Presentation Date: Wednesday, March 26, 2025
Join us for an engaging session where we’ll tackle the increasing challenges in hospital reimbursement and highlight the crucial teamwork between physicians and revenue cycle management (RCM) teams.
Our expert speakers will dive into the financial impact of clinical validation and medical necessity denials and discuss how physicians are playing a bigger role in aligning clinical care with payer expectations. They’ll also share practical strategies, like using AI-driven analytics and structured workflows, to help reduce denials. Through real-world case studies, you’ll see how hospitals are successfully fostering collaboration and implementing physician-led appeal strategies to transform their operations.
About the Presenters:
Kendall Smith, MD, SFHM, ACPA-C
Chief Physician Advisor | PayerWatch – AppealMasters
Dr. Kendall Smith is a Senior Fellow in Hospital Medicine (SFHM) and currently acts as Chief Physician Advisor for PayerWatch – AppealMasters, a leading appeal educator and appeal services firm for hospitals and health systems. He’s been deeply involved in denial and appeals management throughout his hospitalist career. He has served as a physician leader on hospital revenue cycle management teams while also serving as the Physician Advisor for Clinical Resource Management. Dr. Smith is also an AHIMA ICD-CM/PCS approved trainer/ambassador.
Ryan O’Hara
Managing Principal | Denial Research Group
Ryan O’Hara is an accomplished healthcare executive with a wealth of experience in revenue cycle operations. Throughout his 20+ year career, Ryan has demonstrated a deep understanding of the complexities of healthcare financial management and has worked to develop strategies and solutions to drive efficiency, reduce costs, and improve patient outcomes.
He has spent the majority of his time on the healthcare provider side, working as a revenue cycle operations leader across many hospitals and health systems. He also has spent several years working on the EMR and 3rd party business partner side. This has provided for a diverse and rounded background; but one that is always rooted in being a trusted and value-add contributor for healthcare providers.
About the Moderator:
Karla Hiravi, BSN, RN
Senior Vice President Clinical Resources, PayerWatch
President, AHDAM
Karla is a registered nurse and holds a BSN from the University of Pittsburgh, Johnstown. She has over forty years of varied experiences in healthcare, culminating with Clinical Documentation Improvement (CDI), management of a CDI department, followed by development of a successful hospital-based denial and appeal program, authoring of thousands of varied healthcare related appeals between her positions at her local hospital and then at PayerWatch/AppealMasters, presentations at the Administrative Law Judge (ALJ) level, and direct management of thousands of appeals at every level, up to post ALJ appeals.
She has served in many capacities from contracted appeal writer up to and including Senior Vice President of Clinical Resource Management for PayerWatch/AppealMasters, a leading appeal educator and appeal services firm for hospitals and health systems. She serves as President of AHDAM (Association for Healthcare Denial and Appeals Management), the nation’s only association dedicated to healthcare denial and appeal management.
