You’ve likely heard about the Da Vinci project, a private sector initiative that addresses the needs of the Value-Based Care Community by leveraging the HL7® FHIR® platform. This webinar brings participants up to speed on the project’s progress and showcases the Center for Medicare and Medicaid Services (CMS) usage of two Da Vinci Use Cases in Medicare’s FFS Document Requirements Lookup Service (DRLS).
Topics at this presentation include:
- Understanding of project’s core goals and objectives
- Update on progress of in flight individual use case projects
- Where and how to access current implementation guides, project resources and calls
- Future plans
- Q & A
Presenters
Jocelyn Keegan: is Payer Practice Lead for Point of Care Partners, offering expertise in payer/provider collaboration, prior authorization workflows, value-based care and software product development. Jocelyn is the Program Manager the Da Vinci project. In addition she leads NCPDP taskgroups to improve specialty automation and pharmacy ePA. Prior to POCP, Jocelyn led product management efforts that implemented X12, NCPDP and HL7 standards at NaviNet/Nanthealth, including bringing NCPDP SCRIPT ePA standard live with CVS Caremark and CoverMyMeds across Surescripts network. Jocelyn brings 25 years of experience building product, running complex projects and providing strategy advisement to organizations. Prior to Healthcare IT, Jocelyn led change, product and project management organizations for Thomson Financial/Thomson Reuters.
Melanie Combs-Dyer is the Director of the Provider Compliance Group in the Center for Program Integrity at the Centers for Medicare & Medicaid Services (CMS).
Melanie graduated from the University of Maryland School Of Nursing and obtained her Master’s Degree in Health Administration from Towson University. Before joining CMS, Melanie worked as a registered nurse and as a medical record reviewer for the Maryland Peer Review Organization and for the Maryland Health Department.
Melanie has 30 years of experience at CMS and has been involved with many provider compliance efforts. In her position as Director of the Provider Compliance Group, some of the programs and initiatives that Melanie oversees include, but are not limited to the following:
- Electronic Submission of Medical Documentation (esMD) Activities
- Electronic Clinical Template Pilots
- Using HL7 Fast Healthcare Interoperability Resources (FHIR) standards to reduce improper payments, such as the Documentation Requirements Lookup Service (DRLS) Initiative
- Medicare Fee-For-Service (FFS) Recovery Audit Contractors (RACs)
- Medical Review efforts at the Medicare Administrative Contractors
- Medicare FFS Prior Authorization Programs, and Home Health Pre-Claim Review Program