UHC User Group Webinar: UnitedHealth Group’s Approach to Payment Integrity for Employers

Date: December 3, 2019

Time: 3:00 pm - 4:00 pm

Location: Webinar

Payment errors can lead to mispayment and downstream expenses, affecting the overall cost of health care. UnitedHealth Group (UHG) is committed to continuously improving claims processing and controlling cost for employers. Payment Integrity programs reduce the total cost of health care and make it more affordable by ensuring claims are paid accurately. UHG Payment Integrity also detects, prevents and recovers payment for fraudulent, wasteful and abusive practices. When defects are found, Payment Integrity ensures they are remediated.

In the first of our new quarterly webinar series, exclusively for Employers Health and UnitedHealth Group members, attendees will learn:

  • Payment integrity in health care and the various strategies that make up the discipline of Payment Integrity.
  • The UHG Payment Integrity programs and where they fall within the life cycle of a claim: pre-adjudication, pre-payment and recovery.
  • The UHG Payment Integrity programs and how they partner with customers in controlling costs.

Speakers

Samantha Goff is the Payment Integrity Director of Operations of UMR, the third-party administrator (TPA) for UnitedHealthcare. She is responsible for the payment integrity operations for UMR, which includes special investigation unit, subrogation, claim negotiation team and vendor partnerships. Ms. Goff started in the insurance industry in 2007 in a role with Midwest Security Administrators, which is now UMR. She has experience in claim operations, customer service, process improvements, data analytics, payment integrity and more.

Ms. Goff received her undergraduate degree in business management from Viterbo University. She attended Upper Iowa University to pursue an MBA with focus on quality management then returned to Viterbo University to complete a Master of Arts degree in Servant Leadership

 

Kate Ifversen joined the UnitedHealthcare team in August of 2004 and has held various positions within the company including Customer Service Representative, Service Account Manager, Sr. Client Manager and Manager of Business Process for Payment Integrity Strategic Development. In Payment Integrity her responsibilities included overall strategy and delivery of programs for clients as well as coordination of new sale and renewal implementations, and overall day to day management. Acting as a lead for the Payment Integrity Team, Kate is the main contact to analyze, investigate, and develop creative solutions to specific problems related to claims, networks and eligibility.

Prior to working in the healthcare industry Kate worked for five years in banking and finance. Kate is a graduate from Humboldt State University, holding a Bachelor’s degree with a major in Business Administration and a minor in Economics. Kate excelled in Finance, Marketing and Accounting.

Kate is highly motivated, has a positive attitude and strong work ethics. Kate prides herself on efficient time management, her wealth of knowledge relating to a variety of medical plans and the ability to establish and maintain strong business relationships. Kate has been continually recognized for providing a high level of service resulting in superior customer satisfaction.