Consultants

Below are the profiles of each member of our consultant team. Please feel free to contact us to speak to them.

Ronald K. Rybar, FHFMA, CMPA

As the founder and President of The Rybar Group, Ron offers nearly thirty (30) years of experience in healthcare financial management to our clients. Ron began his career working in the Finance department of various Michigan hospitals, before becoming a consultant with a national public accounting firm, focusing on healthcare clients. He formed The Rybar Group in 1989 with the mission to provide quality service to healthcare management, while assisting them in maintaining financial viability through compliant, efficient business operations. he has spent the past twenty-one (21) years leading The Rybar Group in becoming a nationally recognized premier healthcare consulting firm.

Over the years, Ron has worked with providers nationwide on engagements related to data integrity and compliance with federal and third-party payor regulations. He has provided litigation support for a variety of providers and provided testimony in Federal District Court as an expert witness. He has successfully negotiated with Medicare and Blue Cross Blue Shield on hearings, completed numerous Sole Community and Medicare Dependent Hospital Low Volume Adjustment exception requests, negotiated PPO and managed care arrangements on behalf of hospitals, and negotiated in joint-venture situations.

Additional achievements and activities include numerous Interim Chief Financial Officer engagements, cost report preparation, reimbursement and revenue estimating studies for hospitals, home health agencies, hospices and SNF's, and the completion of numerous strategic pricing analysis and feasibility studies for health-related facilities. He has assisted in corporate reorganization, establishment and set-up of new corporate entities, and provided financial training for corporate board members, as well as for associations such as the Healthcare Financial Management Association (HFMA).

In addition to his activities, Ron is an active member of the Great Lakes Chapter of HFMA. He has held numerous positions within the association, including President. He has served in National HFMA positions including Chapter Liaison Representative and on the National Advisory Committee (NAC). He currently serves on the Small and Rural Hospital Council for the Michigan Health and Hospital Association.

Ron received his Masters in Business Administration from the University of Detroit, and a Bachelor of Arts degree in Economics and Political Science from Kalamazoo College.

Pamela M. Sanborn

Pam oversees the Provider Reimbursement Analytics, the Rural Health/Critical Access Hospital Division and the Blue Cross Division of The Rybar Group, Inc. Through this role, she has developed multiple long-term relationships with clients, providing superior communication and expertise on reimbursement and regulatory issues.

During her twenty (20) years of healthcare financial management experience, Pam has worked in the finance area of various large Michigan hospitals, as well as with a multi-practice physician group. During this time, she focused heavily on facility reimbursement, cost report preparation, audits, and special analytical projects.

Pam's expertise includes cost report preparation and review, third-party audits, appeals, preparations of reports and special payment requests, and preparation of financial statement audit workpapers. Her background includes preparing annual operating and capital equipment budgets, monthly financial statements, variance analysis, and Managed Care risk contracting. She has successfully completed mediation of numerous PRRB cases. Pam's focus is to assist our clients in ensuring that they are optimizing their reimbursement opportunities.

Over the years, Pam has developed an expertise in the Rural Health/Critical Access arena. She has assisted multiple facilities with feasibility studies, the application process, understanding and acquiring a Certification of Need, as well as working with the clients through the actual conversion process. She works with these facilities to ensure that they are optimizing their reimbursement and that they are taking advantage of the numerous opportunities their special designation offers. She has assisted numerous clients with Rural Health Clinic and Provider Based conversions and analyses. Pam has served as an Interim Chief Financial Officer for a Michigan Critical Access Hospital.

Pam specializes in Blue Cross revenue cycle related issues. She has worked with numerous clients on Blue Cross PHA and Peer 5 Model analysis and negotiations, as well as special audit work and appeals.

In addition to her client activities, Pam is an active member of the Great Lakes Chapter of the Healthcare Financial Management Association (HFMA). She is currently serving as the chapter Program Committee Chairperson and has served as chapter Secretary in the past. She will serve as the Chapter's President-Elect as of May 2010. Pam actively presents on various reimbursement related topics to the members of HFMA, as well as other healthcare associations.

Pam is a graduate of Bob Jones University, with a Bachelor of Science degree in Financial Management. She entered the profession in 1990.

Michele Causley, MBA

Michele has over twenty-four (24) years of business operations and financial management experience. Having worked in a variety of industries, she has accumulated a broad range of management experience. Michele oversees our Low Volume Adjustment division.

