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Point of Health

BlueCross BlueShield of Western New York

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Point of Health is a BlueCross BlueShield of Western New York free podcast covering health and wellness, health care reform and ways to save money on health care. *Information or advice provided through this program is for informational purposes only, and should not be considered medical advice. As with any health, fitness, or diet related issue or program, you should speak with your own doctor regarding any questions or concerns you may have.
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This season of for the KinectEd Podcast themed, Racism is a Public Health Crisis, sponsored by BlueCross BlueShield Minnesota, brings together a powerful lineup of guests, offering a multifaceted exploration of how racism intersects with public health. Listeners can expect to hear from a diverse range of voices, each providing unique perspectives on the systemic challenges and opportunities for change in healthcare and beyond. Some of the notable guests this season include Dr. Reggie Edwards ...
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Hear from difference makers from across the region as they share their stories on how they have grown their businesses and inspired the community along the way. Hear from some of Greenville's most accomplished leaders, get the inside scoop on what's going on, and gain valuable takeaways to help you and your business thrive and prosper. All of this and more on Growing a Greater Greenville. - Presented by the Greenville Chamber. Produced by Podcast Studio X.
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From the Trenches is a healthcare analytics podcast from Cotiviti (formerly Verscend Technologies), a leading solutions and analytics company that is reshaping the economics of healthcare. On the show, we explore the latest trends in healthcare quality and performance analytics, risk adjustment, payment integrity, and data management. Tweet your suggestions and comments for the podcast to @cotiviti or email jeffrey.robinson@cotiviti.com.
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Discover how Greenville's soccer clubs are scoring big goals beyond the field! In this episode of Growing a Greater Greenville, we chat with Doug Erwin, Vice Chair and Chief Brand Officer, and Megan Kolak, Senior Vice President of the Greenville Triumph and Greenville Liberty. Doug and Megan share the story behind the clubs' inception and their mis…
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Discover how the Greenville Drive is hitting home runs both on and off the field. Join Greenville Chamber CEO Carlos Phillips as he sits down with Jeffrey Brown, President of the Greenville Drive, to explore the team's impact on the business community and the city as a whole. In this conversation, Jeffrey shares how the Drive has become a vital par…
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Is your Greenville business struggling to find skilled workers in today's tight labor market? Discover how tapping into foreign talent pools could be the solution you need in this eye-opening episode of the Growing a Greater Greenville podcast. Join host Carlos Phillips, Greenville Chamber CEO, as he sits down with Karin Borchert, CEO of BDV Soluti…
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Ever wondered how the Upstate region of South Carolina has become a magnet for international businesses and manufacturing powerhouses? In this episode of the Greenville Chamber's "Growing a Greater Greenville" podcast, we sit down with John Lummis, President and CEO of Upstate SC Alliance, to uncover the secrets behind the region's economic success…
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Stephanie DeFresse currently serves as the Vice President of Sales for the Group and Individual Division at BlueCross BlueShield of South Carolina, where she is also a valued member of the Greenville Chamber board. Mike Harris holds the position of Vice President of Sales for Major Group, Chamber, Associations, and Student Health Plans at BlueCross…
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In this episode, we sit down with Representative Wendell Jones, a distinguished leader whose work spans the realms of business, politics, and community development. Through our conversation, we explore his journey from banking to entrepreneurship and his pivotal role in the Minority Business Accelerator Program, designed to empower minority entrepr…
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Explore the dynamic landscape of education in Greenville County with us as we journey through insightful conversations with Dr. Burke Royster, Superintendent of Greenville County Schools. Discover Dr. Royster's remarkable path from humble beginnings to his pivotal role in leading one of the nation's largest school districts. Gain valuable insights …
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Today we sit down with Meghan Barp, CEO of United Way of Greenville County, to engage in a profound discussion about the organization's century-long legacy and its innovative approaches to addressing community challenges. We explore the impactful partnership between United Way and the Greenville Chamber, focusing on our joint efforts in policy-maki…
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In this episode of Racism is a Public Health Crisis, we speak with Dr. Reggie Edwards, the City Manager of Brooklyn Center, Minnesota. Dr. Edwards, tasked with leading the city through after a tumultuous period marked by the police shooting of Daunte Wright. Together, we discuss his approach to addressing systemic racism and public health. A long-t…
