahey Health
To p reas o n s t o atte n d Plus! Choose
Between Two
Pre-Summit Workshops:
A: Define the Role
of a Successful
and Effective
Physician Advisor
B: Generate Revenue
by Streamlining the
Claim Appeal Process
• Streamline transition
processes to support
population health strategies
• Improve clinical
documentation and reduce
length-of-stay through
the observation unit
• Hear from payers to gain
a new perspective on how
to reduce claim appeals
• Navigate the challenges
when facing an
administrative law judge
• Leverage case
management to help
the admission process
• Become a contributing
member of the
NAPA community
• Earn CME credit hours
Supporting Organizations: Educational Underwriter: Organized by:
NAPA
This activity has been planned and implemented in accordance
with the accreditation requirements and policies of the Accred-itation
Council for Continuing Medical Education through the
joint providership of the American Board of Quality Assurance
and Utilization Review Physicians, Inc. (ABQAURP) and World
Congress. ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.
The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity
for a maximum of 12.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate
with the extent of their participation in the activity.
The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is an approved
provider with the Florida Board of Nursing to provide continuing education for nurses. ABQAURP designates
this activity for 12.0 nursing contact hours through the Florida Board of Nursing, Provider # 50-94.
Peter Dehnel, MD
Medical Director
Blue Cross Blue Shield
of Minnesota
Ronald L. Hirsch, MD, FACP, CHCQM
Vice President,
Regulations and Education
AccretivePAS
Clinical Solutions
O. Scott Lauter, MD, FACP, FHM
Chairman, Department of
Medicine, Medical Director, Care
Management, Physician Advisor
Lancaster General Hospital
Charles F. S. Locke, MD
Senior Physician Advisor,
Utilization/Clinical
Resource Management
Johns Hopkins Medicine
Robert L. Mobley, MD, FAAP, CPE
Medical Director,
Quality and Patient Safety
Greenville Health System
F eat u red spea k ers
To register, please visit: www.worldcongress.com/physicianadvisor • Phone: 800-767-9499 • Email: wcreg@worldcongress.com

Who Should Attend:
Hospitals, health systems, clinics,
medical centers, other health care
providing organizations:
• Chief Medical Officers
• Chief Financial Officers
• Physician Advisors
— Those both experienced and new to the role
— Those considering the role
• Medical Directors
• Members of Utilization Management/
Review Committees
• Senior Vice Presidents, Vice Presidents, and
Directors of:
— Case Management
— Care Management
— Claims Management
— Clinical Documentation
— Finance
— Managed Care
— Medical Affairs
— Reimbursement
This meeting also benefits:
• Physician Advisor Outsourcing Companies
• Revenue Cycle Management Companies
• Utilization Criteria Solution Suppliers
• Electronic Medical Record Companies
• Improvement Measurement Criteria Providers
NAPA
This activity has been planned and implemented in accordance with the
accreditation requirements and policies of the Accreditation Council for
Continuing Medical Education through the joint providership of the American
Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP)
and World Congress. ABQAURP is accredited by the ACCME to provide
continuing medical education for physicians.
The American Board of Quality Assurance and Utilization Review Physicians,
Inc. designates this live activity for a maximum of 12.0 AMA PRA Category 1
Credits™. Physicians should only claim credit commensurate with the extent
of their participation in the activity.