Michele's areas of expertise include the completion of numerous Sole Community and Medicare Dependent Hospital Low Volume Adjustment requests. She works with Providers and Medicare Audit Contractors nationwide assessing eligibility and obtaining substantial additional Medicare reimbursement for facilities that meet the regulatory guidelines.

In addition, Michele has assisted clients with interim cost report preparation; third party audits, appeals and reopens; cost report structure reviews and recommendations in order to optimize all reimbursement opportunities; Occupational Mix Survey completion; financial analysis; and forecasting and financial impact studies.

Michele holds a Masters of Business Administration degree from Loyola Marymount University and is a current member of the Great Lakes Chapter of Healthcare Financial Management Association, serving on their program Committee.

James L. Hedges, CPA, CIAP-T, MSCIS

James has over nineteen (19) years of financial healthcare experience and holds a Masters of Science Degree from the University of Detroit Mercy. He has extensive knowledge of payor reimbursement systems, including Blue Cross Blue Shield of Michigan.

Jim is recognized as an expert in the Michigan hospital reimbursement community on Blue Cross front sheets, the underlying claims data, and how they are reimbursed through the settlement process. He has performed cost report audits for hospitals of various sizes, including multiple hospital health systems, as well as conducted multiple Contract Payment Management Reviews. Jim focuses on the technical aspects of the Blue Cross Model identifying opportunities for facilities. Jim specializes in claims related Blue Cross audits working with facilities to ensure correct payments.

In addition, Jim has worked to ensure that projects such as e-Processing, e-Registration, and e-Enrollment complied with applicable laws such as HIPAA Privacy and Security, Medicare, and other regulations. He has analyzed claims data for data integrity issues and compliance with payor regulations to ensure proper reimbursement, has used data mining to validate and test third-party settlements to ensure compliance to contract, and works to identify opportunities to recover lost revenue for providers through the use of 835 tables.

Jim is a Certified Information Assurance Professional with Trainer endorsement through the National Security Review Board. He has served as a university instructor, teaching graduate and undergraduate level courses. Jim is a member of the Healthcare Financial Management Association.

Dawne Beckley, RHIT, CPC

Dawne brings over eighteen (18) years of coding, billing, auditing, and supervisory experience to The Rybar Group. She offers an extensive knowledge in professional and facility coding, billing, and reimbursement methodologies. Dawne focuses on working with clients to achieve optimal reimbursement for the services provided while remaining compliant with Federal and third-party payor regulations.

Dawne works with clients on the various components of the charge master process, including multiple Chargemaster process and quality assurance reviews for hospitals and physicians clinics, and assessments of remittance advices for opportunities. Her specialty focus areas include Ambulatory Surgery, Emergency Department, Observation, Pharmacy and Outpatient Rehabilitation. She works with clients to implement solutions and to understand the financial impact of these changes on their organization. Included in this activity is assisting with CDM team development and providing education to both physicians and professional staff members.

In addition, Dawne has extensive experience with Evaluation and Management (E/M) guidelines and physician service reviews across multiple specialties. She has performed numerous compliance audits for practices, as well as provided Physician E/M Documentation, Coding, and Billing education to providers and physicians.

Dawne hold certifications as a Registered Health Information Technician, a Certified Professional Coder, a Medical Insurance Specialist, and is certified ICD-10-CM/PCS Trainer. She is an active member of the Michigan Health Information Management Association (MHIMA), American Academy of Professional Coders (AAPC), and is a past president / current board member of the Mid-Michigan Health Information Management Association (MMHIMA). She is an Adjunct Faculty Member for a local university, teaching coding classes for their Health Information Technology program.

Jeffery S. Nagy

During his past ten (10) years of experience in healthcare financial management, Jeff has worked in the finance area of various public accounting and audit firms as well as within a healthcare provider network. He specializes in working with Critical Access Hospitals, Rural Health Clinics and Psychiatric Hospitals.

Jeff's experience includes the performance of Chief Financial Officer functions, including oversight of purchasing, billing, payroll and the accounting staff, and work in both the financial and operational areas for the non-profit industry, providing recommendations and having decision-making responsibilities. He has participated in the start -up of a provider network; activities included the set-up of the network billing systems, organizational chart development, strategic goal planning, and other development planning, and prepared financial and operational budgets and monthly financial statements.

More recently, Jeff's accomplishments include cost report preparation and review, third-party audits and appeals and preparation of reports and special payment requests filed with third-party payors. He has prepared monthly financial statements and audit workpapers, general ledger account reconciliations, and variance analysis, participated in special projects, involving due diligence work such as mergers and acquisitions. Jeff has successfully completed mediation on numerous PRRB cases.