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In this episode of Racism is a Public Health Crisis, we feature James C. Burroughs II, the Chief Equity and Inclusion Officer at Children's Minnesota. Burroughs leads the charge in integrating equity and inclusion in one of the nation’s top pediatric health systems. His work focuses on ensuring equitable care for all patients, creating an inclusive…
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Today we continue our “Greater Together” series and explore the dynamic world of high-growth entrepreneurship with Eric Weissmann, executive director of NEXT. Eric sheds light on how NEXT propels Greenville's economic development by nurturing innovative startups. We look at the nuances of supporting high-growth ventures, differentiating them from l…
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Whether you’re a small business owner with zero IT experience or a tech-savvy entrepreneur, this episode packs essential insights for everyone. Today, we sit down with David Pence and Brad Mathisen from Acumen IT, the seasoned tech maestros who've seen the evolution of IT from dial-up to 5G. Gain insider perspectives on cybersecurity, from dodging …
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Leading Equity Inch by Inch: A Conversation with Tiffani Daniels MCBRE In this episode of Racism is a Public Health Crisis Podcast, sponsored by Blue Cross Blue Shield Minnesota, we sit down with Tiffani Daniels, serves as the Managing Director of the Minnesota Business Coalition for Racial Equity (MBCRE). Tiffani brings a wealth of experience and …
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This podcast episode sheds light on the profound intersection of racism, public health, and the field of speech-language pathology. Join us as we delve into the critical work of Dr. Danielle Scott, an esteemed expert focusing on therapeutic relationships between speech-language pathologists and culturally and linguistically diverse students. In thi…
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In our groundbreaking podcast episode, we delve into the powerful declaration that Racism is a Health Crisis and explore the profound impact of privilege and power on the health and well-being of people of color. This courageous stance calls us all to action, urging us to embed equity and inclusion into the fabric of our society. Join us and our es…
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Data-driven policy development will ensure that you make fiscally responsible decisions that benefit all students and work toward educational equity. The use of data and more importantly, disaggregated data is the most effective way to yield transformative change. Join us as we break it down into digestible pieces that will make understanding data …
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In this episode, we talk with Benedicte Eades and Cheryl Garrison from the Greenville Chamber for a compelling discussion on innovative workforce solutions. Benedicte, the Chamber's Career Navigator, sheds light on her transformative journey helping working adults reach their educational potential, opening up avenues for career growth. Meanwhile, C…
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Today we talk with Chris Richardson, the COO of BDV Solutions, an organization reshaping the labor landscape via unique immigration workforce solutions. We explore the pressing issue of labor shortages and how Richardson's team is pioneering resolution pathways by connecting foreign nationals with local and national businesses in need. This episode…
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Today we explore the modern workplace with Kamber Parker, founder of The YoPro Know, to discuss the challenges and opportunities in recruiting and retaining young professional talent. Uncover the myths and truths about millennials and Gen Z, explore the impact of the Great Resignation, and learn how to adapt your business to meet the needs of a div…
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Natasha Pitts, Greenville Chamber Vice President of Diversity and Economic Inclusion, speaks with Jennifer Sutton, owner of Bright+Co Marketers to talk priorities within the Diversity and Economic Inclusion space and why DEI work matters to small businesses. _ Learn more about the Greenville Chamber. Produced by The Greenville Podcast Company.…
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What does an international manufacturer have in common with a local nonprofit? They both invest in leadership development! Hear from Michelin’s Genevieve Caplette and The Children’s Museum of the Upstate’s Lauren Luneckas to hear how they approach professional development and talent engagement and why investing in their team is a top priority. _ Le…
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No matter your position or industry, we are all trying to grow our business. Tune in to learn how Becky Ballenger and Robert Chandler prioritize their team and leverage Greenville Chamber resources to grow their business and boost their network. Thanks to our Presenting Sponsor, BlueCross BlueShield of South Carolina. _ Learn more about the Greenvi…
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The Greenville Chamber works hard every day alongside our business community to grow a greater Greenville. On our podcast, you will hear from difference makers from across the region as they share their stories on how they have grown their businesses and inspired the community along the way. Hear from some of Greenville's most accomplished leaders,…
