Consultants

Stephen C. George, MBA-HA  CV

President, Provider Risk

Stephen George

With over 20 years experience in the practical and academic issues of managed care, Stephen George brings a deep understanding of the managed care field to his clients. Mr. George Brokers is a Consultant: in Insurance, Reinsurance & Stop Loss.

Mr. George is recognized nationally as one of the top professionals in the technical areas of reinsurance and stop loss contracting.

EDUCATOR:

Mr. George, an M.B.A. in Health Administration from the University of Miami, holds Adjunct Professor status at NOVA Southeastern University, and has taught several seminars at the University of Miami on Health Administration in Certificate Programs in Health Administration.

EXPERIENCED AUTHOR & EXPERT:

Recognized by Strathmore's and Marquis's Who's Who in America and Who's Who in Medicine and Healthcare, Mr. George's articles appear in popular and professional journals, newsletters & Letters to the Editor including

  • The National Underwriter
  • The Self Insurer
  • The Wall Street Journal NBEW
  • Medical Economics
  • The Hospital Physician Journal
  • The Miami Herald

The clients with whom Mr. George has worked include such companies as:

  • City of Miami
  • City of Daytona Beach
  • University of Miami
  • University of Washington student Health Plan
  • Broward County Air Port
  • Allstate
  • Bankers Insurance Group
  • United Healthcare - Texas
  • Port Everglades
  • American College of Health Care Executives
  • Columbia / HCA Hospital system
  • Beth Israel Health System (NYC)
  • Montefiore Hospital System
  • Nova University
  • Global Business Resources
  • International Business Communications
  • Institute of International Research
  • John Alden - Provider Markets
  • Health Care Assembly
  • Pyramid Health
  • PHYCOR - North American Medical Management
  • ProHealth HMO
  • Tenet Hospital System
  • Rockwall Independent School District

SPEAKER:
From keynote addresses to workshops, Stephen George has taken an active and visible role within his professional community and is uniquely able to help position his clients to improve their own visibility.
  • Self Funded Risk Management
  • Capitation & Provider Excess Risk Cede Alternatives
  • Health Care Reform - Structural Changes Policy, Finance, Distribution & Reporting
  • ACO Risk Contracting Alternatives
  • PSO's and Private Label Plans
  • Lloyds of London Risk Transfer v. Domestic Market Risk Transfer
  • Captives and Captive Cell Programs: L&H & P&C
  • Navigating PPACA Offerings: Individual, Small Group, Large Group and ERISA
  • Navigating Small Group SHOP v Individual Medical Plan Offerings Inclusive of Tax Credits
  • Securing Competitive Advantage within Oligopoly-Communities
  • Private Label Financing and Product Creation
  • Medicare and Medicaid Risk Contracting
  • Managed Care and Capitation Contracting
  • Managing Risk in a Capitated Environment
  • Organizational Response to a Changing Environment
  • Case Study: Applied Risk contracting
  • Advanced Risk Contracting
  • Stop Loss Insurance: Keys to Fashioning Proper Coverage
  • Introduction to Managed Care
  • Capital Financing - Creating Your Own Insurance Company

Bridget R. Jones, RRA

Vice-President of Claims, Provider Risk

Bridget R. Jones

Bridget Jones joins Provider Risk with over thirteen years of experience within the managed care insurance industry. Ms. Jones has spent the last five years specializing in Provider Stop Loss. Having adjudicated over $60 million in provider excess claims on behalf of leading reinsurers, she is nationally respected as one of the nation's top Provider Stop Loss specialists. A material member of our Policy Installation Team, Ms. Jones makes sure the client is clear on all the many reporting issues. Bridget Jones heads up Provider Risk's exclusive Claims Champion Service.

Ms. Jones' possesses technical and managerial expertise in Provider Stop loss auditing, administration, underwriting, adjudication and catastrophic claims management. She has successfully held several executive level positions with leading reinsurers. These positions include: Vice President of Marketing and Client services, and Executive Director of Claims.

Ms. Jones graduated from Florida International University in 1996 with a Bachelor of Science Degree in Health Information Management. She received her Registered Records Administrators (RRA) designation from the American Health Information Management Association in 1996. She is listed among the Who's Who Among Students in American Colleges and Universities.



