2021 CONVERGE - All Sessions

2021 CONVERGE - All Sessions

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This package includes all recorded educational sessions from 2021 CONVERGE.

 

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  • Contains 1 Component(s) Recorded On: 10/06/2021

    A review of dental actuarial hot topics presented by actuaries from around the industry.

    A review of dental actuarial hot topics presented by actuaries from around the industry.

    Joanne Fontana, FSA, MAAA

    Principal and Consulting Actuary

    Milliman

    Joanne Fontana is a consulting actuary in the Health Practice of Milliman’s Hartford office. She has been with the firm since 2006. During that time she has served insurance companies including several major dental carriers, employers, government entities, and other organizations. Joanne’s focus has been largely on managed care and dental, with experience in premium rate development, provider contract analysis, valuation of post-retirement health benefits, and health care reform. Over the past several years she has worked closely with the National Association of Dental Plans, the California Association of Dental Plans, the American Dental Association, and other dental clients to assess the impact of health care reform on the dental industry. She has worked with carriers and employer groups on the dental insurance procurement process, worked on Medicaid dental procurements with both state entities and bidders, and has done core actuarial dental pricing and underwriting work for many dental carriers. Joanne is considered an industry expert in dental product and pricing, and has presented on dental-related topics at multiple industry forums.Prior to joining Milliman, Joanne spent more than ten years as an actuary with Cigna, where she held various healthcare financial leadership roles including Chief Actuary of CIGNA’s dental insurance business

    Adam Barnhart, FSA, MAAA

    Consulting actuary

    Milliman

    Adam is an actuary with the Milwaukee office of Milliman. He joined the firm in 2007. Adam's expertise is in both managed and traditional healthcare programs, with more than eight years of experience in these areas. He has assisted various entities, including health plans, employers, and health care providers. He has helped clients with product development and pricing, experience analysis, valuation of reserves, and financial reporting.

    Adam is considered a firm-wide leader in Medicare Advantage and Part D consulting. He has completed bid development for many clients.

    April Furlong, MBA

    Compliance Consultant

    Milliman

    April Furlong is a compliance consultant with the Tampa office of Milliman. She joined the firm in 2014 bringing with her 10 years of prior experience in the insurance industry.

    April has experience in compliance consulting, policy form drafting, and other compliance-related services for health products. April has been involved in numerous research and product development projects, focusing heavily on dental and vision products. April also assists health insurers with network filings and research on network adequacy and oversight rules. She has worked closely with supplemental products such as hospital indemnity, critical illness, and accident insurance. She also has experience with the various filing requirements for the Affordable Care Act. She has worked closely with regulators to secure approval on many filings.

    April also has served as client and project manager, overseeing each step of the project and adhering to strict deadlines. She has worked closely with clients to understand their needs during the development, drafting, and filing of a product.

    Prior to joining Milliman, April spent 10 years working in managed care, analyzing data on risk, profits and trends applicable to health plans, and overseeing state filings.

    Tom Murawski, FSA, MAAA

    Consulting Actuary

    Milliman

    Tom provides consulting services to a wide variety of clients in the U.S. healthcare system including insurance companies, stop loss carriers, employers, provider groups, government entities, and advocacy groups.

    Tom’s focus has been on advising clients in understanding the impact and strategic implications of the ACA. His experience includes pricing health benefits, estimating reserves, and projecting financial results. Tom has led projects to assist clients in these activities for many different health products including individual plans, small and large group plans, and stop loss products.

    Tom also has significant experience with dental plan pricing for both commercial and Medicaid populations. He has been involved in studies and analyses of the impact of the ACA on dental insurance, experience analysis studies for large employers and insurers, and review of provider fee schedules.

    Tom frequently presents at industry conferences and regional actuarial meetings on dental and other health benefits topics. Tom has also authored several research reports on the potential impact and implications of proposed healthcare law and regulations. As a result of his research, Tom has met with and advised members of Congress, Congressional Budget Office leadership, and Senior White House Policy Officials on healthcare reform proposals.

