Annette has over 25 years experience in the insurance and managed healthcare industry. She has a diverse and balanced background on both the payer and provider side. This experience enables her to be fair and neutral because she understands the needs of each party.
On the payer side:
Annette started her career in claims and provider relations for a major payer. As PPO's and HMO's gained popularity, she advanced into local IPA's and Medical Groups negotiating capitation arrangements and developing billing software. She expanded her knowledge base further as a Workers Compensation Claims Administrator. She is an IEA Certified Workers Compensation Claims Professional and passed the State of California self-insured certification exam.
Annette served over 10 years as a Senior Contract Manager for Anthem Blue Cross. She was responsible for Ambulatory Surgery Center, physician and imaging center contracting. She was deemed a "subject matter expert" focusing on cost of care initiatives, bundled payments, total joint and spine programs, implant reimbursement, out of network fee schedules and process improvements.
On the provider side:
Annette held positions in risk management at Dignity Health setting up files for potential malpractice litigation. She spent 5 years at Sutter Health as a Claims Administrator and later in sales and marketing for their Occupational Health Clinics developing their MPN. She was the Director of Contracting for an Occupational Medicine Facility and established guidelines to streamline billing and collections. She has worked with physicians and office administrators to develop protocols for DOT physicals, pre-employment exams, drug screenings and ergonomic evaluations.
Annette is a member and strong supporter of the California Ambulatory Surgery Association (CASA) and has spoken on panels many times over the years. She is an advocate for affordable healthcare and fair reimbursement.
Mike is a retired officer from the US Air Force after 26 years of honorable service. He served both as enlisted and officer during his distinguished career, retiring at the rank of Major. His primary career field was aircraft maintenance, but also performed duties in Quality Assurance, Inspection Compliance, Aircraft Accident Investigation, Logistics, Training, Safety, and a US Air Force Academy/ROTC recruiter.
Mike is the lead person for the application and credentialing processes. He will be the main focal point for clients, gathering and populating the forms needed for a quick and successful acceptance. With only a few months in the credentialing business, he was already recognized by the payors for providing clear and concise documentation, making their job of approval easy. Mike is also developing a matrix to help ensure clients stay current on all licensure and certifications to remain in good standing with payors.