The American Board of Quality Assurance and Utilization Review Physicians,
Inc. (ABQAURP) is an approved provider with the Florida Board of Nursing to
provide continuing education for nurses. ABQAURP designates this activity
for 12.0 nursing contact hours through the Florida Board of Nursing, Provider
# 50-94.
CONSIDER A SPONSORSHIP PACKAGE
CAPTURE A TRUE ROI through Sponsorship of the Following:
Agenda Thought Leadership • Networking Cocktail Reception
• Breakfast Symposia • Luncheon • Executive Networking Breaks
To inquire about Sponsorship, Exhibit, Branding, and Executive
Networking Opportunities, Contact:
Chris Karassik, Business Development Manager, World Congress
Phone 781-939-2419 • Email: chris.karassik@worldcongress.com

Physician Advisor Summit
Strengthening the Roles of Medical Directors, Case Managers, and Physician Advisors
March 16 - 17, 2 015 • Buena V i sta Pal ace Hotel and Spa • La ke Buena V i sta , FL
NAPA
DAY ONE – Monday, March 16, 2015 • P re-Summit Workshops
7:30 am –
8:30 am Workshop Registration and Morning Coffee
8:30 am –
11:45 am Workshop a
Define the Role of a Successful and
Effective Physician Advisor
Whether new or experienced in the role, a critical look at the qualities and
benchmarks that make for a successful Physician Advisor can help improve
performance and efficiency in the position. In this in-depth workshop, learn
what defines a Physician Advisor, explore how to measure success, and
grasp the meaning of confusing territory and terminology.
• Review the responsibilities of a Physician Advisor that lead to success
within the role
• Convey the role and boundaries of the Physician Advisor to
medical staff and administration
• Determine annual goals that are progressive and achievable
* Inpatient length-of-stay * Reduced readmission rates
* Physician education processes * Denials management
* Two-Midnight Rule implementation
• Outline daily tasks to ensure efficiency
* Number of claims to review * Concurrent case review
* Interaction with other departments * Time spent in rounds
* Time spent on physician education * Data review
* What claim appeals to follow up on
• Explore the difficult territory and terminology that a
Physician Advisor faces
Andre Abbate, MD, FACHE, MBA
Senior Medical Director, Care Coordination
Banner Health
Raman Dhaliwal, MD, FACHE, MHA
Senior Medical Director, Care Coordination
Banner Health
Joseph Miaskiewicz MD, FCCP, SFHM
Chief, Utilization Review and Clinical Documentation
North Shore Medical Center, Partners Healthcare
Ven Mothkur, MD, MBA, LSSBB
Corporate Physician Advisor
Franciscan Alliance, Inc.
Workshop B
Generate Revenue by Streamlining the
Claim Appeal Process
As the shift towards lower cost and higher quality continues, organizations
are ever more cognizant of the financial impact of every process and
decision. In this workshop, learn effective ways to overturn denied claims to
gain revenue.
• Explore how to integrate the clinical aspect into revenue cycle
management within a health system to improve the bottom line
• Outline methods to change the culture within a claim appeals program
without changing the structure
• Articulate a successful case to Medical Directors at different insurers to
overturn the denial
• Discuss the clinical differences between Interqual and Milliman
• Write an effective letter of appeal using critical elements in the
patient case
• Present an effective argument in front of an administrative law judge
• Hear about experiences peers have had speaking in front of an
administrative law judge
Robert L. Mobley, MD, FAAP, CPE
Medical Director,Quality and Patient Safety
Greenville Health System
Felicia Wade, MD
Physician Advisor
United HealthGroup/
Executive Health Resources
There is a 15 minute coffee and networking break from 10:00 am – 10:15 am
11:45 am –
1:00 pm Lunch on Your Own/Main Summit Registration
About The National Association of Physician Advisors (NAPA)
Connect with your peers and continue the conversation year round by joining the NAPA LinkedIn Group.
Visit www.physicianadvisors.org to join
The 12th Annual Observation Management Summit • April 28-29, 2015 • Chicago, IL
NAPA
Focus: the evolving role of the Observation Unit. Hear from your peers on implementing and streamlining an effective
Observation Unit within your hospital, utilizing key personnel and resources while addressing managed care requirements,
and the processes involved in patient utilization and case management. NAPA members and their colleagues
may take $300 off their registration for this meeting – use Promo Code NAPA300* when reserving your seat.
Visit www.worldcongress.com/observation *Not valid for Government Rate, Workshop Only, or Webcast options. May not be combined with any other offer.

DAY ONE – Monday, March 16, 2015 • main conference
To register, please visit: www.worldcongress.com/physicianadvisor • Phone: 800-767-9499 • Email: wcreg@worldcongress.com 1:00 pm –
1:15 pm Chairman’s Welcome and Opening Remarks
1:15 pm –
2:00 pm Communicate the Clinical and Financial Value of the Physician Advisor to an Organization
In this session, discover how a Physician Advisor can not only improve clinical outcomes but also generate revenue.
