In the new era of an alphabet of healthcare oversight including - Recovery Audit Contractors
(RACs),
Medicare Administrative Contractor
(MACs), Comprehensive Error Rate Testing
(CERTs), Payment Error
Rate Measurement
(PERMs), the Office of the Inspector General
(OIG), the Office of the Medicaid
Inspector General
(OMIG), Managed Care Organizations
(MCOs), and many others Proven Healthcare
Solutions'
Admission Review Management Service provides hospitals and healthcare systems
a flexible, cost-effective, turn-key solution to address the ever-challenging requirements
of ensuring real time, point of service medical necessity review determinations of patients
coming in through the Emergency Department. This includes utilization review using the latest evidence-based
screening criteria to determine the right level of care to be provided to these patients- inpatient, outpatient
observation status or discharge for outpatient follow-up.
Proven Healthcare Solutions is an industry leader with more than 30 years
experience focusing on hospitals and healthcare systems. Our multi-disciplinary
leadership and management team bring the experience of providing expert solutions
to the operational, compliance, and clinical challenges faced by hospitals and healthcare systems.
Using our state-of-the-art Electronic Admission Review Manager(E-ARM™) application, our experienced
RN Admission Review Screeners will provide your facility with the flexibility of
just-in-time review,
at the point of service.
By taking a Six Sigma, lean manufacturing approach; Proven Healthcare Solutions is designed
to accommodate all of your Emergency Department and key outpatient service line Admission Review needs from providing night, weekend or holiday
coverage, or any combination in between, to complete screening, at the point of service.
PHS eliminates Monday morning chaos or backlogs for your case managers to review, while eliminating retrospective admission denials.
John Fontanetta, MD, FACEP
Chief Medical Officer
Dr. Fontanetta is a practicing emergency physician and a regional leader in health
information technology for the Emergency Department and in Rapid Discharge Unit design,
implementation and operations. He is a professional society member of the
New Jersey Chapter of the American College of Emergency Physicians and American
Medical Association. He was awarded the Presidential Scholar for Phi Beta Kappa,
Alpha Honor Society. He graduated Summa Cum Laude at Fordham University in Bronx,
New York and received his medical degree at Cornell University Medical College
in New York, New York.
Dr. Fontanetta completed his Internal Medicine Residency at Thomas Jefferson University
Hospital in Philadelphia, Pennsylvania and fellowship in Pulmonary Medicine at Albert
Einstein College of Medicine, Bronx Municipal Hospital Center in Bronx, New York.
He is a Diplomat of the American Board of Emergency Medicine, Diplomat of the
American Board of Internal Medicine, Diplomat of Subspecialty Pulmonary Medicine,
and board eligible in Critical Care Medicine. Dr. Fontanetta is also a Fellow of the
American College of Emergency Physician.
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Karen Kasnetz
Regional Sales Director
Karen Kasnetz brings over 30 years experience in healthcare
to Proven Healthcare Solutions, with an expertise in the
areas of sales and marketing, account management, operations,
hospital service line management, wellness and disease management.Prior to joining Proven Healthcare Solutions, Karen was a Vice
President and Business Unit Leader for a large healthcare company.
Karen is a Registered Dietitian; she received a Bachelor of Science
degree with honors in Human Nutrition from Cornell University in
Ithaca, New York. She also completed a dietetic internship at the
University of Medicine and Dentistry of New Jersey in Newark,
New Jersey.
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Sandra Santangelo, RN, BSN
Director of Quality and Product Development
Sandra Santangelo has joined Proven Healthcare Solutions as Director of Quality and Product Development, and is
responsible for operational development and oversight, along with quality performance and quality management.
Sandy has been involved in healthcare since 1983 in clinical care, utilization, and medical management.
Prior to joining Proven Healthcare Solutions, Sandy had more than 17 years of experience in the managed care industry,
including five years with a major NJ insurance company. She managed the medical appeals unit, responsible for day-to-day
operations and maintaining state and federal compliance. In this role, Sandy was responsible for appeals for all product lines,
including HMO, POS, PPO, indemnity, and Medicare. She interfaced regularly with hospitals, medical practices, independent medical
review organizations, self-funded groups, and departments within state and federal governments.
She has experience designing and implementing healthcare management programs, including clinical tools, procedure manuals,
quality management, workflow documentation, and training. Sandy has also developed and managed an appeals department for a
large New Jersey Medical Center.
Sandy has an extensive clincal background. Her primary area of practice as a registered nurse was adult oncology. She also
worked in various adult inpatient units and in the ambulatory care setting.
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Scott Serbin
Director of Marketing
Scott Serbin, Director of Marketing and Sales, brings over 19 years of
multi-faceted health care experience to Proven Healthcare
Solutions, including expertise in physician group management,
emergency department marketing and sales, retail health care,
managed care, medical education and corporate training.
He holds a Bachelor of Science Degree in Education from East
Stroudsburg University-East Stroudsburg, PA and a Bachelor
of Arts Degree in Communications from William Paterson
University-Wayne, NJ.
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Our operations team has over 30 years of multi-disciplinary healthcare experience and is
comprised of:
- Nationally Recognized Physician Leaders
- Board Certified Physicians
- Hospital Executives
- Nurse Executives
- Experienced Nurse Reviewers
- Certified Coding Specialists
- Experienced RAC Reviewers
- Data Analytics Experts
- Healthcare Research Experts
WHO WE ARE