Ratan Consultants We provide comprehensive solutions for all major aspects of the Healthcare Management Consulting Industry
Contract Negotiation
Medical Coding Review
Claims Design and Auditing
Network Management
Operational Guidance
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Kavita Ratan
Kavita Ratan has over 25 years of experience in the healthcare industry including more than 12 years as a healthcare consultant. She specializes in managed care negotiations, medical coding review, financial modeling, pricing analysis, managed care operations, payer relations, claims management and auditing. She has worked with consulting firms, independent physician associations (IPAs), management services organizations (MSOs), and hospitals.
Professional Experience
• More than 12 years as an Independent Consultant specializing in managed care negotiations, claims auditing, medical coding analysis, financial modeling, pricing analysis, hospital revenue cycle management and health care legislation/policy research.
• 3 years in hospital managed care specializing in negotiations, revenue cycle management, service line and program assessment.
• 12 years in leadership roles in independent physician associations (IPAs) and management services organizations (MSOs) specializing in claims management, member and provider services, system configuration and IPA management.
Project Experience
• Managed care contract negotiator representing physician groups, hospitals, ancillary providers including home health, telehealth, behavioral health, skilled nursing facilities, hospice, incontinence product suppliers, payors and UM vendors
• Medical coding review and negotiations with payors/providers related to ICD10-CM, ICD10-PCS, CPT, HCPCS, MS-DRG & APC
• Payor liaison to facilitate operational and revenue cycle management
• Legislative research resource for issues that impact health care policy, coding and reimbursement
• Claims and contracting business process reengineering
• Extensive claims auditing projects and protocol development – Medicare, Medicaid & Commercial membership
• Network build for Government Payors in California
Education
• Bachelor of Science in Business Administration, University of California, Riverside
• Master of Health Administration, University of Southern California
• Certification in Hospital-Based Coding, Phoenix College
• Certificate and Healthcare Compliance (CHC)
• Course Work in Population Health
Professional Organizations
• American College of HealthCare Executives (ACHE)
• American Health Information Management Association (AHIMA)
• Healthcare Compliance Association (HCCA)
Certifications
• Certified Coding Specialist (CCS) - AHIMA