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  • *FREE* Protection and Prevention of Dental Fraud Waste and Abuse (2019)

    Contains 1 Component(s) Recorded On: 09/26/2019

    Free! Sponsored by Javelina from Mphasis

    Payers across the spectrum of benefits administration are being charged with increasing quality of outcomes while at the same time reducing administrative cost. The ability to detect medical necessity and fraud waste and abuse in real time and through advanced analytics models becomes an ever-increasing necessity for most dental payers. 

    In this webinar, we will discuss the finding of an experienced team of dental clinicians and the impact Fraud Waste and Abuse has in the dental market.  We will also focus on how you and your clients can benefit from this data combined with next-gen technology solutions. Discussion will focus on:

    • Fraud Waste and Abuse
      • Why It Matters
      • What Types are Prevalent
      • How to Build an effective FWA containment Plan
      • How to leverage available technology

    This Webinar is sponsored by:

    John Danza

    VP, Product Strategy - Context 4 Healthcare

    Mr. Danza leads the product strategy efforts for Context 4 Healthcare. With more than 30 years of experience within the healthcare industry, Mr. Danza’s focus is on analyzing the strategic direction of Context’s solutions and services, and identifying the ways in which Context can continue to meet the needs and expectations of its clients.

    Mr. Danza has been a speaker at a number of healthcare industry events and has been published on the topic of methods for health plans to maximize revenue when offering products on the Health Insurance Exchanges.

    Dr. Steve Nesnidal

    Medical Director and Director, Medical Content and Compliance - Context 4 Healthcare

    Dr. Nesnidal leads the Medical Content and Compliance department for Context 4 Healthcare. Dr. Nesnidal and his team are focused on identification of situations indicating potential FWA and compliance violations. He has both clinical care experience along with medical billing experience. He is an MD and an AAPC certified professional coder (CPC).

    Dr. Nesnidal practiced Emergency Medicine clinically after completing his residency at Henry Ford Hospital’s Emergency Medicine Residency Program in Detroit, MI. He earned his MD at Rush Medical College in Chicago, IL after his BA in Biology from University of Chicago.

    Tim Smith

    Senior Solution Manager, Mphasis

    Tim Smith has more than 20 years of experience working to provide solutions to commercial clients and government agencies in the Healthcare market. Tim's experience brings in depth understanding of enterprise wide business processes across the payer spectrum from Claims automation, enrollment and billing to Care Management and constituent engagement. In addition, Tim has developed an in depth understanding of multiple payer types and the lines of business they support.  Throughout his career, Tim has been on the front line working with clients to define solutions that drive future success and growth.

  • *FREE* Using Analytics and Value-Based Models to Give Teeth to Dental Plans (2019)

    Contains 1 Component(s) Recorded On: 10/03/2019

    FREE. Sponsored by SKYGEN USA.

    Dental is constantly changing and continually facing cost pressures.  Understanding how to create efficiency and how to deliver greater value is a must for dental insurers to win in today’s competitive marketplace.  To give teeth to dental programs, insurers have the opportunity to reduce costs and improve the quality of care with analytics and value-based payment models. 

    In this session, learn how:

    • To use analytics to improve benefit design, identify high-performing providers and direct more members to those dentists
    • To recognize high-performing providers, remediate under-performing providers
    • To begin using value-based models to help drive providers toward delivering more appropriate preventive services
    • To give dental providers who meet higher standards the opportunity to earn more revenue without committing to raising fee schedules across the board

    This webinar was sponsored by:


    Dr. Judy Greenlea Taylor

    Dental Director, CareSource

    Dr. Judy Greenlea Taylor, a native of Atlanta, GA has practiced dentistry in the public and private sectors for 28 years and currently operates a private practice in Union City, southwest of Atlanta. In addition to her ongoing role as practitioner and CEO of Greenlea Dental Center, PC, she serves as Dental Director for CareSource, a nationally recognized nonprofit managed care plan, serving Medicaid, Marketplace and Medicare beneficiaries in several state markets. With direct oversight and management of the Georgia Market dental operations, Dr. Greenlea Taylor provides strategic direction and development for dental policy and program design to ensure access to quality oral healthcare. She additionally, provides oversight of professional clinical review, quality management, utilization management and dental professional relations.

    Dr. Greenlea Taylor’s extensive career includes key leadership positons and roles. These include serving as the 92ndPresident of the National Dental Association (NDA), a Consultant to the Department of Health and Human Services (HHS), a state board official appointed to the Georgia Department of Public Health by Governor Nathan Deal, where she served two terms and served as an Officer - Secretary. As the only dentist on the Board, she advised the Commissioner and department on issues related to oral health, policy and programs to improve oral and overall health in Georgia.  She additionally serves on numerous other boards and committees at local, state and national levels. She is a nationally recognized public health educator, lecturer and consultant.