  • Contains 1 Component(s) Recorded On: 10/05/2021

    Objectives of this session include: To foster communication and collaboration among grant makers and others To help strengthen the grant-making community’s knowledge, skills, and effectiveness To achieve better health through better philanthropy

    Objectives of this session include: 

    • To foster communication and collaboration among grant makers and others 
    • To help strengthen the grant-making community’s knowledge, skills, and effectiveness 
    • To achieve better health through better philanthropy 

    Cara V. James, PhD

    President and CEO

    Grantmakers In Health (GIH)

    Dr. Cara James is president and CEO at Grantmakers In Health (GIH). Prior to joining GIH, she served as -director of the Office of Minority Health at the Centers for Medicare & Medicaid Services (CMS) where she provided leadership, vision, and direction to advance the U.S. Department of Health and Human Services and CMS goals related to reducing disparities and achieving health equity for vulnerable populations, including racial and ethnic populations, persons with disabilities, sexual and gender minorities, and persons living in rural communities. Under her guidance, CMS: 

    • Developed its first CMS Equity Plan to Improve Quality in Medicare, its first Rural Health Strategy;
    • Created an ongoing initiative to help individuals understand their coverage and connect to care; Increased the collection and reporting of demographic data; and
    • Developed numerous resources to help stakeholders in their efforts to reduce disparities.

    Before joining CMS, Dr. James served as director of the Disparities Policy Project and director of the Barbara Jordan Health Policy Scholars Program at the Henry J. Kaiser Family Foundation, where she was responsible for addressing a broad array of health and access-to-care issues for people of color and other underserved populations, including the potential impact of the Affordable Care Act, analyses of state-level disparities in health and access to care, and disparities in access to care among individuals living in health professional shortage areas. Prior to joining the foundation, she worked at Harvard University and The Picker Institute. She is a past member of the National Academies of Sciences, Engineering and Medicine’s Health and Medicine (NASEM) Roundtable on the Promotion of Health Equity and has served on several NASEM committees. She has published a number of peer-reviewed articles. Dr. James holds her doctorate in health policy and her bachelor’s degree in psychology from Harvard University.

  • Contains 1 Component(s) Recorded On: 10/06/2021

    Changes in consumer expectations and technology are driving fundamental shifts in every part of our lives and every sector of the economy. In some cases accelerated by the pandemic, these broader forces will also shape the future of dental care and benefits. In this panel session, industry leaders and members of the NADP Future of Dental Care Access Task Force will discuss the forces influencing change in the dental industry and strategic insights for organizations and the Association.

    Changes in consumer expectations and technology are driving fundamental shifts in every part of our lives and every sector of the economy. In some cases accelerated by the pandemic, these broader forces will also shape the future of dental care and benefits. In this panel session, industry leaders and members of the NADP Future of Dental Care Access Task Force will discuss the forces influencing change in the dental industry and strategic insights for organizations and the Association.

    Mary Lee Conicella, DMD, FAGD

    Chief Dental Officer

    Aetna

    Dr. Mary Lee Conicella is Aetna’s Chief Dental Officer and oversees dental clinical initiatives, policies and claim review.  She is a member of Aetna’s Medical Affairs Team and serves on the Virtual-First and Health Equity Committees.  She has published numerous articles related to the impact dental care has on holistic health and was instrumental in creating Aetna’s Rush to Brush Initiative to reduce hospital-acquired pneumonia, and Aetna's groundbreaking Dental-Medical Integration program.  Dr. Conicella received her DMD from Temple University School of Dentistry and achieved Fellowship status in the Academy of General Dentistry during her time in private practice.  She spent many years on the faculty at the University of Pittsburgh School of Dental Medicine, and currently sits on the NYU College of Dentistry Dean’s Strategic Advisory Council. Mary Lee has been a volunteer with NADP since 2006 and she is currently serving her second term as a member of the NADP Board of Directors.

    Jeremy Hedrick

    SVP, Careington & President, DialCare

    Careington & DialCare

    Jeremy Hedrick serves as senior vice president at Careington International Corporation as well as president of its affiliate telemedicine company, DialCare, which offers teledentistry, telemedicine, and tele-behavioral health services nationwide. He has been a vital component of Careington’s growth for the last 20 years, serving in many critical senior leadership roles throughout the Careington companies. During his tenure, Jeremy has helped lead the strategic growth of Careington’s network development department, customer support call center, compliance, claims administration, operations of Careington’s affiliate nationally licensed TPA, as well as operations of Careington’s UK affiliate, Munroe Sutton. In each of these roles, Jeremy has been intimately involved in the workings of these critical segments of the industry and an integral part of the growing network lease and discount dental market. Jeremy is currently serving his second term on the NADP Board of Directors and his second year as the Board Chair.

