Joseph Rivet, Esq., CCS-P, CHC, CEMC, CPC, CPMA, CICA, CHRC, CHPC, CCEP, CAC, CACO, AHIMA-Approved ICD-10-CM Certified Trainer

Joe Rivet is a Managing Partner at Rivet Health Law. He is a licensed attorney in Michigan and is also an arbitrator through AHLA. He practices health law with a focus on transactional matters, compliance, reimbursement, contracts, third-party payor audits, and appeals. Prior to becoming an attorney, Joe started his career in coding. He has written 3 books on E/M auditing, published many articles, and frequently speaks on healthcare reimbursement topics. Joe holds numerous coding and compliance credentials

Thursday Keynote Session

When the Juice Isn't Worth the Squeeze:  Navigating Federal Rule Changes, AI-Driven Denials, and Costly Appeals

The evolving landscape of federal regulations and AI-driven payer policies is reshaping denial management — for better or worse. This session will break down the latest proposed federal rules and legislative activity impacting reimbursement and appeals. Attendees will explore real-world denial scenarios, including those influenced by artificial intelligence and algorithm-based decision-making.

But this isn’t just about policy — it’s about practicality. How do you determine when pursuing a denial is worth the effort? When do you escalate — and when do you walk away because the cost to overturn exceeds the potential reimbursement?

SESSION OBJECTIVES:

The participants will gain:

• An overview of key proposed federal rules and legislative updates affecting denials
• Insight into current payer use of AI in denial generation and procession
• Framework for assessing break-even points - knowing when to fight and when to let it go

Walk away with actionable strategies to protect your revenue without wasting valuable time and resources on unwinnable battles.