A Journey through the Development and Deployment of a Pre-Payment Modelling System | Kisaco Research

Showcasing one health plan’s process for creating a pre-payment system focused on reducing provider abrasion by paying more claims correctly the first time.

Session Topics: 
Payment Integrity
Speaker(s): 

Author:

Jordan Limperis

Data Scientist
LA Care

Highly motivated Data Scientist with a strong background in healthcare data and systems. Experienced in Inpatient Hospital and Laboratory Epic Systems, where I applied data-driven insights to improve clinical and operational efficiency. Currently, I am pursuing my career at L.A. Care, focusing leveraging advanced machine learning techniques to analyze noisy data, ensuring accuracy and efficiency in healthcare operations, particularly in payment integrity.

Jordan Limperis

Data Scientist
LA Care

Highly motivated Data Scientist with a strong background in healthcare data and systems. Experienced in Inpatient Hospital and Laboratory Epic Systems, where I applied data-driven insights to improve clinical and operational efficiency. Currently, I am pursuing my career at L.A. Care, focusing leveraging advanced machine learning techniques to analyze noisy data, ensuring accuracy and efficiency in healthcare operations, particularly in payment integrity.

Author:

Edgar Dominguez

Claims Integrity Business Manager
LA Care

Healthcare Operations expert with 20+ years of healthcare payer experience including 12+ years in Claims Administration with multiple fortune 200 companies.  I’m currently focused on implementing payment integrity initiatives aimed at cost avoidance by the use of data analytics.  I am a firm believer that data science is the wave of the future and will afford the healthcare industry with boundless opportunities to mitigate waste and reduce overall healthcare costs.

Edgar Dominguez

Claims Integrity Business Manager
LA Care

Healthcare Operations expert with 20+ years of healthcare payer experience including 12+ years in Claims Administration with multiple fortune 200 companies.  I’m currently focused on implementing payment integrity initiatives aimed at cost avoidance by the use of data analytics.  I am a firm believer that data science is the wave of the future and will afford the healthcare industry with boundless opportunities to mitigate waste and reduce overall healthcare costs.