    Donna Hunter

    VP, Strategic Business Development

    United Concordia Dental

    Donna Hunter, vice president, Strategic Business Development, is responsible for overseeing corporate strategy; marketing; business insights and analytics; corporate communications; and community outreach.  She joined United Concordia Dental in 1997 and has held numerous positions within Finance and Sales before moving into her current role. Prior to joining United Concordia, Donna worked at both Sprint and Pennsylvania Blue Shield in Finance, where she developed cost management models. Knowing that an organization’s culture is key to overall success, Donna has worked in these roles with leaders at all levels to align strategy and organizational health. She leads the Women’s Network Group at United Concordia and regularly serves a panelist for other women’s groups in the community.   With more than 25 years of experience in the insurance industry, Donna holds a Master of Business Administration from Mount Saint Mary’s University and a Bachelor of Science in Finance from Shippensburg University.

    Theresa McConeghey

    AVP, Specialty Benefits Division

    Principal

    Theresa McConeghey is an assistant vice president in the Specialty Benefits Division of Principal®. She has more than 40 years of experience in the Life and Health industry working with employee benefits. Throughout her career, Theresa has held leadership roles in Group Administration, Claims, Underwriting, Compliance and Product Development. She is currently accountable for product management, product development and regulatory compliance associated with Principal Life’s Group Dental, Vision, Life, Disability, Accident and Critical Illness product lines. Theresa’s role includes dental network activities for PPO, Discount and DHMO programs. She also oversees all Group product advocacy initiatives for Principal, including activities associated with health care reform.She was a member of the National Association of Dental Plan’s (NADP) health care reform taskforce throughout its lifespan.  Currently Theresa co-chairs NADP’s Commission on Advocacy Policy (CAP) and is the immediate past chair of the NADP Board of Directors.

  • Contains 1 Component(s) Recorded On: 10/07/2021

    In its first year, the Biden Administration and Congressional Democrats have moved aggressively on healthcare in several ways that impact oral health and dental plans. These include strengthening the ACA Exchanges, funding Medicaid expansion in states that have yet to expand the program and providing funding to states to establish All Payer Claims Databases that might require dental claims submission.

    In its first year, the Biden Administration and Congressional Democrats have moved aggressively on healthcare in several ways that impact oral health and dental plans. These include strengthening the ACA Exchanges, funding Medicaid expansion in states that have yet to expand the program and providing funding to states to establish All Payer Claims Databases that might require dental claims submission. And they’re just getting started. In the coming months, the industry could see significant healthcare legislation and regulations on a host of additional topics that could impact oral health and dental plans, including health equity, price transparency, provider networks and directories, patient/consumer protections, and dental coverage in Medicare. While dental plans will not be the primary focus of most of what’s coming, they will continue to be impacted by broader healthcare reforms. In this session, Mike Adelberg, a former US Department of Health and Human Services senior leader and close follower of federal policies that impact dental plans, will survey relevant Biden Administration moves to date and forecast moves that may be coming.

    Mike Adelberg

    Principal

    Faegre Drinker Consulting

    Mike Adelberg is the leader of Faegre Drinker Consulting’s health care strategy practice. He brings unique insights into the processes, policies and people driving the major government healthcare programs—Medicare, Medicaid and “Obamacare” (the Affordable Care Act). Before joining Faegre Drinker Consulting, Mike held several senior positions within the Centers for Medicare and Medicaid Services (CMS). He was responsible for establishing Affordable Care Act policy for pediatric dental coverage and Stand Alone Dental Plans and, prior to that, oversaw Medicare Advantage contracting and market conduct, including with regard to dental supplemental benefits. Since joining Faegre Drinker, Mike has led numerous engagements related to the regulation of dental plans and helping dental plans pursue new opportunities within government programs

  • Contains 1 Component(s) Recorded On: 10/05/2021

    Learn more about DSO trends in this panel discussion featuring perspectives from the industry and leading DSO professionals. Panelists will cover key DSO trends, manpower challenges, the current dental office experience and administrative hurdles regarding eligibility, article intelligence and diagnostic codes.

