"Just because you can, doesn’t mean that you should." - Ian Malcolm, PhD
Rick has over thirty years of expertise in the healthcare finance and reimbursement service areas. He has worked in a variety of roles in hospital finance departments, including ten years as a CFO for Acute Care and Rural hospitals. Additionally, he has consulted for multiple national healthcare consulting firms and worked for a healthcare payor. Rick prides himself on providing the high level of service that is synonymous with The Rybar Group.
Experience:
Strong understanding of both present and future reimbursement and payment issues and strategies to ensure providers are optimizing their opportunities
In-depth knowledge of accounting, budgeting, reimbursement and revenue cycle functions, including Medicare and Medicaid Cost Reporting, Third-Party Reimbursement, Contractual Modeling, Corporate Compliance, Strategic Planning, Financial Analysis, Budgeting, Decision Support and Payor Reimbursement Systems
Specialization in ensuring rural health providers are optimizing their opportunities and that they qualify for all potential Medicare and Medicaid reimbursement
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Former Chapter President, Western Chapter of the Healthcare Financial Management Association (HFMA)
Former Board Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Member, Michigan Association of Certified Public Accountants (MICPA)
Julie Hardy, MSA, CRCE, RHIA, CCS, CCS-P
"What other people think of you is none of your business."
Julie draws upon her extensive experience acquired while working in executive-level positions at academic medical centers, integrated health systems, children’s hospitals, and hospital-owned medical groups.
With a focus in revenue cycle management including coding, billing, compliance, reimbursement, and vendor management, Julie has helped to enhance provider financial performance, resulting in improved reimbursement and increased physician compensation while maintaining compliant practices. She has a special interest in process improvement, project management, and operational optimization, regularly providing guidance as to best practices and methods that support processes leading to optimal revenue.
Experience:
Identification of revenue opportunities through improved revenue cycle processes and the optimization of physician contracts
Assistance throughout third-party audits to ensure providers have the resources needed to support documentation, coding and billing.
Expert testimony on behalf of physicians related to coding and compliance matters
Associations:
Member, Medical Group Management Association (MGMA)
Business Committee Chair, Michigan Medical Group Management Association (MiMGMA)
Member, American Health Information Management Association (AHIMA)
Member, American Academy of Professional Coders (AAPC)
Member, American Association of Healthcare Administrative Management (AAHAM)
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Jesse C. Parker, CPA
"Listen with curiosity. Speak with honesty. Act with integrity."
Jesse offers extensive healthcare regulatory reimbursement and payment experience. Through his work for one of the Medicare Administrative Contractors (MAC), Jesse offers experience with financial and governmental reimbursement audits for healthcare organizations and government entities.
Utilizing his first-hand experience within the MAC, Jesse provides our clients with a current understanding as to what the auditors are requesting and how providers can work to optimize their reimbursement while meeting the regulatory requirements. He is instrumental in assisting our clients in identifying revenue opportunities through analysis of their cost reports and the application of regulatory opportunities.
Experience:
Healthcare regulatory reimbursement and payment experience
Analysis of cost report structures, statistical allocations, and data to ensure proper reimbursement for facilities in multiple states
Medicare and Medicaid cost report regulatory requirements and optimization
Associations:
Member, Florida Association of Certified Public Accountants (FICPA)
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
"The secret of getting ahead is getting started." - Mark Twain
Steve has assisted numerous rural hospitals in ensuring that they benefited from the special reimbursement opportunities available through their designation. His innovative problem-solving capabilities and the ability to link business strategies to successful outcomes is invaluable as he supports clients through the appeal process. He has been deeply involved in several cost report preparations and optimization engagements and has analyzed cost report structures, statistical allocations, and data to ensure proper reimbursement for facilities in multiple states. Steve holds expertise in all facets of accounting, including corporate budgeting, financial reconciliations, and financial reporting. His experience includes multiple years as a Corporate Controller for a national business strategy organization.
