Regulatory and Billing Advisor
Ms. Denise Garris began her career in healthcare in 1997 with the American Academy of Family Physicians (AAFP) where she gained valuable experience analyzing legal, regulatory and legislative issues that affected family physicians nationally. One of the primary focuses during her tenure was leading staff in a multi-year, multi-disciplinary project to refine and clarify the Evaluation and Management CPT codes and guidelines impacting reporting for services for all medical specialties.
She partnered with multiple physician societies and the American Medical Association (AMA) throughout this process. She also gained exposure to physician practice administration, practice finance, strategic planning and project management for primary care medical practices.
In 2002, Ms. Garris joined the American College of Cardiology (ACC) as a specialist in private payer advocacy. She built strong relationships with private health plans while advocating for a wide variety of issues important to cardiology. Beginning in 2005, Ms. Garris assumed a new role as director of regulatory affairs overseeing the work on coding, coverage and reimbursement. As the primary staff liaison between the cardiology community and the AMA and Centers for Medicare and Medicaid Services (CMS) Ms. Garris became well-versed in the development of AMA Current Procedural Terminology (CPT) codes and Relative Value Update Committee (RUC) submissions. She also developed expertise in Durable Medical Equipment (DME) and HCPCS coding/applications for items such as drugs, devices, and radiopharmaceuticals.
Ms. Garris has extensive reimbursement experience in areas such as Medicare/Medicaid program administration, commercial insurance company policy, coverage and program implementation, claims adjudication, and physician office/outpatient and Independent Diagnostic Testing Facility (IDTF) billing. A significant component of her current work involves supporting clients in effectively quantifying and communicating the value of their products and services to government agencies or commercial payers. These efforts often involve an assessment of unmet needs in the marketplace, including strategizing coding and payment precedents and reviewing optimal coding and reimbursement paths to support commercialization goals as well as assisting in the execution of strategy.
Ms. Garris has over twenty years of experience in analyzing the health care environment, educating physicians/practices and advocating for clients before regulatory agencies. She is certified as a professional coder, ICD-10 proficient and an internationally recognized coding expert. To date, she has collaborated on over 120 CPT code change applications resulting in the creation of over 340 separate and distinct CPT codes, in addition to 11 HCPCS applications for new products and 22 revisions to HCPCS descriptors. In 2015, the American Medical Association recognized Denise with an Excellence in Education Award.
Denise is a graduate of the University of Arizona with a degree in Business Administration and she holds an MBA from the University of Phoenix. She lives outside of Baltimore with her partner Drew, their boys Liam and Colton, and two dogs.