    Learn more about DSO trends in this panel discussion featuring perspectives from the industry and leading DSO professionals. Panelists will cover key DSO trends, manpower challenges, the current dental office experience and administrative hurdles regarding eligibility, article intelligence and diagnostic codes.

    Jeremy Jonckheere

    VP, Insurance Products & Strategic Relations

    Pacific Dental Services

    Jeremy Jonckheere is Vice President, Plan Partnerships at Pacific Dental Services where his work covers insurance plan relationships, strategic partnerships, medical integration and operations including patient benefits and credentialing.  Prior to his work with Pacific Dental Services, Jeremy held numerous positions at DaVita including senior director of strategy, director strategic development and government affairs, and director of new markets. He holds an MBA in Finance, Marketing and Biotechnology from Northwestern University, Kellogg School of Management and an HBA in Business Administration (Honors) from the University of Western Ontario, Richard Ivey School of Business.

    Andrew Smith

    Executive Director

    Association of Dental Support Organizations (ADSO)

    Andrew Smith served as executive vice president of government relations and external affairs for Parallel (formerly Surterra Wellness) where he managed the state and federal government relations teams, served as the company’s chief advocate and spokesperson to policymakers and regulators, and led the company’s advocacy and communications goals in the public affairs space.

    Prior to joining the private sector, Andrew spent a decade working in government, campaigns, and public policy. In particular, Andrew worked as finance director and senior advisor for Virginia Governor Terry McAuliffe where he oversaw the strategy, development, and implementation of a record-breaking $44 million fundraising operation.

    Andrew is originally from Chicago and is a graduate of Georgetown University with a degree in government and history. He currently lives in Greenwich, Connecticut with his wife Laura and their two children, Holden and Caroline.

    Roma Virani, BDS, MBA

    Vice President, Payer Relations & Credentialing

    Great Expressions Dental Centers

    Roma Virani, BDS, MBA joined the Great Expressions Dental Centers’ (GEDC) leadership team on September 1, 2020 as vice president of payer relations and credentialing. Roma oversees GEDC’s payer relations strategy, and the credentialing and insurance operations departments. Roma has more than 20 years of experience in the dental industry with a focus on dental insurance strategy, payer relations, dental benefits, dental networks and revenue cycle management. Prior to joining GEDC, Roma was the director of revenue cycle management and payor relations at ProHEALTH Dental. Previously Roma was the director of dental insurance strategy and claim adjudication management at the NYU College of Dentistry, where she also taught dental and hygiene students a course in practice management.  Roma has also worked in the payer and dental industry as executive vice president of dental at Stratose, Inc., (now owned by Zelis Healthcare), and as and President of Assurant Employee Benefits’ PPO network, Dental Health Alliance. Roma received a BDS (Bachelor of Dental Surgery) degree from the University of Mumbai, and an MBA from the University of Connecticut.

  • Contains 1 Component(s) Recorded On: 10/05/2021

    The small group dental market can be a challenge for plans to penetrate, manage and grow given the level of fragmentation, high churn rate, and competition. In order to succeed in this market segment, while remaining financially stable, HealthScape has identified a variety of key success factors and strategies. This session will explore bundling with medical or other ancillary offerings, distribution channels, digital opportunities, administrative best practices, and more.

    The small group dental market can be a challenge for plans to penetrate, manage and grow given the level of fragmentation, high churn rate, and competition. In order to succeed in this market segment, while remaining financially stable, HealthScape has identified a variety of key success factors and strategies. This session will explore bundling with medical or other ancillary offerings, distribution channels, digital opportunities, administrative best practices, and more.

    Brian Goetsch

    Managing Director

    HealthScape Advisors

    Brian advises health plans, specialty health organizations and private equity investors on a variety of strategic and operational topics. Brian has led successful healthcare engagements across a wide range of topics including market entry and expansion; product development and launch; transaction advisory services; and performance improvement. Prior to joining HealthScape, Brian served as a senior executive at EyeMed Vision Care leading the development and execution of its partner channel “One-Stop-Shop” strategy. During his tenure, he successfully led multiple cross-functional initiatives including EyeMed’s expansion into Medicaid; investment in its Medicare Advantage solution and the launch of its medical-surgical vision solution. He also supported efforts to develop, implement and contract more than 10 successful partner deals covering millions of members. Previously, Brian was a director at HealthScape Advisors and started his career with Huron Consulting Group. Brian earned his Master’s and Bachelor’s degrees in Accountancy from the University of Illinois and was a Certified Public Accountant (inactive) and Certified Fraud Examiner (inactive).

