Brian R Boyce, MHA, BSHS, CPC, CRC, CPC-I
Medical Coding, Business Operations
Risk Adjustment, HCC, Part C, Part D, RADV, HRADV, Medicare Advantage, ACA, Affordable Care Act, Medicare fraud, medical record review, clinical bioethics, medical management, compliance, clinical documentation, clinical informatics, coding audit, medical billing, ICD-9, ICD-10, OIG audits
Clinician, Author, Speaker, Educator, USAF veteran.
Author of the CRC (certified risk adjustment coder) credential curriculum - offered nationally by the AAPC.
National Risk Adjustment expertise working with Medicare, Medicaid, and the Affordable Care Act (ACA) models nationally.
Support for health plans, ACO's, and physicians in numerous medical coding and documentation audits.
Experience working on national cases before the OIG and DOJ.
National independent validation auditor (IVA) for many health plans for government regulatory audits for Medicare Advantage Risk Adjustment Data Validation (RADV) , and the ACA (HRADV).
Experience in HEDIS and other quality measure programs.
Experience in CLIA and OSHA in healthcare settings- especially CLIA-waived testing performed in outpatient settings.
Trained in Total Quality Management (USAF) and Six Sigma (Juran Institute).
Former ethics participant on internal review board (IRB) for local hospital system.
Experience managing p...