• Communicate the business case and added value of a Physician Advisor to administration
• Discuss how a Physician Advisor plays an integral role on quality and cost throughout a hospital or health system
• Identify the potential impact of a Physician Advisor on financial and clinical outcomes
Ronald L. Hirsch, MD, FACP, CHCQM
Vice President, Regulations and Education
AccretivePAS Clinical Solutions
2:00 pm –
2:45 pm Discover Integrated, Patient Centric, and PCP Aligned Processes to Improve Care
Across the Continuum
Streamline care coordination processes using Physician Advisors and Lean methodology that improve clinical outcomes and reduce cost.
• Discuss how to integrate and re-align transition processes to support a population health strategy
• Learn about care management process improvements using simple techniques from Lean methodology that focuses on efficiency
• Explore how transitions can positively affect patient and financial outcomes
O. Scott Lauter, MD, FACP, FHM
Chairman, Department of Medicine; Medical Director, Care Management;
Physician Advisor, Extensivist, Care Connections, Lancaster General Health
2:45 pm –
3:30 pm Improve Efficiency in Multidisciplinary Rounds by Integrating Hospitalists
Hear one perspective of incorporating senior hospitalists into unit-based multidisciplinary rounds and its influence on office-based physician hospital
attending’s performance to improve efficiency, quality of patient care, and care transitions.
• Explore methods to anticipate the needs of the patient and provider through communication with key personnel such as case managers, nurses, social workers, etc.
• Identify communication gaps among patient care teams to improve collaboration and decrease documentation errors
• Discover how this process increased accountability among the multidisciplinary team
• Learn how to incorporate various tools, such as a discharge flow sheet and nursing follow-up form, into multidisciplinary rounds
William P Stanford, MD PhD
CEO, Stanford Hospitalist Medical Group; Physician Advisor, Cedars-Sinai Medicine/Clinical Innovation
Cedars-Sinai Medical Center
3:30 pm –
4:00 pm
Networking and Refreshment Break
4:00 pm –
4:45 pm Overcome Utilization Management Challenges Specific to an Academic Medical Center
Navigate the challenges of educating residents and incorporating residents’ work flow as they pertain to Medicare and Commercial insurance payment.
• Discuss Utilization Management best practices among hospitals that have residency programs
• Explore the process of educating residents on CMS rules and regulations, including the Two Midnight Rule and the Inpatient Only Procedures list
• Understand how to create efficient workflows that may differ for attending versus non-attending providers, such as Physician Assistants, Nurse
Practitioners, residents, and fellows
Charles F. S. Locke, MD
Senior Physician Advisor, Utilization/Clinical Resource Management
Johns Hopkins Medicine
4:45 pm –
5:30 pm Roundtable Discussions: Birds of a Feather
What works in one hospital setting may not in another — or may not be feasible to try all together. During these roundtable discussions, attendees split
into groups to meet their ‘birds of a feather’ peers who share similar experiences, challenges, and opportunities based on the type of organization they
represent. The moderator poses questions and topics of discussion to the room that each group individually discusses to come up with solutions that can
be directly applied in their type of setting.
Group #1 Group #2 Group #3 Group #4
Large Hospitals and
Mid-Sized Hospitals and
Critical Access Hospitals Pediatric Hospitals and
Health Systems
Health Systems
Health Systems
Moderator: Jeff Epstein, MD
Senior Medical Director
Baycare Health System
5:30 pm –
6:30 pm
Cocktail and Networking Reception

DAY TWO – March 17, 2015
8:00 am –
8:30 am Morning Coffee with NAPA
Come chat with other members of the National Association of Physician Advisors community to connect with professionals in the Physician Advisor industry.
• Learn ways to become more involved in NAPA
• Share suggestions and ideas to improve the NAPA community
NAPA
About NAPA:
Created as a response to the need for a convenient way to network and exchange information in the physician advisor community, the
National Association of Physician Advisors (NAPA) is the only national association dedicated to the role of the Physician Advisor. NAPA
has since expanded to over 500 members serving as a central hub for discussions, opportunities, and networking for this growing role.
8:30 am –
8:45 am Chairperson’s Welcome and Review of Day One
8:45 am –
9:30 am CASE STUDY: Avoid Unnecessary Admission and Increase Capacity
Hear how one organization continues to build a positive and effective relationship with case managers to increase capacity and decrease length-of-stay.
