As Director of Business Development, Kelley spearheads Allia’s expansion efforts aligning the company’s value with physician and health systems to resolve complex reimbursement challenges. She works closely with healthcare providers to support sustainable financial performance in an increasingly complex reimbursement environment.
Prior to joining Allia Group, Kelley directed marketing and business development initiatives for over 7 years at a leading revenue recovery company specializing in managing federal and state independent dispute resolution (IDR) processes for out-of-network providers nationwide.
Earlier in her career, Kelley held a management position in administration for a community hospital, where she gained firsthand insight into hospital operations and the financial challenges healthcare providers face.
Kelley earned her Bachelor of Science degree in Business Administration from Manhattan University. She is focused on helping providers secure fair reimbursement from insurers for unpaid or underpaid medical services through the Allia Group’s suite of innovative legal solutions.
For years, out-of-network reimbursement worked on payer terms. Rates were set, payments were issued, and providers had limited recourse.
Healthcare reimbursement is often described as a system of rules, contracts, and good-faith exchange. A provider delivers care, documents it, submits a claim, and receives payment. Simple enough.
A recent study commissioned by the Americans for Fair Health Care (AFHC), evaluating the Qualifying Payment Amounts (QPAs) under the No Surprises Act (NSA) Independent Dispute Resolution (IDR) process, finds that reported QPAs do not align with the actual median in-network contracted rates.