    She has received numerous honors and awards for both her professional and community service accomplishments. Some honors include esteemed fellowship into both the American College of Dentists and International College of Dentists. Atlanta’s WXIA TV 11ALIVE  Community Service Award; Outstanding Citizen Award from Secretary of State Brian Kemp (2015), affording her every courtesy as a Goodwill Ambassador from Georgia; proclamations and commendations from the State of Georgia, the City of Atlanta, City of Union City and the Georgia Department of Public Health. In addition, most recently, Hidden Figures Award recipient, honoring Women Leaders in STEM.

    Dr. Greenlea Taylor earned her Bachelor of Science degree from Prairie View A&M University (Texas A&M University System) and historically was the first graduate of the Benjamin Banneker Honors College. She earned her D.D.S dental degree from University of Iowa, completed a General Practice/Oral Surgery Fellowship Residency at Emory University and a Master of Public Health Degree (MPH) from Emory University Rollins School of Public Health. She received course certification in health disparities research from Columbia University and a certificate in Cultural Competency with HHS, and serves as a facilitator trainer.

    Marcel Tetzlaff

    Vice President of Provider Experience and Benefits Management, SKYGEN USA

    Marcel Tetzlaff leads SKYGEN USA’s continuing commitment to helping its clients provide superior program stewardship. He and his team are responsible for developing and executing the company’s Enhanced Benefit Management program that is designed to ensure delivery of the most appropriate and efficient care possible. By leveraging SKYGEN USA’s technology, along with its clinical, analytical and administrative expertise, the appropriate intervention can be initiated to achieve optimum performance, including recognizing and rewarding high performing providers.  

    Marcel has more than 20 years of experience in managing government and commercial medical and dental plans. During that time he has implemented best practices for Medicare Advantage programs and developed workflows, reports, education, training, and documentation for the Medicare Shared Savings Program (MSSP), Risk Adjustment Factor (RAF), Health Effectiveness Data Information Set (HEDIS), and other quality and efficiency measures. Marcel earned his MBA at the University of Wisconsin-Milwaukee with a major in healthcare management. He also holds a Bachelor of Business Administration Degree from the University of Wisconsin-Whitewater.

  • *FREE* Don't be afraid of network accessibility, Zelis makes it easy (2019)

    Contains 1 Component(s) Recorded On: 10/24/2019

    FREE - sponsored by Zelis

    It's the week before Halloween... it's no trick: Get the treat of accessibility analysis against competitors and the market. Join Zelis Network Analytics’ webinar to learn how competitive accessibility can help you:  

    • Identify network access gaps 
    • Benchmark the maximum accessibility possible for all lines of business in a market using state and federal standards
    • Distribute resources for accessibility reporting more broadly in your organization, including front-line sales reps
    • Assess competitive position prior to quote, to identify opportunities that warrant full organizational resource commitment

    This webinar is sponsored by


    Laura Kravet McMullen

    Director, Client Engagement at Zelis Healthcare

    Laura McMullen has significant experience in diverse aspects of the healthcare industry. She has provided marketing and communications expertise at Cigna Dental, National Healing Corporation, and the University of Miami Sylvester Comprehensive Cancer Center. As Director of Client Engagement for Zelis Network Analytics, she draws on her industry knowledge to help customers leverage network analytics to drive business results. Educated at Nova Southeastern University and the University of Florida, Laura currently serves on the Education Commission for the National Association of Dental Plans, keeping her ear to the industry’s trends and needs.

  • NADP 2019 Dental Benefits Report: Plan Design

    Contains 1 Component(s)

    Full Voting: FREE | Non-Voting: $195 | Non-members $395

    The Plan Design Report includes data reported by product type (DHMO, DPPO In-Network, DPPO Out of Network, and Dental Indemnity). The report includes data about Annual Maximum levels, enrollees reaching the Annual Maximum, Lifetime Orthodontia Maximums, Deductible levels, and information about the percentage of enrollment with products with special features like Max Rollover, Implant coverage, TMJ coverage, Preventive and Diagnostic plans, and plans with coverage for Cosmetic procedures.

  • NADP/LIMRA 2018 U.S. Group Dental Claims Processing Metrics (published Nov. 2019)

    Contains 1 Component(s)

    Full Voting Member: $0.00 | Non-Voting Member: $200.00 | Full Price: $400.00

    In 2005 LIMRA International and NADP conducted their first annual joint research study to survey group dental carriers' contact center and claims processing performance. This report, the ninth in the series, provides dental carriers with an industry-specific performance benchmark for customer contact center performance.

