Amy E. Goldberg, BS, MBA
Amy has over fifteen years in the pharmaceutical and consulting industry. She started her professional career as a Pharmacist for Thayer Pharmacies. Amy has held positions in Sales with Eli Lilly and was a Specialty Sales Representative for Lilly representing Prozac. Following her tenure at Lilly, Amy joined Boston Healthcare Associates as a consulting project manager involved in managing a wide range of consulting projects focused on reimbursement, strategic product and market planning within both the pharmaceutical and medical device industries. Amy has a strong understanding of the public and payer markets and their impact on integrated delivery systems and group purchasing organizations. She has extensive experience developing discussion guides and conducting interviews with providers, patients and decision makers within the payer market. Amy has excellent analytical, organizational and communication skills and takes a lead role in analyzing project information to create clear, action orientated programs. Amy has a Bachelor of Science degree from University of Connecticut and a M.B.A. from Boston College.
Arlene Cymerman is a member of the American Health Information Management and Association and is licensed as a Correct Coding Specialist (CCS-A). Arlene has over five years of reimbursement coding and claims processing experience. She has been responsible for the management of claims processing, coding and collections and offers extensive knowledge of coding and managed care support. She has successfully negotiated managed care agreements for providers. Arlene’s strong skill has been her ability to work with plans to turn around denied claims during the appeals process while following the payers appeal process and timelines. Her ability to work with managed care plans to negotiate effective coverage and payment for providers and her knowledge and experience with the payer appeals process permit Arlene to offer support for hospitals and physicians utilizing new technologies.
Constance (Connie) Mehesy
Connie is a certified radiology coder (RCC) and has been providing patient targeted reimbursement support for facilities over the past fifteen years. She has successfully managed Medicare and Medicaid billing and collections, developed and monitored quality assurance and compliance programs and has provided quality compliance training programs for physicians, clinical staff and reimbursement staff as a Corporate Compliance manager. Connie has developed coding strategies and tactics at the facility level and has worked with manufacturers to assist with implementation of new coding strategies from product launch to new coding development. Connie offers a wealth of experience in use of the coding system prior to the development of permanent CPT codes for new technologies. She has been a member of the American Academy of Professional coders since 1994 and holds her Radiology Coding Certification since 2002.
Christina (Tina) Horun
Tina has been actively working in the medical field for over twenty years in reimbursement and as a health care professional. Her career started as a critical care nurse, working in numerous hospital departments, which included Emergency, Intensive Care Unit, Cardiac Cath Lab, Operating Room and Post Anesthesia Care. Tina worked in the home healthcare field with various responsibilities including Director of an 800 employee home health staff, management of assisted living caregivers for the elderly and disabled and home health nursing. Tina assisted in the start-up of a licensed home healthcare agency, obtaining Accreditation in accordance with the Medicare and State Programs. Over the past ten years, she has worked in the area of health care reimbursement providing support to pharmaceutical and biotechnology companies as well as healthcare providers. She has developed contacts within managed care organizations, and with Medicare and Medicaid program directors and physicians. Tina has assisted in the revision of state local medical policies for state Medicare programs. She is an active registered nurse and member of the Critical Care Nurses Association.
Douglas E. Busby, MD. MSc. MDiv, FACPM
Dr. Busby has considerable diversified experience in health care delivery and management, and has authored over twenty six (26) publications. He was the Medical Director for Medicare (Illinois) with the Health Care Service Corporation, and has also served as Senior Scientist for the Lovelacc Foundation. Medical Director for Continental Airlines, Deputy Federal Air Surgeon for the FAA, and Chair of the Department of Environmental Health for the Cleveland Clinic Foundation. He has additionally been in the private practice of preventive, occupational and aerospace medicine, and for the past five years has been engaged in extensive consulting activities relating to Medicare coverage and payment issues. Dr. Busby received his MD (cum laude 1960) and his MSc in biophysics (1964) from the University of Western Ontario. He took his residency training at the Ohio State University and the Lovelace Foundation for Medical Education and Research. He is a diplomate of the American Board of Preventive Medicine in aerospace medicine (1966) and is qualified by this board in occupational medicine (1984). He also received graduate training in pulmonary physiology and general surgery. He is a Fellow of the American College of Preventative Medicine, a Fellow of the American College of Occupational and Environmental Medicine and a Special Achievement Award recipient of the Federal Aviation Administration. Dr. Busby is not only a medical doctor, but also an ordained minister. He has had a productive career in medical care, research and administration. He is an independent medical writer and longtime member of the American College of Preventative Medicine.
Kathy A. Francisco
Kathy offers over twenty years of managerial experience focused in reimbursement, payer relations and state and federal governmental affairs. Her areas of expertise include strategic and tactical reimbursement coverage and coding, policy development and implementation, sales and marketing support and legislative policy development. She has developed strategic reimbursement solutions to pharmaceutical, medical device and biotechnology firms as well as health care providers and managed care organizations nationally and internationally. She has successfully implemented Medicare policy change at a national level in less than ninety days and has built solid relationships with Medicare Medical Directors, Managed Care Organizations, medical societies and the Centers for Medicare and Medicaid Systems. Kathy has taken a very active health policy role with numerous medical societies, industry trade associations and health care coalitions and been an invited speaker at state society meetings, state conferences and national society and professional health care meetings across the country as well as several international symposiums. She is considered an expert in the area of health care reimbursement and offers a vast amount of knowledge within the federal regulations and governmental policy arena.
Letitia [Tish] Clark
Tish offers over twenty years of experience in the insurance industry in various management roles where her strong management, analytical and communication skills are key attributes. Tish has a strong benefit and claims administration background and understanding of what key components are required for insurance companies to provide coverage for new technologies. Tish has successfully implemented training and compliance programs within the insurance industry and has been responsible for auditing and analyzing claims. She has been instrumental in the establishment of a precertification department that has been key to the successful coverage for new technologies that otherwise may not be approved for coverage by insurance plans across the country. Tish offers extensive knowledge in the areas of coding, compliance and coverage.