Happenings
Division 28 Celebrates High Achievers
Associate of the Month – July
Chad Jennings
Chad Jennings, a medical reviewer II, is the Division 28 July Associate of the Month because of his willingness to help coworkers answer healthcare provider’s questions about outpatient therapy. When providers need clear explanations, Chad researches the official rules and guidelines to give accurate information. When needed, Chad will join provider-education calls to answer complex questions. He is friendly, efficient and always checks that providers understand his answers before ending the conversation.
Associate of the Month – August
Rebecca Anderson
The August Associate of the Month is Rebecca Anderson, a medical reviewer II in Home Health and Hospice. She was selected for demonstrating outstanding initiative by volunteering to call providers to request missing documentation for claims reviewed by the Comprehensive Error Rate Testing (CERT) contractor. During these calls, she educated providers about the CERT Program and gave clear instructions to ensure documentation supported the billed codes. Rebecca’s efforts made a measurable impact. Two claims originally marked as errors were successfully overturned after her follow-up calls. This work is an important part of Medical Review and Provider Outreach and Education’s mission to reduce the CERT error rate.
Associate of the Month – September
Raimi Matthews-James
Raimi Matthews-James, auditor I, has been recognized as Division 28’s September Associate of the Month. Raimi exemplifies professionalism and teamwork, consistently communicating with providers in a courteous and professional manner. Despite being with Palmetto GBA for a short period of time, she has made a remarkable impact by quickly mastering essential processes and sharing her knowledge with others. Her proactive approach and willingness to help have made her an invaluable resource, particularly through her initiative in training new auditors and providing one-on-one guidance on desk review templates. This hands-on support accelerates onboarding and ensures auditors are prepared to manage workloads effectively. Raimi’s dedication to quality and collaboration reflects the very best of Palmetto GBA’s values.
Process Improvement of the Quarter
Automating ALJ Cases for Monthly CMS Reports
Team members: Jennifer Abrams, Sanoussy Diallo, Khosrow Heidari, Daisie Snyder
Palmetto GBA’s Medical Affairs team has improved their efficiency by automating the monthly Administrative Law Judge (ALJ) case reports they send to the Centers for Medicare & Medicaid Services. The previous manual process required up to 18 hours to compile data, calculate totals and create charts for multiple lines of business. The team created a new computer-based automated process, named Process Improvement of the Quarter, which imports the Appeals data, performs all necessary calculations and generates Word and Excel reports in just one hour per jurisdiction. This improvement not only eliminates human error but also reduces costs, allowing chief medical officers to focus on analyzing outcomes rather than performing repetitive tasks.
Team of the Quarter
Provider Audit Support Services Team
Team members: Mayetta Anderson, Stephanie Broach, Brandalyn Dedonis, Devin Evans, Lakin Long
Since their formation in 2024, the Provider Audit Support Team has consistently exceeded expectations by streamlining processes, improving accuracy and fostering collaboration. Through automation and by using standardized templates and robust reporting systems, they have improved efficiency and quality across the department. Their commitment to training, open communication and continuous improvement have created a culture of trust and innovation and earned them the Q3 Team of the Quarter award.
