Matthew S. Tolf, Retired

STRATEGIZING HEALTHCARE LANDSCAPES: I am a results-driven, Certified Professional and DOI Licensee with 25+ years of key industry experience. My expertise lies in Managed Care Contracting & Reimbursement Analytics. The healthcare landscape continues to undergo profound change impacting provider, payor and patient. Payors and providers have historically been in an adversarial relationship. My objective has been to bring them together. Having worked on both teams; my insight helped providers navigate a complex reimbursement landscape and avoid costly pitfalls. For insurance payors; I held leadership roles in provider relations and network management as the primary liaison for managing provider relationships. For providers; understanding post-payment claim audits, including coding validation can be tricky and requires diligence. Together, we've disputed these audits and even reviewed internal processes to help reduce them. They are now integral to your denial management workflow. At the end of the day; we optimized cash flow, reduced days in AR, prioritized denials and achieved a higher clean claim rate. In some cases, a complete front desk overhaul was required to enhance POS collections and properly secure authorizations. Over the years we worked jointly to successfully report and secure key CMS financial incentives like: Meaningful Use (MU), PQRS, and QCDR. Collectively; we compared commercial payor rates and renegotiated unfavorable contracts to ensure alignment with the right payors and products for your market. As an external partner I've been able to collaborate with key stakeholders at many Chicago area hospitals and enjoyed every interaction! I've also had the pleasure of working alongside many incredible people. Who knows, maybe you might see me at the next conference, forum or workshop. In the meantime; if you would like to stay in touch, please contact me on this platform as I've retired my LinkedIn account. Someone once said, retirement isn't the end of the road; it's the beginning of the best journey yet. ###