    Luke Pisarcik

    Director

    Healthscape Advisors

    Luke has extensive experience in supporting clients with strategy creation and tactical execution, organizational design, and new product development. Throughout his career, Luke has advised his clients on a variety of industry topics including, but not limited to: Value-Based Care Program Design, Ancillary / Specialty Health, Behavioral Health, and Organizational Redesign.  Of note, Luke recently worked with a private equity owned ancillary carrier to implement a multi-year value creation plan expected to generate a yearly, eight-figure Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) expansion.  This project required coordination across the entire enterprise and multiple vendors to implement.  Luke and his team focused on financial modeling, program management, business requirement design, and strategic execution support.  Luke has also led multiple internal and external ancillary transaction advisory teams performing data room analysis, financial and discounted cash flow modeling, provider network analytics, investment thesis development, market/competitive research, operational assessments, and functional diligence process management. Luke began his career working in a variety of finance roles at United Technologies before joining HealthScape in 2011 as a consultant. Luke earned his bachelor's degree in finance from the University of Illinois. 

  • Contains 1 Component(s) Recorded On: 10/05/2021

    A 2020 survey conducted by West Monroe found the integration of oral health into overall health is the biggest factor behind dental and health plan convergence. From a public health perspective, the importance of the relationship between the two has been known for some time. However, due to reimbursement challenges, technological limitations, and the overall complexity of the U.S. healthcare system, dental and medical care have yet to be fully coupled. But that’s beginning to change—and it seems that change is primed for acceleration.

    A 2020 survey conducted by West Monroe found the integration of oral health into overall health is the biggest factor behind dental and health plan convergence. From a public health perspective, the importance of the relationship between the two has been known for some time. However, due to reimbursement challenges, technological limitations, and the overall complexity of the U.S. healthcare system, dental and medical care have yet to be fully coupled. But that’s beginning to change—and it seems that change is primed for acceleration.

    In this session, a panel of industry experts from Pacific Dental Services, Sonicare, United Concordia Dental and West Monroe will examine the forces driving the dental and health insurance markets together as an entrée to a discussion of the integration of oral and overall health. This integration, furthered by dental and health plan convergence, is a matter of improving health outcomes through a more dynamic, connected healthcare system. A key point of our discussion is that, for payer organizations—both dental and health—this is a matter of building a better business, one centered on the member-as-patient and driven by data and technology. We’ll introduce a range of measures payers can take right now to achieve that end, backed by key considerations around using data to improve dental insurance products and plan-provider coordination.

    Benjamin Baenen

    Director of Healthcare & Life Sciences

    West Monroe Partners

    A results-focused healthcare leader, Ben directs transformational initiatives spanning product innovation, new market entry, operational transformation, and technology disruption. He has spanned the payer value chain and launched a number of new technologies, strategic initiatives, and member engagement platforms. He has implemented consumer shopping portals, provider portals, robotics initiatives, billing engines, process changes. These projects created significant value for his clients, ranging for new member acquisition, increased provider engagement, and reduced calls to the call center. Ben has deep expertise in healthcare payer operations, supporting claims system analysis, system selections and vendor analysis, business transformation, functional requirements and design, usability testing, and operational readiness planning. Contagiously enthusiastic, Ben promotes collaboration within the firm and with clients in order to achieve the best results. He joined West Monroe in 2007 after earning a bachelor’s degree in economics from DePauw University.

    Jeremy Jonckheere

    VP, Insurance Products & Strategic Relations

    Pacific Dental Services

    Jeremy Jonckheere is Vice President, Plan Partnerships at Pacific Dental Services where his work covers insurance plan relationships, strategic partnerships, medical integration and operations including patient benefits and credentialing.  Prior to his work with Pacific Dental Services, Jeremy held numerous positions at DaVita including senior director of strategy, director strategic development and government affairs, and director of new markets. He holds an MBA in Finance, Marketing and Biotechnology from Northwestern University, Kellogg School of Management and an HBA in Business Administration (Honors) from the University of Western Ontario, Richard Ivey School of Business.