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In Point of Health episode 58, "Everything BlueCross BlueShield Members Need to Know About Latus Medical Care," Peggy Smering, RN, Practice Administrator for Latus Medical Care gives us an inside look at the new primary care office that will exclusively serve BlueCross BlueShield members.By BlueCross BlueShield of Western New York
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When a health plan is deciding whether to pay a claim, there’s no shortage of information to consider and reviews that must be performed, including medical coding and documentation. And perhaps the most challenging question to answer is this: is the information on the claim clinically appropriate? On episode 18 of “From the Trenches” podcast, we sp…
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In Point of Health episode 48, “Ways to Keep Kids Busy on a Budget," Cait Zulewski, director, corporate relations for BlueCross BlueShield of Western New York shares information about all of the fearless family activities that BlueCross BlueShield is sponsoring in Western New York this summer.By BlueCross BlueShield of Western New York
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Payment accuracy programs are critical to delivering value to health plan members. Some plans excel at recovery management while others struggle—and the difference in financial results is significant. But regardless of size, any health plan can improve its recovery results by pulling a few key levers. Cotiviti's Chris Mastro, vice president of oper…
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For health plans, managing payment recovery is very challenging and hard to accomplish without negatively impacting their net promoter scores. And this proves especially difficult when using collection agencies that are not experts in claims payment and the plan’s individual overpayment concepts. On the latest episode of our “From the Trenches” pod…
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Although the cost of inpatient hospital stays continues to rise, health plans are finding that their inpatient claim auditing programs are returning less value. They’re also facing challenges such as provider abrasion resulting from requesting too many medical charts to validate those claims, which makes it more difficult to successfully retrieve m…
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As they look to tame their data and turn it into actionable insights, many payers are significantly ramping up their data analytics strategy by building a data lake, housing both structured and unstructured data. Serving 1.5 million members, Excellus BlueCross BlueShield of New York is making significant progress on its own data lake journey. We sp…
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The longstanding barriers to data sharing between healthcare organizations have been breaking down over the past decade, removing a major obstacle to partnerships between payers and providers. But major challenges remain, as data management only continues to grow in complexity and healthcare organizations try to make sense of a flood of information…
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Healthcare organizations must constantly improve their technologies and processes to stay one step ahead of healthcare fraud. So, what does the leading national organization focused on the fight against healthcare fraud see on the horizon in this ongoing battle? On the latest episode of our “From the Trenches” podcast, we sit down with Louis Saccoc…
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When a health plan denies a claim, the provider wants to know why it was denied. Sometimes, the answer is that a modifier appears to have been used inappropriately, which Cotiviti detects using a process we call clinical validation. And as it turns out, clinical validation doesn’t just lead to better outcomes for the payer, but also the members and…
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Compliance is becoming an increasingly difficult challenge for Medicare Advantage plans, especially when it comes to their risk adjustment programs. When CMS selects plans for a risk adjustment data validation (RADV) audit, they need to have a high degree of certainty that their diagnoses submitted for reimbursement are valid. So, what’s the soluti…
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You’ve submitted your final data to NCQA and CMS, marking the end of the HEDIS® 2018 marathon. Now it’s on to the next challenge: Star Ratings performance. In the latest episode of Cotiviti's “From the Trenches” podcast, we wrap up this year’s HEDIS season, discuss the Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Rating System, …
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The countdown is on for the June 15 deadline to submit your HEDIS 2018® data, and there’s no shortage of details to keep track of to ensure your submission is accurate, locked on time, and approved by your auditor. We hear from Cotiviti product manager Jamison Gillitzer and senior data analyst Charan Govind, who offer important reminders to help he…
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Automated claim editing systems are a crucial component of accurate and efficient claims payment. But there will always be claims that are too complex to be auto-adjudicated and need a human touch. So, what exactly do you need to clinically validate a claim? We talk with Kris Jensen, registered nurse and clinical consultant for Cotiviti's Payment A…
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