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EXPERIENCE
Kate
Driggers Consulting,
Destin,
Florida.
Owner—Established October
2000
 |
Provides
Medicare
services specifically for physician practices—doctors &
staff—including phone support, newsletters and bulletins, seminars and
workshops, and practice analyses. |
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Created
web site at http://www.katedriggers.com. |
| Is
compiling Medicare for the Physician Practice, a
comprehensive manual of Medicare basics for any physician practice in
the U.S. |
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Is
also compiling Medicare for Kentucky Optometry ~ The
Manual,
a thorough, step-by-step manual which will be maintained
through regular content updates. |
| Is
proficient
with DOS and with Windows 3.xx and Windows 95/98/ME/2000/XP environments and applications,
including Microsoft Office Premium
(Word, Excel,
Access, PowerPoint, Outlook, Publisher, FrontPage, PhotoDraw, Internet
Explorer). |
COMMONWEALTH
EYE SERVICES, Lexington,
Kentucky.
Compliance
Officer / Liaison with Referring Doctors / Administrator, 1988 -
1999
Third
Party Compliance & Training:
| Interpreted
Medicare, Medicaid, and other third-party regulations:
coordinated chart changes
with regulatory requirements; provided training and updated procedures for
clinical and clerical staff; provided on-going analysis of revenue
projections and billing problems; often was first to analyze and report
claims processing problems to Medicare and Medicaid carriers. |
| Developed
chart audit materials for Evaluation & Management codes; audited
charts in doctors’ practices, reported
findings to doctors, and trained
staff in E&M coding audit procedures. |
| As
Compliance Officer, researched and developed the initial stages of a
practice compliance program meeting
federal guidelines. |
| Served
as a practice management and third-party resource for 100+ referring
doctors; has presented
third-party material to doctors and staff in dozens of seminars/workshops and in
several hundred one-on-one
settings: CPT coding &
documentation, ICD-9 diagnosis coding, program coverage, appeals process. |
| Counseled
patients with third-party claims problems. |
Organizational
& Administrative:
| Served
as liaison for 100+ referring doctors in marketing/professional relations
capacities; created and maintained extensive referring doctor relational
database with Microsoft Access. |
| Created
and maintained credentialing database in Microsoft Access for five doctors
in practice; handled all managed
care credentialing activities until 1998, then trained a credentialing
coordinator to assume those duties. |
| Designed and updated
procedures manual; provided procedural and computer skills training for
all non-clinical staff. |
| Advised
practice owners on computer hardware and software purchases; installed
new/upgraded hardware; constructed peer-to-peer network; installed software and trained staff on its use. |
| Developed
and prepared statistical and narrative reports & analyses as needed
for practice owners. |
| Coordinated
practice re-location in summer 1997:
served as liaison between practice owners and architect,
general contractor/sub-contractors, and vendors; designed clerical office
cabinetry and planned staff task changes with office manager; organized
schedule of actual move with eight equipment and furniture movers. |
| Assisted
owners of large-volume surgical referral practice in opening the new practice
setting in 1988: helped plan office design and furnishings; advised on
purchase of computer hardware and software; developed procedures manual,
and implemented computer systems for patient and practice accounting,
training
office manager and all clerical staff. |
| Communicates
well at all levels verbally and in writing. |
OMNI
EYE SERVICES, Lexington,
Kentucky.
Professional
Services Representative, 1986
- 1988.
Provided
third-party, administrative, and liaison services as described above for same doctors in their
previous practice setting.
Business
Office Manager, 1984
- 1986.
Oversaw
office operations:
supervised and trained clerical staff; interacted with patients and referring
doctors; analyzed and solved third-party problems; worked accounts
receivable; prepared statistical reports using Lotus 123.
FEDERAL
MEDICARE
CARRIERS (BLUE CROSS & BLUE SHIELD OF KENTUCKY and METROPOLITAN
LIFE INSURANCE), Lexington,
Kentucky.
Supervisor,
Systems Resolution and Supervisor,
Administrative Services, 1982
- 1984.
| Assisted
management in the administration of the Medicare program. |
| Supervised
26 Systems Resolution employees in medical utilization review, Medicare as secondary payer,
electronic media claims, accounting, and claims development. |
| Supervised
13 Administrative Services employees in fraud & abuse investigations, quality assurance
review, preparation of bulletins for the medical provider community,
internal procedure writing, and computer file maintenance. |
| Oversaw
interpretation of federal directives, development of studies, personnel
training, and implementation of procedural changes with emphasis on
reduction of expenses and improvement of operation accuracy and
efficiency. |
Quality Assurance Monitor, 1980
- 1982.
| Supervised
4 employees in quality review of post-payment sample claims. |
| Analyzed
error claims; provided feedback to management and to claims
processing. |
| Negotiated
error findings with federal HCFA Regional Office reviewers. |
| Completed
statistical reports. |
KENTUCKY
DEPARTMENT FOR HUMAN
RESOURCES,
BUREAU FOR SOCIAL SERVICES,
Paris, Kentucky.
Social
Worker II, 1978 - 1980.
Provided
counseling and supportive services to individuals and to families in child
protection and juvenile situations.
FEDERAL
MEDICARE
CARRIER (METROPOLITAN LIFE INSURANCE),
Lexington, Kentucky.
Administrative
Analyst, 1977 - 1978.
| Interpreted
and rewrote federal regulations for office use. |
| Conducted
internal audits and time studies of office procedures. |
| Trained
office personnel in medical terminology. |
| Prepared
statistical and descriptive managerial reports and informational releases. |
| Developed
and wrote formal office procedures. |
| Performed
statistical research projects. |
From
1972 to 1977, worked as a social worker in South Carolina
and Virginia.
EDUCATION
B.A.
in Liberal Arts, magna cum laude, Clemson University, 1970.
ADDITIONAL
Volunteer
counselor (Okaloosa and Walton Counties)
for S.H.I.N.E. (Serving Health Insurance Needs of Elders),
a Florida Department of Elder Affairs program
Organist for St. Andrew's-by-the-Sea Episcopal
Church, Destin, Florida
Amateur Radio—Technician
Class License (K4SLX)
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Kate Driggers Consulting