    Marilyn Ward, DDS, FAGD

    Director of Global Clinical and Dental Scientific Affairs

    Philips HealthTech

    Marilyn Ward received her DDS degree from the University of Texas Health Science Center at San Antonio Dental School. She is currently director of Global Clinical and Dental Scientific Affairs for Philips HealthTech. There she leads a team of clinical and dental research experts to develop innovations in oral healthcare and works with industry thought leaders and academicians to validate the evidence base science. She has published, trained and lectured nationally and internationally on oral biofilm, oral healthcare research including the Oral Systemic link and teeth whitening.  Marilyn is the former director of Esthetics in the Department of Restorative Dentistry and Biomaterials at the University of Texas Dental Branch at Houston. She is a Fellow of the Academy of General Dentistry and has memberships in American Dental Association, American Academy of Cosmetic Dentistry and the International Association of Dental Research.  Marilyn maintains an aesthetic and restorative dental practice in Houston, Texas. She and her husband make Seattle, WA their home where they are avid hikers, skiers and golfers.

    Anthony J. Warren, DDS

    Dental Director

    United Concordia Dental

    Anthony J. Warren, DDS, dental director at United Concordia Dental, brings more than 30 years of experience as a general dentist providing comprehensive dental care including oral surgery, implant reconstruction, IV anesthesia and sedation dentistry. At United Concordia, Dr. Warren lends his clinical experience through developing and implementing leading research, dental policy and clinical review.

    Previously, Dr. Warren owned and operated a solo practice in rural New Mexico for more than 20 years.  Prior to entering private practice, Dr. Warren served as a commissioned Dental Officer for the U.S. Air Force Dental Corps at the Holloman Air Force Base in New Mexico. Dr. Warren also has experience as a software engineer prior to entering dental school.

    Holding a Bachelor of Science in Commerce from Texas A&M in software engineering and a Doctor of Dental Surgery from Texas A&M Health and Science Center, Dr. Warren completed his residency in advanced education in general dentistry at the U.S. Air Force Medical Center, Scott Air Force Base and a separate oral and maxillofacial surgery Anesthesia Fellowship at Holloman Air Force Base.

    Dr. Warren served as a board member and examiner for the New Mexico Board of Dental Health Care - Anesthesia Committee.  Other honorariums include Board Member and guest lecturer at New Mexico State University Dental Hygiene Community College. Most recently, Dr. Warren completed a humanitarian mission with the Samaritan's Purse and SIM at the Galmi Hospital in Niger Africa.  Other medical/dental humanitarian missions include the New Mexico Mission of Mercy and the Commission Ministry Network, Maya-Mesoamerican Mission in Xela, Guatemala.

  • Contains 1 Component(s) Recorded On: 10/05/2021

    The demand for teledentistry has drastically increased as a result of the COVID-19 pandemic, as many dental practices were forced to close early in the pandemic, which left individuals without access to much-needed care. Many were left with few options other than visiting the emergence room for dental emergencies, resulting in costly bills and potential exposure to COVID-19.

    The demand for teledentistry has drastically increased as a result of the COVID-19 pandemic, as many dental practices were forced to close early in the pandemic, which left individuals without access to much-needed care. Many were left with few options other than visiting the emergence room for dental emergencies, resulting in costly bills and potential exposure to COVID-19. A large number of these individuals turned to teledentistry for their dental needs, providing them the opportunity to virtually connect with licensed dentists nationwide for dental care, treatment advice and expert second opinions from the safety and comfort of their homes. As COVID-related protocols evolve and social distancing restrictions continue to lift across the nation, it remains unclear what the teledentistry industry will look like post-pandemic and if the strong demand for teledentistry will continue into the future. This session will feature an expert panel who will examine industry trends and will do a deep dive into the full-circle future of teledentistry from the standpoints of the dentist, patient, payor, health plan, dental support organization and more. Additional topics explored by the expert panel will include:  

     

    • Teledentistry as a hybrid approach to dental care, providing virtual advice and diagnoses at times outside of dentists’ operating hours or for fewer in-person appointments, saving consumers time 
    • The advantages of using teledentistry for second opinions on recommended dental treatment, helping consumers to save money by avoiding unnecessary procedures 
    • The importance of teledentistry for individuals who live in rural areas who otherwise must travel long distances to visit a dental office to receive care 
    • Teledentistry as an employer-sponsored benefit, allowing employees to spend less time out of the office for in-person dental appointments 

