Larry Hegland, MD, MMM

Dr. Larry Hegland is the System Medical Director for Recovery Audit and Appeal Services for Ministry Health Care. He also serves as Chief Medical Officer for Ministry Saint Clare’s Hospital, Ministry Good Samaritan Medical Center and The Diagnostic and Treatment Center in Weston, Wisconsin. Dr. Hegland received his training as an anesthesiologist at Northwestern University and possesses a degree in Medical Management from Carnegie Mellon University. Dr. Hegland is the Treasurer for the American College of Physician Advisors.

High Performing Physician Advisor Program

Alvin Gore, MD, CHCQM

Utilization Management Director, St. Joseph Health, Sonoma Co.

Dr. Alvin Gore is a Director for Utilization Management at two hospitals at St. Joseph Health. While performing all traditional responsibilities of the Physician Advisor, he is also involved with less traditional duties such as cost of care reduction projects, bundle payments, population health, and full-risk cohort management, as well as CDQI (quality) projects. Dr. Gore is the Vice President of Operations for the American College of Physician Advisors.

Medicare Basics

Steve Meyerson, MD

Dr. Steven J. Meyerson is a nationally recognized expert in care management and physician advisor education. He is an internist and geriatrician by training. He has served as medical director of care management at Baptist Hospital in Miami, FL, as well as SVP of education and regulations at R1 (formerly Accretive) Physician Advisory Services. He currently heads SJM Consulting, a Medicare compliance consulting firm. For his distinguished service to physician advisors for many years, he received the inaugural ACPA Lifetime Achievement Award in 2015. He currently lives with his wife in Asheville, NC.

Medicare IM, HINN, DND Notifications

Medicare ABN, MOON Notifications

Denise Wilson, MS, RN, RRT

SENIOR VICE PRESIDENT, DENIAL RESEARCH GROUP/APPEALMASTERS

Denise Wilson is a Registered Respiratory Therapist, Registered Nurse, and has a Master’s degree in Information Systems from the University of Illinois, Springfield. Ms. Wilson has over 30 years' experience in healthcare, including clinical management, education, compliance, and appeal writing. She has extensive experience as an appeals expert and has managed thousands of appeal cases and presented hundreds of cases at the Administrative Law Judge level. As a nationally known speaker and educator on denial and appeals processes, payer behaviors, and standards of care, she has educated thousands of healthcare professionals around the country in successfully overturning medical care denials. Ms. Wilson is a member of the American College of Physician Advisors Advisory Board.

Commercial Appeals

Denise Goodman

Attending Physician, Division of Critical Care Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago

Professor, Northwestern University Feinberg School of Medicine

Medical Director, Case Management and Care Coordination (Physician Advisor), Ann & Robert H. Lurie Children’s Hospital of Chicago

Dr. Denise Goodman attended medical school at State University of New York at Buffalo, completed a pediatrics residency at Cincinnati Children’s Hospital Medical School, and then a pediatric critical care medicine fellowship at Pittsburgh Children’s Hospital.  Her first faculty position was at the University of Minnesota before moving to Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago (formerly Children’s Memorial Hospital).She is a Professor of Pediatrics, has been a practicing pediatric intensivist for over 25 years, and is medical director of a large invasive home ventilation program. She has enjoyed the classic academic life of clinical care, teaching, and research and has also served on the pediatric critical care medicine Subboard of the American Board of Pediatrics and is an Associate Editor at the Journal of Pediatrics. As Medical Director of Case Management and Care Coordination at Lurie Children’s she is responsible for denials management, utilization management, and physician education on a number of topics. In addition, she has led or participated in numerous special projects at the intersection of clinical care and the revenue cycle, including readmission reduction, prior authorization, out-of-network processes, and length of stay management. Awards include selection to “Best Doctors in America” and election as a Fellow of the American College of Critical Care Medicine. Dr. Goodman is the Chair of the American College of Physician Advisors Pediatric Physician Advisor Committee.

Pediatric Physician Advisors

Erica Remer, MD, FACEP, CCDS

PRESIDENT, ERICA REMER, MD, INC.

Dr. Erica Remer practiced as an emergency physician for 25 years and has extensive coding, CDI, and ICD-10 expertise. She was a Physician Advisor of a large multi-hospital system for four years before transitioning to independent consulting in July 2016. Her passion is educating CDI specialists, coders, and healthcare providers with engaging, case-based presentations on documentation, CDI, ICD-10, and denials management. She has written numerous articles and serves as the co-host of Talk Ten Tuesdays, a weekly national podcast. Dr. Remer is on the Association of Clinical Documentation Integrity Specialists (ACDIS) Advisory Board, the Board of Directors for the American College of Physician Advisors (ACPA), and she is Co-Chair for the ACPA Clinical Documentation Integrity Committee.

Sepsis