• Examine the elements that often extend length-of-stay through data
• Effectively communicate and collaborate with medical staff to ensure cooperation and compliance
• Utilize the observation unit to sustain progress of improved clinical documentation and reduced length-of-stay
Robert J. Brewer, MD, MHSA
Medical Director, Utilization Management
Henry Ford Hospital
9:30 am –
10:15 am Outline the Critical Criteria for Observation and Inpatient Admittance through
Clinical Documentation
Navigate the challenges of patient status determinations and their impact on revenue and staff.
• Examine the key elements of patient status determinations and effective clinical documentation to improve patient satisfaction
• Hear lessons learned from challenging real-life cases that were determined as Clinical Code 44 due to ineffective clinical documentation
• Recognize the difference in components for inpatient versus observation to avoid staff confusion
Bernard M. Bettencourt, Jr., DO, MPH, FACEP, FACOEM
Medical Director, Lahey Accountable Care Unit, Senior Staff Physician, Department of Emergency Medicine
Lahey Health
10:15 am –
10:45 am
Networking and Refreshment Break
10:45 am –
11:30 am PANEL DISCUSSION: Gain Payer Insight regarding Claims
Hear Medical Directors at health plans discuss claim determinations and ways to build positive relationships with them. Learn about the current priorities of
different insurers to gain an understanding of the most likely claims that would have success if appealed.
• Examine the differences between Interqual and Milliman and when it matters in a claim
• Discover effective methods of communication during a claim denial that can lead to consideration of the denial being overturned
Panelists:
Peter Dehnel
Medical Director
Blue Cross Blue Shield of Minnesota
Uday Deshmukh, MD, MPH, CPE, FACP
Senior Medical Director
Florida Blue
Vaughn W. Payne, MD, MBA, CPE, FACC
Medical Director, Kentucky
Humana-CareSource
Howard Shaps, MD
Medical Director
WellCare

DAY TWO – March 17, 2015 ( continued)
11:30 am –
12:15 pm Overcome Claim Denials with an Administrative Law Judge through Effective Positioning
and Oral Arguments
Whether it’s inadequate documentation, a mistake in the process, or something that went awry, learn how to turn over a claim denial with an
administrative law judge.
• Identify ways to supplement inadequate documentation to improve the bottom line
• Explore how to navigate judge bias to use to your advantage in order to win the case
• Incorporate previous winning arguments and critical elements from the appeal letter to support oral arguments
Jessica L. Gustafson, Esq.
Founding Shareholder
The Health Law Partners, P.C.
Abby Pendleton, Esq.
Founding Shareholder
The Health Law Partners, P.C.
12:15 pm –
1:30 pm
Luncheon
1:30 pm –
2:15 pm Build a Cohesive Relationship Using Different Approaches to Gain Physician Buy-In
One of the biggest responsibilities that a Physician Advisor has is educating the medical staff. This session outlines strategies to make the education process
easier for both sides.
• Examine the effectiveness of current practices and identify which ones make a positive impact
• Recognize groups of individuals who need a significant investment of time and resources to improve education efforts
• Identify innovative methods to communicate difficult regulations with those who are time-pressed or confused
Ronnie Mathews, MD
Hospitalist, Physician Advisor, Assistant Professor
University of Alabama Medical Center
2:15 pm –
3:00 pm Discover the Financial Benefits of Improved Clinical Documentation
The need to improve clinical documentation for compliance, financial, and clinical reasons has never been more important. This session outlines ways to
ensure a successful clinical documentation process.
• Learn how clinical documentation plays an integral part in financial outcomes for the hospital or health system
• Integrate members from different departments to gain different perspectives of clinical documentation to improve education efforts
• Implement a successful CDI program that can generate revenue and cut costs
Amanda Cain, MD, MBA, Med
Chief Utilization Officer
Northeast Georgia Medical Center
3:00 pm –
3:45 pm Prepare Staff During the ICD-10 Delay to Improve Efficiency
This session outlines what organizations can do to move forward before the new implementation date to ensure a smooth transition when the change occurs.