    Mary Lee Conicella, DMD, FAGD

    Chief Dental Officer

    Aetna

    Dr. Mary Lee Conicella is Aetna’s Chief Dental Officer and oversees dental clinical initiatives, policies and claim review.  She is a member of Aetna’s Medical Affairs Team and serves on the Virtual-First and Health Equity Committees.  She has published numerous articles related to the impact dental care has on holistic health and was instrumental in creating Aetna’s Rush to Brush Initiative to reduce hospital-acquired pneumonia, and Aetna's groundbreaking Dental-Medical Integration program.  Dr. Conicella received her DMD from Temple University School of Dentistry and achieved Fellowship status in the Academy of General Dentistry during her time in private practice.  She spent many years on the faculty at the University of Pittsburgh School of Dental Medicine, and currently sits on the NYU College of Dentistry Dean’s Strategic Advisory Council. Mary Lee has been a volunteer with NADP since 2006 and she is currently serving her second term as a member of the NADP Board of Directors.

    Jeremy Hedrick

    SVP, Careington & President, DialCare

    Careington & DialCare

    Jeremy Hedrick serves as senior vice president at Careington International Corporation as well as president of its affiliate telemedicine company, DialCare, which offers teledentistry, telemedicine, and tele-behavioral health services nationwide. He has been a vital component of Careington’s growth for the last 20 years, serving in many critical senior leadership roles throughout the Careington companies. During his tenure, Jeremy has helped lead the strategic growth of Careington’s network development department, customer support call center, compliance, claims administration, operations of Careington’s affiliate nationally licensed TPA, as well as operations of Careington’s UK affiliate, Munroe Sutton. In each of these roles, Jeremy has been intimately involved in the workings of these critical segments of the industry and an integral part of the growing network lease and discount dental market. Jeremy is currently serving his second term on the NADP Board of Directors and his second year as the Board Chair.

    Mike Davis

    President and Chief Operating Officer

    Dominion National

    Mike Davis is a founder of Dominion National and has overall responsibility for the company. Davis has nearly 30 years of experience in dental benefits and had served in various executive positions with MIDA Dental Plans, a successful DHMO in the Mid-Atlantic region, prior to establishing Dominion. Davis has been instrumental in driving the innovation of Dominion’s systems, services and plans since its inception in 1996. Most recently he has led the company’s pursuit into teledentistry to improve outcomes, member satisfaction and experience. Under Davis’ leadership, Dominion has grown to serve over 900,000 members, offer access to over 350,000 national dentist listings and employ a staff of over 200. Dominion’s expansion offering benefits to commercial groups, individuals and health plans resulted in the company’s 2016 re-brand to Dominion National. Davis helped Dominion become one of the first dental benefits providers in its region to introduce interactive, online benefit administration and other groundbreaking models and technologies to improve the client experience. Over the past decade, Dominion also became known for its innovative online dental programs for individuals and associations. Davis participates on several boards, including Dominion National and a regional DSO. He earned a bachelor’s degree from Radford University.

    Matthew Zubiller

    Chief Growth Officer

    Smile Brands, Inc.

    Matthew is a senior executive officer, strategic visionary, and operational leader focused on driving growth by balancing core operational excellence with a deep commitment to innovation and team building. His experience ranges from starting companies, to growing businesses to scale, and leading mature billion dollar portfolios.

  • Contains 1 Component(s) Recorded On: 10/05/2021

    Discover how Artificial Intelligence (AI) enhanced with Big Data is unlocking exciting new possibilities in the dental market.

    Discover how Artificial Intelligence (AI) enhanced with Big Data is unlocking exciting new possibilities in the dental market.  

    The future of dental is bright with data and analytics that incorporate exciting new advancements in artificial intelligence — everything from A.I.-powered dental image analysis to uses in maintaining accurate, cost-effective and efficient dental claim review operations. These advancements can help payers serve members more effectively while managing costs. However, A.I. is only as effective as the underlying data powering it. A.I.-powered image analysis can only operate on the fraction of claims that contain accompanying x-rays of acceptable quality. Plus, the current regulatory environment requires experienced human dental consultants to be in the loop. In this session, presenters will discuss how A.I.-enhanced image analysis, algorithmically derived claims analysis and highly trained human dental consultants complement each other to provide opportunities for the ultimate in utilization review effectiveness. In addition, this session will explore the latest progress on the artificial intelligence initiatives developed with  P&R Dental’s strategic partner, Denti.AI Technology Inc.

