Meet Our Authors & Presentors

RAC University LIVE

eduTrax® continues to create both Live and online courses covering the activities, processes and targets of the many agencies now monitoring and auditing healthcare providers in the US. Our intent is to inform, educate, and whereever possible, create practical solutions for implementing processes or process changes for effective reimbursement optimization.

 

Below are individual biographies of our authors and instructors, who produce these solutions.


Patricia Dear

RN, CCM
President, Chief Executive Officer and Co-Founder
AlphaQuest, LLC and eduTrax, LLC

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About Ms. Dear:

Patricia Dear has more than 30 years experience in the healthcare industry, encompassing a solid understanding of Federal and State (Medicare & Medicaid) regulatory requirements and guidelines affecting many types of providers. Ms. Dear has worked with the Department of Justice in several states providing resource and industry expertise. She was part of the OIG team that investigated allegations against St. Joseph's Hospital of Atlanta, concerning medical necessity and documentation, and was instrumental in achieving a $26 Million settlement. She continues to work with the DOJ, and is a nationally recognized speaker on reimbursement and compliance issues.

Ms. Dear is a Registered Nurse (RN) and a Certified Case Manager (CCM).

Previously, she has held additional certifications for Certified Rehabilitation Registered Nurse (CRRN), and Certified Professional Coder (CPC).

Contact Info:

AlphaQuest, LLC
eduTrax, LLC
PO Box 1938
Ellijay, GA 30540

www.alphaquestllc.com
www.edutrax.net

1.706.635.3559

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Paula Digby

CCS, CPC, CPCI
Senior Vice President, Chief Content Officer and Co-Founder
AlphaQuest, LLC and eduTrax, LLC

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About Ms. Digby:

Paula Digby has been in medical coding and billing, auditing and medical coding education and training for more than 24 years. A founding principal with AlphaQuest and eduTrax®, Paula works with healthcare organizations and physician practices to identify and rectify revenue capture and process issues which have the potential to paralyze the organization. She also directs chart to bill audits on behalf of those organizations. She has broad experience across multi-physician practice specialties in supervision, management, reimbursement and coding. Paula works on various Department of Justice files as an expert coding resource.

Ms. Digby is an AHIMA Certified Coding Specialist (CCS) and through the American Academy of Professional Coders (AAPC) is a Certified Professional Coder (CPC) and a Certified Coding Instructor (CPCI).

Contact Info:

AlphaQuest, LLC
eduTrax, LLC
PO Box 1938
Ellijay, GA 30540

www.alphaquestllc.com
www.edutrax.net

1.706.635.3559

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Stephanie Albright

RHIA, CPC

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About Ms. Albright:

Ms. Albright has been in the healthcare industry for over 20 years with vast experience in coding and billing, and in physician and healthcare staff education and training. Her area of expertise includes ICD-9-CM, CPT-4 and HCPCS coding in a variety of healthcare settings. She serves several long-standing clients through coding, auditing, education, and training. These clients include a nationally recognized healthcare consulting firm and an internationally recognized manufacturer of surgical spinal products and technologies.

Stephanie is member of the American Health Information Management Association (AHIMA); the American Academy of Professional Coders (AAPC); and is a founding member of the Northwest Georgia Chapter of the AAPC. Stephanie graduated from the Medical University of South Carolina in Charleston, S.C. with a Bachelor of Science degree in Health Information Management.


Contact Info:

AlphaQuest, LLC
eduTrax, LLC
PO Box 1938
Ellijay, GA 30540

www.alphaquestllc.com
www.edutrax.net

1.877 338 8729

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Michele P. Madison

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About Ms. Madison :

Michele Person Madison is a Partner in Morris, Manning & Martin, LLP’s Healthcare Practice, where she provides general legal advice to health systems in various regulatory and business matters. Ms. Madison also works with information technology companies and advises clients on compliance with regulations and industry standards. Ms. Madison is highly experienced in managing legal issues arising in hospitals, physician offices or integrated health systems including employment, investigations, risk management assessment and corporation management, and she provides legal education for health systems’ medical staff, management team and employees in these areas. She often facilitates and manages implementation of compliance plans for HIPAA privacy and security regulations, drafts and completes Certificate of Need applications and facilitates regulatory compliance, and provides oversight and guidance regarding medical staff governance and credentialing issues.