Perform system-wide analysis of the potential impact of payer policy changes
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Claudine Hildreth
"You'll laugh about it one day, so why not laugh now?"
As a seasoned Client Relationship Professional, Claudine works as the business liaison of the organization, focusing on the success, satisfaction, and growth of our clients. She has developed an in-depth knowledge of the healthcare industry, having worked in various operational and administrative roles within the hospital, clinical office, pharmaceutical distribution, and consulting settings. Over the years, Claudine has helped shape the strategic direction of a number of organizations, working with several non-profits and for-profits through restructuring and change, developing strategies to ensure stability while creating a new framework and plan for growth. She has proven experience in directing business efforts, working to align resources and services to meet the needs of organizations and lay the groundwork for future growth and stability.
Experience:
Development of mutual beneficial strategic relationships
Contract analysis and negotiations
Strategic direction and organizational alignment through restructure and growth
Marketing and promotion of services
Associations:
Member of the Board of Directors for numerous non-profit organizations
Caren is passionate about serving rural health providers. Having spent her career working with Critical Access Hospital (CAH) and other Rural Hospitals, she offers strong financial, accounting, revenue cycle, and reimbursement experience. Her prior provider experience and hands-on knowledge of the issues impacting rural hospitals allows her to identify both present and future reimbursement and payment opportunities.
Areas of focus have included financial, reimbursement, cash flow analysis, pro-forma scenarios, accounting, general ledger, financial statements, contractual allowance, contract management and negotiations, operational efficiency, and revenue cycle analysis.
Experience:
Financial and accounting expertise from Critical Access Hospitals (CAHs) and Rural Hospitals
Ensures that rural health providers optimize their payments under their designations
Assisted several health systems to implement strategies for optimizing the opportunities of their rural hospitals
Worked in a variety of roles in the finance departments of CAHs, including multiple years as a Chief Financial Officer
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Timothy M. Jodway, CPA, COC
"There are three sides to every story…mine, theirs, and the truth."
Having worked with national healthcare consulting firms and in a variety of roles in the finance departments of hospitals and health systems, including multiple years as a Chief Financial Officer, Tim provides a range of strategic initiatives centered on the complexities of reimbursement and the use of the cost report for optimizing reimbursement.
Tim offers a hands-on knowledge of the issues impacting providers allows him to identify both present and future reimbursement and payment opportunities. This includes an in-depth knowledge of accounting, budgeting, reimbursement, contract negotiation and revenue cycle functions, including Medicare and Medicaid Cost Reporting, Third-Party Reimbursement, Contractual Modeling, Corporate Compliance, Strategic Planning, Financial Analysis, Budgeting, Decision Support and Payor Reimbursement Systems.
Experience:
Assisted several hospitals on turnaround related activities, resulting in significant system changes and improvements
Redesign initiatives for both financial and revenue cycle related functions, resulting in improved revenue, processes and outcomes
Active role from both the buyer and seller side in hospital and health system pre-acquisition due diligence as well as work implementing changes post acquisition
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Member, American Academy of Professional Coders (AAPC)
Clair Kelley, CPC, CPMA, COBGC, RH-CBS
"No act of kindness, no matter how small, is ever wasted." - Aesop
Clair offers a range of expertise in the area of professional service coding, auditing, and education. Over the years, she has worked in several settings, and her experience includes working with a robust residency program and a multitude of specialties, including internal medicine, family medicine, maternal fetal medicine, obstetrics and gynecology, and psychiatry. Clair’s experience with the various aspects of professional coding allows her to assist clients in developing solutions that yield measurable results. Through her activities she has developed an extensive knowledge of coding, offering a valuable balance of revenue and compliance expertise.