    Michael Urbach

    EVP

    P&R Dental Strategies

    Mike is executive vice president, Strategic Sales & Business Development for P&R Dental Strategies and is responsible for overseeing all aspects of driving revenue growth for our dental analytics business solutions. Mike has over 20 years’ experience in the health care informatics space and has developed and successfully sold a variety of informatics solutions to all stakeholders in the health care marketplace including payers, providers, suppliers and consumers. Mike has worked at informatics companies large and small, public and private, including: HCIA, Solucient, Pharmetrics and IMS Health. Mike has a BA from Syracuse University and an MBA and an MHA from the University of Pittsburgh.

  • Contains 1 Component(s) Recorded On: 10/06/2021

    Learn more about best practices in delegated credentialing from the perspectives of both plans and DSOs. Panelists will discuss ways to streamline processes and foster positive relationships for both plan to plan, as well as plan to DSO credentialing delegation.

    Learn more about best practices in delegated credentialing from the perspectives of both plans and DSOs. Panelists will discuss ways to streamline processes and foster positive relationships for both plan to plan, as well as plan to DSO credentialing delegation.

    Theresa Bacon

    Director Provider Relations

    Aspen Dental Management

    Theresa Bacon joined Aspen Dental Management Inc. (ADMI) in 2012 as the manager carrier relations and has served as director of insurance operations since March 2019.  Leading provider credentialing and plan enrollment for more than 900 Aspen Dental branded practices in 44 States.   Theresa currently serves as the chair of the DSO Advisory Council and has been a member of the NADP Operations and Codes Workgroups since 2015. Past volunteer experience includes Provider Directory Validation, CAQH and Delegated Credentialing Sub-WorkGroups.

    With more than 20 years in the dental industry, prior professional experience includes leadership roles at Coast Dental Services and roles with general dentistry and endodontic private practices.

    Mike Cole

    Vice President of Insurance Plan Management

    Dental Care Alliance

    In April 1999, Mike Cole joined Dental Care Alliance (DCA), an NADP Associate member and one of the largest dental service organizations in the country. As vice president of Insurance Plan Management, Mike oversees the teams responsible for insurance relations, revenue cycling and the credentialing departments. Prior to joining DCA, he was a network manager for both Prudential Healthcare and United Concordia. With more than 30 years in the dental healthcare industry, he was instrumental in fostering partnerships between DCA and the insurance plans. Working together to achieve the best outcomes has led to creation of the NADP credentialing application, NADP-supported directory validation process and innovations with the patient experience. My received the Don Mayes Award at CONVERGE 2019.

    Mike has been active in the NADP for the last eight years and has served on the Operations Workgroup, where he is currently the vice chair. Mike is a graduate of the University of Missouri – Columbia and is also a Certified Employee Assistance Professional (CEAP).

    Andrea Braykovich Garrett

    Provider Network Management

    Guardian Life

    Andrea Braykovich Garrett has more than 20 years of experience in all facets of provider network management, including responsibility for credentialing and Dental Support Organization relationship management. While employed by DenteMax and Dental Network of America from 2000-2017, Andrea established delegated credentialing programs for both DSOs and network leasing plan partners. She also co-authored the NADP 2015 update to the Dental Plan Accreditation Standards for credentialing and credentialing delegation. Andrea is currently the director of Dental Networks for the Guardian Life Insurance Company of America.

    Kristen Smith

    Director, Provider Network Operations

    United Concordia Dental

    Kristen S. Smith is the director, Dental Network Operations at United Concordia.  She has overall leadership responsibility for all credentialing, delegated credentialing, provider data management and support functions.  

    Kristen has more than 32 years of clinical and administrative dental experience.  She has worked for United Concordia for 30 years where she has held positions in professional relations, claims operations and audit, provider data management, quality/process improvement and project management. Prior to United Concordia she worked as a dental office manager and clinical dental assistant. 

    Kristen has her Bachelor of Science from East Stroudsburg University, a PA Teaching Certificate, and is a Juran certified Six Sigma Black Belt.