Contact Info:

Morris, Manning & Martin, LLP

www.mmmlaw.com

(404) 504- 7621

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Cynthia R. DuPree

CPA, FHFMA, CCS Partner Draffin & Tucker,LLP



About Ms. Dupree:

Cynthia R. DuPree is a Partner with Draffin & Tucker, LLP in Albany, Georgia. She serves as Director of Consulting and Compliance Services for the firm. Prior to joining Draffin & Tucker, Cindy served as Director of Financial Analysis and Vice-President of Budget and Reimbursement for two large hospital systems. She is an active member of the Georgia HFMA, where she has served as a board member, chapter officer and has earned fellowship status. Cindy is a Certified Coding Specialist and is a frequent speaker to health care organizations including HFMA and Hospital Associations, as well as presenting in-house seminars to individual hospitals. She is also a frequent contributor to eduTrax, a web-based health care educational program.

Contact Info:

229-883-7878

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www.draffin-tucker.com

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R. Wes Sternenberg

CPA

Partner Draffin & Tucker, LLP



About Mr Sternenberg :

R. Wes Sternenberg, CPA, is a partner with Draffin & Tucker, LLP. He obtained his Bachelor of Business Administration degree in accounting from the University of Georgia in 1997. In 2008, Wes became Director of the Firm’s Quality Control Department.

Over the eleven years prior to 2008, his professional career was devoted exclusively to the Healthcare Industry. Wes has been directly involved in the full range of accounting, reimbursement and tax services provided to hospitals, nursing homes, and other healthcare facilities.

Currently as the Quality Control Director, Wes assists the firm with accounting and auditing research, attest engagement reviews, peer review compliance, monitoring and evaluating new accounting, auditing and other professional pronouncements, training and development of firm personnel, and establishment and monitoring of the firm’s quality control policies.

Wes is a Certified Public Accountant licensed to practice in the State of Georgia. He is a member of the American Institute of Certified Public Accountants, the Georgia Society of Certified Public Accountants (Secretary of the Albany Chapter) and the Georgia Chapter of the Healthcare Financial Management Association.

Contact Info:

 

229-883-7878

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www.draffin-tucker.com

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Robert S Gold

MD, Co-Founder DCBA, Inc.


About Dr. Gold:

Robert S. Gold is cofounder and CEO for DCBA, Inc., a consulting firm that concentrates on development of Clinical Documentation Improvement (CDI) programs that aid in proper reimbursement for services delivered, accurate morbidity and mortality profiles, support to the medical staff of hospitals and accurate assignment of ICD and DRG code sets.

A physician highly skilled and experienced in quality improvement, utilization, compliance and risk management systems in healthcare, developed in arenas of hospital care, outpatient and primary managed care, locum tenens and home health care, Dr. Gold has been successful in developing quality of care and cost-effective business system changes in dealing with physicians, other providers of health care, administrators and medical support personnel. He is a firm believer in physician to physician interactions, team approach and statistical analysis benefits to problem solving in healthcare as a profession and as a business.

 

Contact Info:

 

1.770.452.1842

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Mary Askew

Charge Description Master and Coding Coordinator

Draffin & Tucker, LLP

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About Ms Askew :

Mary Askew directs all charge description master and medical record reviews for the respected accounting firm of Draffin & Tucker, LLP. She is a certified coder with over 10 years experience in providing healthcare consulting services and 15 years hospital related experience. Mary works directly with Cindy DuPree, a Partner in the firm and frequent contributer to eduTrax.

 

Contact Info:

 

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www.draffin-tucker.com


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Teresa Downie

RN, Utilization Review, Certified Clinical Documentation Specialist, Certified Legal Nurse Consultant

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Teresa Downie:

Teresa Downie has greater than 35 years of experience in the healthcare field, both in inpatient and outpatient settings. As a Registered Nurse, a Certified Clinical Documentation Specialist and a Certified Legal Nurse Consultant, she works with patients, physicians, healthcare facilities, attorneys, insurance companies, and utilization review organizations. As a certified clinical documentation specialist, Ms Downie works efficiently to balance cost effectiveness with accuracy in documentation, resource usage, reimbursement and improved quality patient care.

Ms. Downie's healthcare experience encompasses a solid understanding of Federal and State (Medicare & Medicaid) regulatory requirements and guidelines affecting healthcare beneficiaries, healthcare providers, managed care organizations and physician practices. Her experience has included dealing with an independent review organization for a facility under a corporate integrity agreement. Her clinical experience allows Ms. Downie to accurately blend rules and regulations with treatment plans and documentation which ultimately equals appropriate and optimal reimbursement as well as improved quality of care.

 

Contact Info:

912-246-0165

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