    For questions, please contact Jerry Berggren, NADP Director of Research & Information

  • It Takes Two to Tango – Directory and Claims Data (2019)

    Contains 1 Component(s) Recorded On: 11/14/2019

    Members - $100 | Non members - $195

    It’s not a secret that dental directories overstate access across the industry - network size is a key metric for consultants, employer groups, and other plan sponsors. However, customer and regulatory pressure to clean directory data up is increasing. The challenge to present an accurate directory view is complicated by the need to pay claims for services provided by in-network dentists at non-primary locations. It’s daunting to take the plunge and risk your market share. Join us to hear how to address this complicated initiative and learn ways to use data to right-size your provider directory while maintaining your market presence.  

    Topics to explore include:

    How consumer complaints and studies have led to increased regulation around accuracy 

     Challenges in solving this issue including network growth trends 

     Differentiating between provider directory and claims data

    Comprehensive approach to cost-efficient directory accuracy

    Laura Kravet McMullen

    Director, Client Engagement at Zelis Healthcare

    Laura McMullen has significant experience in diverse aspects of the healthcare industry. She has provided marketing and communications expertise at Cigna Dental, National Healing Corporation, and the University of Miami Sylvester Comprehensive Cancer Center. As Director of Client Engagement for Zelis Network Analytics, she draws on her industry knowledge to help customers leverage network analytics to drive business results. Educated at Nova Southeastern University and the University of Florida, Laura currently serves on the Education Commission for the National Association of Dental Plans, keeping her ear to the industry’s trends and needs.

    Jimmy Carter

    Sales Executive, Zelis Healthcare

    Jimmy joined Zelis in 2014 and is part of the sales and business development team at Zelis Network Analytics. He is responsible for all sales efforts with new prospects and existing accounts. These efforts include the Network360 analytics suite, Provider Data Accuracy and Network Builder and Optimizer projects as well as client-customized deliverables.

    Most recently before joining Zelis, Jimmy worked for Quest Diagnostics as a Senior Account Manager. Jimmy has over 10 years of sales experience as well as, operations, project management and consulting, 

    Jimmy graduated from the University of Kansas with a degree in Community Health.

  • Public Programs: Updates on the State of Medicare, Medicaid, and Marketplace Dental Coverage (2019)

    Contains 1 Component(s) Recorded On: 11/21/2019

    Members - $100 | Non Members - $195

    With the US House of Representatives’ recent consideration of adding a dental benefit to Medicare, oral health is once again in the policy spotlight. Millions of Americans receive their dental care through a public program or marketplace, and growing public knowledge of the link between oral and overall health is drawing the attention of policymakers. Join us to hear an update on the ongoing dental policy developments at the state and federal level, as well as the outlook for Medicaid expansions, public options, and more.   Topics to explore include:

    • A snapshot of dental plan enrollment in public programs and private plans
    • Federal Policy Developments on Dental in Medicare and Medicaid
    • State Policy Developments on Exchanges and Medicaid

    Eme Augustini

    Executive Director, National Association of Dental Plans

    As of November 1, 2019, Eme has taken on the role of executive director at the National Association of Dental Plans (NADP). Eme joined the NADP Government Relations team in 2012 and quickly mastered the issues facing the industry at both the state and federal level. She was promoted to Associate Director of Government Relations and became Director of Government Relations in early 2017. In this role Eme was responsible for all federal and state legislative and regulatory affairs for NADP. Eme was instrumental in establishing NADP's Advocacy in Action day in Washington, D.C. which has raised NADP's profile in Congress. Prior to joining the NADP Government Relations team in 2012, Eme worked with a national trade association managing regulatory compliance and grassroots advocacy programs. She earned her bachelor's in political science and philosophy from Texas A&M University and is pursuing an MBA with business analytics emphasis from Texas Woman's University.

    Jerry Berggren, MBA

    Director of Research & Information, NADP

    Jerry brings more than 20 years of experience in market research, strategy and analysis to his role at NADP.  Prior to joining NADP in 2004, Jerry worked in market research and advertising in healthcare, financial services and electric utility industries.  Jerry earned his BA in Political Science from Louisiana State University and his MBA from Tulane University.

    Owen Urech

    Government Relations Analyst, National Association of Dental Plans

    Owen joined NADP in April of 2019 after previously serving as a research intern with the Health Management Academy and Health Policy Coordinator for the Roosevelt Institute. During his time with Roosevelt, HMA, and several political campaigns Owen developed extensive experience crafting public policy and engaging activists. He graduated from American University in 2018 with a degree in political science specializing in American government.