Experience:
Documentation compliance optimization
Identification of missed charges and coding opportunities
Assist with the completion of payer audit-based corrective action plans
Associations:
Member, American Academy of Professional Coders (AAPC)
Member, National Alliance of Medical Auditing Specialists (NAMAS)
"I am a very strong believer in listening and learning from others." - Ruth Bader Ginsburg
Sue offers a range of expertise in the area of professional service coding, billing, auditing, and education. Her extensive knowledge of the coding and billing process offers a valuable balance of revenue and compliance expertise, including hands-on experience with billing operations and denial management. She has a special strength in pediatrics, surgery and obstetric-related specialties including general OB, maternal fetal medicine, urogynecology and gynecologic oncology.
Experience:
Professional service coding, billing, auditing, and education
Identification of missed revenue opportunities
Completion of audits of professional documentation
Educate on regulatory requirements
Associations:
Member, American Academy of Professional Coders (AAPC)
Member, National Alliance of Medical Auditing Specialists (NAMAS)
Hope Bonnetti
"People who are truly strong lift others up. People who are truly powerful bring others together." - Michelle Obama
As a member of our Revenue Cycle team, Hope brings extensive expertise in professional service coding, auditing, and education to the clients of The Rybar Group. With over a decade of experience with a large healthcare system, she focuses on maintaining quality, ensuring compliance, and facilitating appropriate reimbursement for providers.
Hope has worked across various domains of professional coding and compliance, gaining a deep understanding of the intricacies involved. Her experience encompasses a wide range of specialties, enabling her to provide valuable insights and solutions tailored to specific medical disciplines. When working on projects, Hope applies a critical eye, diligently examining the details, identifying any discrepancies, potential risks, or areas that require improvement. Her approach helps ensure accuracy, compliance, and optimal financial outcomes for clients.
Experience:
Development and implementation of system-wide annual coding updates and guidance
Experience with multiple provider types and services, including, physicians, advanced practice providers, and other qualified non-physician practitioners
Extensive knowledge of professional billing methodologies
Collaborate with compliance, billing, and administrative leaders to achieve common goals
James L. Hedges, CPA, CHDA, CIAP-T, MSCIS
"What goes around comes around."
Jim’s extensive knowledge of the third-party payor reimbursement systems is continually in high demand. He is recognized as an expert in the hospital reimbursement community on Blue Cross Blue Shield of Michigan, the underlying claims data, and how it impacts payment and the reimbursement process. With a focus on the technical aspects of commercial payer reimbursement, Jim works to position clients to identify both present and future opportunities.
Experience:
Expert hospital reimbursement consultant on Blue Cross Blue Shield of Michigan
Third-party payor reimbursement systems
Identification and resolution of underpaid claims
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Member, American Health Information Management Association (AHIMA)
"Believe you can and you're halfway there." - Theodore Roosevelt
Jessica is an instrumental member of our Volume Decrease Adjustment team. With extensive expertise in healthcare regulatory reimbursement, she has played a significant role in assisting rural hospitals and health systems to benefit from special reimbursement opportunities linked to their hospital designation.
Over the past several years, Jessica has contributed to numerous successful Volume Decrease Adjustment requests for Sole Community and Medicare Dependent Hospitals. Her efforts extended to assistance with Provider Reimbursement Review Board (PRRB) hearings, as well as with the analysis and conversions for Rural Health Clinics and hospital departments seeking Provider-Based status. Jessica is dedicated to continuously identifying improved reimbursement opportunities for our clients.
Before joining The Rybar Group, Jessica worked as a litigation paralegal, a background that has proven invaluable in navigating complex regulatory documents and ensuring precise documentation for appeals. Her paralegal experience has equipped her with the skills to meticulously handle the regulatory processes and support our clients in achieving optimal reimbursement outcomes.
Experience:
Healthcare regulatory reimbursement
Terri Kalinski
"With the new day comes new strength and new thoughts." - Eleanor Roosevelt
With over thirty-five years of experience, Terri offers extensive experience in the areas of healthcare finance, reimbursement and revenue cycle. Her work in the finance and revenue cycle departments of hospitals provides her with a clear understanding of system integration and its effect on clinical and financial outcomes.
