OpenPoint Health Solutions is a consulting firm that specializes in the out-of-network healthcare cost containment industry. The services that we offer include revenue-generating strategic product expansion and business development initiatives, product development and enhancement, and provider network optimization software and consulting. OpenPoint Health also provides guidance to companies in the healthcare industry seeking Venture Capital to support the growth of their organizations.

NMFS enhances the cash flow and reduces the administrative burden of Medical Providers and Commercial Payors by consolidating hospital reimbursements, accelerating Medical Provider reimbursement and performing value added services to Commercial Payors. NMFS’s ability to improve revenue cycle time (time from billing to collection) is an important competitive edge in the healthcare industry for both Commercial Payors and Medical Providers.Orchestrated development of operational claim payment platform for innovative medical funding start-up. Organized efforts to merge operations of two developmental companies into new organization. Assisted in bringing on-board initial venture capital investment in early 2021.• Directed on-boarding of initial hospital clients onto the NMFS claim payment platform with commercial payor partners.• Established interfaces and protocols with commercial payor partners for the transfer of claim payment data to NMFS medical providers. • Coordinated cross-team development of the NMFS claim payment platform across operations, finance, client relations, and IT departments.

Evaluated operational processes to determine methods for improving efficiency of organization. Provided direction on additional cost containment services for organization to offer to marketplace. Located acquisition targets, provided assistance to management team and produced specialized utilization reports for senior management and outside investment groups. • Significantly decreased labor expenses by developing and supervising a team to recruit providers for internal discounts resulting in a drop of fee negotiations from 90% to 70% of claim volume which continued to rise by 20% annually.• Cultivated and executed relationship with partner organization, offering Medicare reference-based pricing as additional service to existing clients and in marketplace.• Generated a 20% increase in success rates and 25% increase in saving dollars from HRGi's Elite Provider Program through improved provider matching criteria. • Led team that performed rewrite of critical behaviors and practices for organization’s fee negotiation team, leading to 10% increase in success rates and saving rates of overall fee negotiation results. • Managed the transformation of the negotiation audit team from being considered a daily burden whose only goal was to find mistakes to a helpful unit designed to highlight the best practices and improve the overall performance of the negotiation team.• Participated in the decision-making process of HRGi’s future direction, goals, and finances as a Board Member.HRGi provides industry-unique, cost-containment technology and solutions to the healthcare industry. Over 50 million consumers across the United States and Canada have access to HRGi products and services. HRGi’s mission is to assist healthcare payers to achieve their financial objectives by delivering innovative, client specific, cost-containment solutions.

Managed growth of operations team, maintain rapid expansion of overall organization. Led implementation of several national insurance companies and third-party administrators onto organizational platform. Cultivated consistent interface with sales and marketing department to ensure customer satisfaction with client implementations and on-going operations. Developed and maintained communication channels with IT and accounting departments throughout growth of company.• Managed growth of California operations team from 13 employees in 2012 to 60 employees in 2017, increasing revenue 700%.• Led implementation team for onboarding onto organizational platform for top five health insurer, three of top 10 third-party administrators, two of five largest Canadian travel insurers and top five auto insurer. • Created daily and monthly trend utilization reports at both the product and client level to ensure management visibility into the claim activity at our California operations office.• Contributed to the sales process with our CMO through leading the in-person discussions surrounding how HRGi would interface with the potential client’s claims administration system and our previous implementation experiences with similar organizations. • Brought two venture capital firms onboard as investors in 2017.

Implemented all payor clients, focusing on systems integration area. Developed process for transfer and maintenance of provider network data to web-enabled repricing partner for payor client access and EDI file processing. Researched and performed due diligence on TPAs, medical billing companies and fee negotiation companies as possible acquisition targets. Developed innovative medical claim payment mechanism, utilizing automated clearing house technology and VISA/Mastercard infrastructure. Led implementation efforts for all clients, including nation's third largest health insurer and second largest third-party administrator, leading to over $100 million in annual repriced claims.Federal Medical, Inc. (FedMed) offer financial services to the medical community. The core business provides large payors and TPAs access to contractual discounts of a national provider network with over 3,000 hospitals and 300,000 physicians.

Analyzed demographic results of direct marketing campaigns with multiple credit card companies to provide improvements for future campaigns. Coordinated initial online website development and online advertising campaign with companies, including Yahoo, AOL, DrKoop and DoubleClick. Identified initial Pharmacy Benefit Management acquisition and led due diligence efforts. Participated in initial public offering as company executive.

Provided consistent reporting on utilization at client and provider level of PPO network to senior management. Located and performed due diligence activities on potential PPO network acquisitions. Developed set of monthly analytical reports on claim and provider demographic data to assist management in understanding current business trends and future opportunities.

Worked with finance department to improve medical cost projections and IBNR forecasting. Created episodic database for cost analysis of outpatient hospital versus ambulatory surgery center procedures. Developed and presented reports to hospitals explaining relative costs. Supported decision-making process on Medicare HMO program strategy.

Assisted in setting inpatient hospital payment rates for Medicare. Determined standardized payment amount and outlier payment thresholds.