    Alisha Hightower

    Director of Compliance for The Guardian Life Insurance Company of America

    Alisha Hightower is the director of compliance for The Guardian Life Insurance Company of America (Guardian) working primarily on government programs including Medicaid, CHIP, and Medicare Advantage under their subsidiaries Access Dental Plan, Premier Access Insurance Company and Avesis. Alisha joined Guardian’s subsidiaries in 2013 where she was the Director of Exchange Programs, later taking over Government Programs. Prior to joining Guardian she was with the Department of Health Care Services as the Chief of the Dental Managed Care Unit, overseeing the California Medicaid dental managed care contracts. She received her Bachelor’s in Criminal Justice and Economics in 2005 from CSUS.

  • 2019 Dental Benefits Report: Enrollment

    Contains 1 Component(s)

    Full Voting Member: FREE | Non-Voting Member: $395 | Full Price: $895

    To provide current information about the prevalence of dental benefits in the population of the United States, the National Association of Dental Plans conducts an annual survey of its membership and other dental benefit providers. The NADP has been collecting this information since 1994 and the findings in this report draw on this history. This report contains specific information on Dental HMO, Dental PPO, dental Indemnity, and Discount Dental enrollment at the national and state level and Direct Reimbursement and publicly funded benefits at the national level.

    While national and state information is provided in this report, no company specific data is reported. Company specific information along with states of operation can be found in NADP's Member Directory.

    NADP's mission is to promote and advance the dental benefits industry to improve consumer access to affordable, quality dental care. For more information regarding this report please contact Jerry Berggren, Director of Research and Information, by calling 972.458.6998 x 113

  • DSO Membership Plans - An Emerging Industry Trend (2019)

    Contains 1 Component(s) Recorded On: 12/12/2019

    Members - $100 | Non Members - $195

    What are professionally administered membership plans and how are DSOs utilizing them to better service and retain patients? This webinar will answer the following questions:

    • What are the features and advantages of professionally administered membership plans?
    • How are these plans helping to improve access to dental care and oral health?
    • Who benefits from membership plans?
    • What is a discount medical program operator (DMPO) and why is it important?
    • What do DMPO regulations generally cover?
    • What are the regulatory challenges facing DMPOs?
    • What does the future hold for membership plans?

    Eric Johnson

    Founder and CEO, Membersy

    Eric Johnson is the founder and chief Executive officer of Membersy, an Austin-based digital health company that provides dental practices with thoughtfully designed membership programs to make dental care more approachable. 

    Driven by his entrepreneurial spirit and passion to help dentists better service and retain patients through membership-based dentistry, Membersy currently provides membership technology, marketing and administrative solutions to more than 4,000 dental practices across 42 states.

    Prior to founding Membersy in May 2015, Eric was director of strategic partnership at The CDI Group, a Los Angeles-based knox keene licensed dental benefits company. Previously, Eric was the national sales manager for Careington International, a Dallas-based dental dental benefits company. 

    Eric holds a bachelor's degree in political science with an additional emphasis on history from The University of North Texas. He lives in Austin, Texas with his wife, their 3 children and 1 dog. In his free time, Eric likes to travel and play golf.

    Seth Bills

    Executive Vice President and In-House Counsel, Membersy

    Seth Bills joined Membersy in 2018 as executive vice president and in-house counsel, a multifaceted role combining corporate counsel, operations, and human resources functions. Seth has worked with Eric Johnson and Membersy virtually from the beginning, serving as outside counsel and assisting with contracts, state licensure, regulatory compliance, corporate governance and other legal matters.  

    Seth has focused on health law throughout his career, providing counsel to hospital groups and physicians on contract and licensure matters, state and federal regulatory schemes, and HIPAA compliance. Through his work with Membersy, Seth has developed extensive working knowledge of the discount medical program space in all fifty states. 

    Seth earned a B.A. from the University of Texas and a J.D. from Southern Methodist University Dedman School of Law, and is a licensed attorney in the State of Texas.

  • Special Focus - 2019 Mini Series (with recordings)

    Contains 4 Product(s)

    $500 (members) and $750 (non members)

    Mini Package includes 4 webinars:

    1. Developments in Interdisciplinary Treatment
    2. Overcoming Impediments to Use of Electronic Transactions - An Industry Primer
    3. Challenges & Best Practices in Directory Validation
    4. Network Challenges (Credentialing/Leasing) -What's Next?

    Dates and Times TBD.