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The nuanced world of behavioral health creates a challenging environment for precision in payment integrity. Keeping up with varying diagnoses, policy changes, care delivery and treatment types can be a complex, manual process - leading to lengthy processes and missed detail. Learn from Shift and Constellation Quality Health experts on emerging behavioral health trends, use cases, AI-powered tools, and the steps taken in facing a complex, real-world case involving opioid prescriptions, abuse, and recovery.

In this webinar, attendees will learn:

  • Emerging trends in behavioral health from substance abuse to recovery centers
  • A case walkthrough from Robyn Winters of Constellation Quality Health resulting in over $1M in prepay savings - involving a behavioral health provider who was both prescribing opioids and running a treatment center for addiction
  • A technology perspective from Shift on how investigations and other behavioral health areas can benefit from advanced analysis and artificial intelligence tools

Speakers

Mark-Starinsky-V1-150x150
Mark Starinsky

Product Lead US Healthcare, Shift Technology

Mark Starinsky, AHFI, CFE, CHC, SE is a product lead for Shift Technology’s Healthcare Improper Payment Detection solution, where he is responsible for building and managing Shift’s leading AI solution for Payment Integrity. Before Shift, Mark managed Product and Service Delivery for payment integrity solutions at Covitivi and General Dynamics IT. 

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Jesse Montgomery

Head of Value Engineering & Customer Success US Healthcare, Shift Technology

Jesse is Head of US Healthcare Customer Success & Value Engineering at Shift and has over 20 years of expertise in the healthcare industry. He has held leadership positions in strategy development and execution for health plans and healthcare organizations. His areas of focus include payment integrity, data science, analytics, clinical review, policy development, network strategies, market expansion, and partnership development.

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Robyn Winters

Director of Payment Integrity, Constellation Quality Health

Robyn, RN, BSA, QP, AHF, is a Registered Nurse and an Accredited Healthcare Fraud Investigator. With over 30 years of experience in healthcare billing, management, service provision, and auditing across multiple service types, including inpatient and outpatient service arenas, she has extensive expertise in the field. Having been a service provider for many years, she has witnessed firsthand how healthcare waste and fraud impact both the people served and the industry itself.

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