Anne Galvi, MD, FACS, Milliman Care Guidelines (MCG) certified, has been professionally active in the healthcare arena for forty-one years. Her experience ranges from a practicing physician, provider physician executive, and a payer physician executive. Dr. Galvi possesses a unique perspective on medicine, believing that physician attention to charting and documenting in the medical record is paramount to a physician practicing good medicine. She is a firm believer in William Osler’s one of many sayings: “A Good Physician treats the disease. A Great Physician treats the patient with the disease.”

Dr. Galvi’s clinical background is in general surgery, with 10 years of hands-on experience as a physician surgical first assistant in most surgical subspecialties. While in private practice she learned the value of complete and accurate documentation and coding to optimize compliant net patient reimbursement from payers. She had the opportunity to learn and be mentored from seasoned colleagues as well as teach other physicians, enhancing their revenue streams. Dr. Galvi then spent 5 years in a forensic support services practice interacting with attorneys, paralegals, insurance companies, and case managers.

More recently she has worked as a physician advisor on the inpatient side of a large multistate healthcare system and as a medical director in a multi-plan health insurance consortium. While on the payer side, Dr. Galvi often finds her determinations start with “Denied for XYZ. No documentation of the following ….” She has had the opportunity to assist the payer’s Claims Recovery department by reviewing physician documentation and other medical records to successfully implement recovery on overpaid claims.

Throughout her career she has made every effort to produce well-written documentation that clearly and succinctly captures relevant facts and data as well as providing bottom line analysis and direction. She enjoys “Telling a Story” to the audience which will often serve to persuade them to her point of view. Dr. Galvi subscribes to the philosophy of the right care at the right time in the right revenue with the right clinical judgment, medical decision making, and thought processes with the right documentation.

She has had the privilege of hosting numerous presentations to medical groups and associations on the role of the physician in adhering to and consistently applying best practices and standards of documentation to accurately reflect the true patient’s clinical story, adequately capturing the physician’s clinical judgment and medical decision making that supports medical necessity for all patient care either provided and/or ordered.