She has served as the liaison between executives, clinical managers and staff to understand the impact of clinical processes on the revenue cycle. With a strong understanding of the front-, middle- and back-end of the revenue process, Terri uses a teamwork approach to implement solutions to improve overall workflow processes.
Terri’s systematic approach to reviewing hospital revenue cycle process, results in efficiency and financial gain.
Experience:
Evaluate and implement improvements to the revenue cycle by optimizing available software
Improved efficiency and financial outcomes
Implementation of Cerner Soarian EMR and Patient Accounting
Implementation of a clinical documentation improvement program to decrease inpatient denials and identify the appropriate level of care
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Deb Kenney, CPC, CPMA, CRC, CPEDC
"Improvise, adapt and overcome" - U.S. Marine Corp
Deb’s experience in revenue cycle management, coding, billing, compliance and auditing allows her to assist clients in implementing sustainable solutions related to optimizing revenue and workflows, establishing and maintaining reporting methodologies and ensuring compliance. She has worked at numerous medical centers, physician groups, hospitals and national healthcare consulting firms, including work as the Director of Revenue Management for a multi-location Federally Qualified Health Center that provided primary care and Integrated Behavioral Health services.
As a consultant, Deb has assisted several multi-specialty practices and hospital-based physician groups in an array of payer reimbursement-related needs. Through her activities she has developed expertise in risk and compliance, medical records management, multi-specialty physician coding, chart auditing, medical billing and payer contracting.
Experience:
Developed expertise in risk and compliance, medical records management, multi-specialty physician coding, chart auditing, medical billing and payer contracting.
Assessment of revenue cycle activities, developing and implementing workflow and process improvements
Associations:
Member, American Academy of Professional Coders (AAPC)
Member, National Alliance of Medical Auditing Specialists (NAMAS)
"You are never too old to set another goal or to dream a new dream." - C.S. Lewis
Sarah holds expertise in various facets of accounting, finance, and revenue cycle. This includes work as a Revenue Cycle Specialist for a rural referral center and teaching hospital and as a Financial Analyst as part of a health system. Over the years, Sarah has provided analytical support for process improvement initiatives, as well as assisted with the annual budget, monthly close processes, and bank and G/L general ledger reconciliation.
Currently, Sarah works with a variety of providers, assisting them in optimizing their reimbursement opportunities. Her focus includes work with contractual reviews, preparation of various cost reports, cost report strategies and governmental and third-party appeals and reopens.
Experience:
Analytical support for process improvement initiatives
Preparation of Medicare cost reports for critical care hospitals and rural health clinics
Appeals and re-opens to obtain optimal reimbursement
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
Tammy Raab
"To acquire knowledge, one must study; but to acquire wisdom, one must observe." - Marilyn vos Savant
With over a decade of experience in healthcare reimbursement, Tammy offers a wealth of expertise to our clients. Her background spans across both public, non-profit medical centers and national healthcare consulting firms, where she has honed her skills in reimbursement, financial analysis, and data analysis. Her specialty lies in Medicare and Medicaid cost reporting. Tammy has a proven track record of collaborating with hospitals of various designations to help them optimize their reimbursement potential.
Currently, Tammy serves as a Reimbursement Consultant, extending her support to a wide range of healthcare providers, including hospitals of various designations, Skilled Nursing Facilities, Federally Qualified Health Centers, and Rural Health providers. Her mission remains unchanged: assisting providers in achieving optimal reimbursement outcomes. She continues to work on contractual reviews, the preparation of various cost reports, cost report strategies, and navigating the complex landscape of governmental and third-party appeals and reopens.
Experience:
Contractual reviews
Strategies for optimizing revenue with Blue Cross Blue Shield
Various Medicare-related appeal opportunities
Navigating governmental and third-party appeals and reopens
Associations:
Member, Michigan Great Lakes Chapter of the Healthcare Financial Management Association (HFMA)