As a consultant in our Rural Health/Critical Access Division, Jeff has worked with numerous clients on Rural health Clinic analysis and conversions and Provider Based status. He works with these facilities to ensure that they are optimizing the opportunities their special designation offers.

Jeff graduated from the University of Michigan, School of Management, with a Bachelor of Business Administration. He is a current member of Great Lakes Chapter of the Healthcare Financial Management Association.

John Rynearson

John has over five (5) years of experience working in financial positions across multiple markets, including healthcare. He received his Masters in Business Administration from the University of Michigan and is Six Sigma Green Belt certified.

John currently serves as a consultant on our Low Volume Adjustment (LVA) team, working with hospitals nationwide to take advantage of this reimbursement opportunity. He has participated in the completion of numerous LVA requests for Sole Community and Medicare Dependent Hospitals. John also assists clients with third-party appeals, and cost report structure reviews to ensure all reimbursement opportunities are optimized.

John's previous experience includes providing analytical support to the Strategic Planning Division of a major regional medical center including market and financial analysis, business plan support and pro forma financial statement preparation. His work with two leading global automotive suppliers included accounts receivable management and cash forecasting; multiple financial analysis projects; and preparation of executive management level reports for review and presentation purposes.

John is a current member of the Great Lakes Chapter of the Healthcare Financial Management Association, serving on their Sponsorship Committee.

Keith Poniers

Keith has over fifteen years of financial and accounting experience. During this time, he has developed an expertise in all facets of accounting, including corporate budgeting, negotiations with financial institutions, accounts receivable and account payable functions.

Keith's experience includes oversight of all financial aspects of a rapidly growing manufacturing corporation; responsibility for financial control and reporting, financial analysis, forecasting, cash flow, and annual and long-range planning. He prepared and analyzed monthly journal entries, financial statements, and financial ratios, and performed assessment on capital expenditures.

More recently, Keith's accomplishments include cost report preparation and review, department feasibility studies, financial analysis, third-party audits, appeals and preparations of reports and special payment requests filed with third-party payors. He works with providers nationwide on reimbursement and regulatory related issues.

As a consultant in our Blue Cross Division, Keith focuses on identifying improved reimbursement opportunities for our clients. He has performed multiple Blue Cross Blue Shield reimbursement analyses and model reviews.

Keith received his Bachelor of Science degree in Business Administration from Indiana University, majoring in Accounting. He is a member of the Eastern Michigan Chapter of the Healthcare Financial Management Association.

Gregory L. Murray, MBA

Greg has over 25 years of experience as a healthcare financial management professional working in various large Michigan hospitals. He offers our clients innovative problem solving capabilities and the ability to link business strategies to successful outcomes. Greg's competencies include Third-Party Reimbursement, Corporate Compliance, Strategic Planning, Financial Analysis, Budgeting, nonprofit tax knowledge and Decision Support.

Greg has served as the Director of Financial Planning for a large multi-hospital healthcare system with responsibilities for reimbursement, operating and capital budgeting and financial analysis. As a Financial Consultant for a joint venture Radiation Oncology Center, his involvement included start-up, obtaining bond financing, and managing financial operations. In addition, he served as a financial consultant for a successful low income health plan, developing financial systems and acting as the Chief Financial Officer.

Over the years, Greg has managed and directed the financial operations from both the Home Health & Hospice and Durable Medical Equipment companies within a large healthcare system with responsibilities for revenue cycle, cost reports, budgeting, analysis and compliance. He developed, implemented and directed a system-wide corporate compliance program for a larger healthcare system, including multiple joint ventures. This included, developing and implementing compliance policies, HIPAA privacy regulations and EMTALA, reviewing physician contracts for compliance reports for the Board and Corporate Office. Greg was financially involved in the merger and closing of four hospitals, the opening of a new medical center and the formation of a new healthcare system. He has worked to ensure heealthcare system compliance with IRS regulations and corporate taxes (corporate IRS returns) for a large healthcare system, involved with both FASB 109 and FIN 48 projects.

Greg's focus is in the Medicaid arena, reviewing Medicaid Disproportionate Share Hospital pools, and cost reports, working with facilities to optimize reimbursement. His expertise will assist facilities in relation to payor contractual calculations.

Greg is currently a member of the Health Financial Management Association (HFMA) and the Health Care Compliance Association. He is a former recipient of the Follmer & Reeves Award from HFMA.