• Re-prioritize efforts given the delay and additional allotted time to prepare
• Investigate ways to increase efficiency with ICD-10
• Prepare a plan to have staff educated and ready for the change to avoid confusion and frustration
Steve Griffin, MSN, RN, CCM, NE-BC, CCDS
Director, Clinical Documentation Improvement
Baycare Health System
3:45 pm Close of Summit
CONSIDER A SPONSORSHIP P ACKAGE
CAPTURE A TRUE ROI Through Sponsorship of the Following:
Agenda Thought Leadership • Networking Cocktail Reception • Breakfast Symposia • Luncheon • Executive Networking Breaks
To inquire about Sponsorship, Exhibit, Branding, and Executive Networking Opportunities, Contact:
Chris Karassik, Business Development Manager, World Congress • Phone 781-939-2419 • Email: chris.karassik@worldcongress.com

Registration Fee: Register By
12/19/2014
Register By
1/30/2015
Register By
Standard 3/16/2015
Conference $ 1695.00 $ 1995.00 $ 2295.00
Conference Plus 1 Workshop $ 1990.00 $ 2290.00 $ 2590.00
Conference Plus Flash Drive $ 1795.00 $ 2095.00 $ 2395.00
Conference, Workshop, & Flash Drive $ 2090.00 $ 2390.00 $ 2690.00
Health Plans
Conference $ 1395.00 $ 1695.00 $ 1995.00
Hospitals & Health Systems / Academic
Conference $ 795.00 $ 1095.00 $ 1395.00
webcast options
Live Webcast Only $ 895.00 $ 995.00
Live Webcast Plus Flash Drive $ 995.00 $ 1095.00
Webcast Archive on Flash Drive $ 895.00 $ 995.00
Fee for conference includes welcome coffee, lunch, reception, refreshments, and web-based
conference documentation available pre- and post-event, accessible through
password-protected website. Checks in U.S. funds drawn from U.S. bank payable to:
WC Research Inc. No personal checks accepted. Verification may be required for rate
approvals. Please contact us should you have any special needs.
SPECIAL TEAM DISCOUNTS: Your organization may send
ONE executive FREE for every three delegates registered.
All registrations must be made at the same time to qualify.
To register your team, contact us at 800-767-9499.
Participant Substitution and Cancellations:
Your registration may be transferred to a member of your organization up to 24 hours
in advance of the conference. Cancellations received in writing on or before 30 days
prior to the start of the event will be refunded, less a $395 administrative charge.
No refunds will be made after this date; however, the registration fee less the $395
administrative charge can be credited to another World Congress conference if you
register within 6 months from the date of this conference. In case of conference
cancellation, World Congress’ liability is limited to refund of the conference registration
fee only. World Congress reserves the right to alter this program without prior notice.
Satisfaction guaranteed: World Congress stands behind the quality of its
conferences. If you are not satisfied with the quality of the conference, a credit
will be awarded towards a comparable World Congress conference of your
choice.
Register Now! E-MAIL
WEBSITE
WorldCongress.com/
PhysicianAdvisor
wcreg@worldcongress.com
Best Value
PRSRT STD
U.S. Postage
PAID
Gallery
Venue:
Buena Vista Palace Hotel & Spa
1900 E Buena Vista Drive
Lake Buena Vista, FL 32830
P: 866-397-6516
www.buenavistapalace.com
Room Rate: $169 • Cut-off Date: 2/23/15
World Congress
500 West Cummings Park, Suite 5200
Woburn, MA 01801
HW15024
PHONE
800-767-9499
781-939-2400 outside the U.S.
Please mention WC Research/World Congress
when registering to receive this special rate!
S AV E U P TO $ 6 0 0 — S ee p r i c e g r i d f o r d eta i l s
Strengthening the Roles of Medical Directors, Case Managers, and Physician Advisors NAPA
Ne w i n 2 0 1 5
• Explore
utilization
management
best practices to
reduce cost while
improving quality
• Hear
innovative methods
to gain physician
buy-in to improve
adherence
to changing
requirements
• Improve
CDI programs
by integrating
key personnel
• Discover
ways to
supplement
inadequate
documentation
to win the
claim appeal
• Increase
capacity and
decrease
length-of-stay
through staff
collaboration
and compliance
Earn CME & Nursing Contact Hours. See website for details!
March 16-17, 2015 • Buena Vista Palace Hotel and Spa • Lake Buena Vista, FL

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