The 2025 Optimizing Appeals and Grievances Summit brought together mid- to senior-level professionals from Medicare, Medicaid, and commercial health plans for an in-depth exploration of appeals and grievances (A&G) management. Through expert-led sessions, real-world case studies, and strategic discussions, attendees gained practical insights into streamlining A&G processes, enhancing member satisfaction, and ensuring compliance with evolving CMS regulations. Key themes included proactive grievance management, process improvement, and the adoption of member-centric approaches that drive both operational efficiency and regulatory success.

2025 Conference Sessions

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  • Regulatory Update: Changes Impacting Appeals & Grievances
  • Best Practices to Prepare for Internal and External Audits
  • Case Study: Use of Technology to Ensure Capturing All Cases
  • FDR Management: Keeping Vendors on Track with Goals and Processes
  • Appeals and Grievance Training: Building a Strong Foundation
  • Inquiry, Grievance, Coverage Request, or Appeal? How to Ensure Proper Classification
  • Enhancing Member Experience Through Communication Improvements
  • Case Study: Strategies for Reducing Appeals and Grievances
  • Grievance Management: Responses that Build Member Loyalty
  • Keeping Your Universes in Tip-Top Shape
  • How Utilization Management Policies Impact Appeals

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