PROFESSIONAL ASSOCIATIONS:

  • American Health Information Management Association (AHIMA)
  • Florida Health Information Management Association (FHIMA)
  • South Florida Health Information Management Association (SFHIMA) (Board Member; Director)
  • Provider Excess Loss Association (PELA)
  • Group Underwriters Association of America (GUAA)

SPEAKER:

Bridget Jones has taken an active and visible role within the Provider Stop Loss professional community. She has spoken nationally at several programs and continues to train claims professionals on the intracacies of Provider Stop Loss claim adjudication on such topics as Understanding Capitation and Managed Care, Provider Excess Loss 101-103.

  • SFHIMA Kendall Regional Medical Center Miami, FL
  • Swiss Re Healthcare Marketing and Underwriting Seminar Atlanta, GA
  • FDI Group, Detroit, MI
  • McNeary Insurance Consulting, Charlotte, NC
  • GUAA (Semi-Annual Meeting), New York, NY

E. Marshall Cook

Principal, Hirschler Fleischer

E. Marshall Cook

Marshall Cook has represented the interests of physicians and other health care providers since 1993. As a principal of the firm, he oversees the health care practice of Hirschler Fleischer, focusing on the representation of individual physicians, physician groups, hospitals, other health care professionals and providers in all aspects of their medical practice and business affairs. His experience in the organization, operation and management of Virginia's only statewide IPA (6,000+ physicians), in the negotiation of a joint venture HMO with the nation's second largest health care company, and in current managed care contract negotiations on behalf of some of Virginia's largest physician groups provide him not only with the most current skills in health law, but also with practical, operational knowledge of the practices of health care professionals and insurers alike.

As General Counsel for the Medical Society of Virginia (1993-1995) and Deputy Attorney General of Virginia (1990-1993), Mr. Cook also brings significant business and governmental expertise.


Reed Tinsley

President, Reed Tinsley and Associates, Houston

Reed Tinsley

Reed Tinsley, CPA, is president of Reed Tinsley and Associates, a Practice, Management, and CPA firm. He works closely with physicians, medical groups, and other delivery systems with managed care contracting issues, operational matters, strategic planning, and growth strategies. His entire practice is concentrated in the health care industry.

Reed has published numerous articles in national and regional publications and is frequently asked to speak on a variety of health care topics, including capitation, revenue enhancement, and integration strategies. His articles have been published in the Journal of Medical Practice Management, MGMA Journal, Hospital Physician, Texas Medicine Family Practice Journal, and Group Practice Journal.

Mr. Tinsley also serves on the Editorial Panel of Consultants for the following publications:
  • Family Practice Management
  • Managed Care Contract Negotiator
  • Healthcare Fraud and Abuse Newsletter
  • Cardiology Administrator's Compliance and Reimbursement Insider

Both the American Medical Association and the Southern Medical Association have sponsored Reed's seminars. In addition to his consulting and speaking projects, Reed has also written two books,Medical Practice Management Handbook for CPAs and Medical Practice Management: A Strategic Operations and Contracting Guide for Physicians and Managers, both published by Harcourt Brace. He has also co-authored three other healthcare books published by John Wiley and Sons and the IPA Association of America. His most recent books are entitled: Performing an Operational and Strategic Assessment of a Medical Practice, Valuation of a Medical Practice, and Healthcare Financial Operational Manual for IPAs. Reed's soon to-be published book in entitled Medical Practice Mergers and will be published by the AMA in 2001.

Mr. Tinsley may be reached at 713-975-1000 or by email at reed.tinsley@hcpag.com.

HARCOURT BRACE BOOKS:

Medical Practice Management Handbook for CPAs
Medical Practice Management: A Strategic Operations and Contracting
Guide for Physicians and Managers
PUBLICATIONS:
Journal of Medical Practice Management
MGMA Journal
Hospital Physician
Texas Medicine Family Practice Journal
Group Practice Journal

Walter C. Marsh, FSA, MAAA

Provider Risk

Walter C. Marsh, FSA, MAAA

ACTUARIAL

Serving the healthcare marketplace, Fellow of the American Society of Actuaries

CONSULTING

Walter C. Marsh uses sophisticated technical tools, the extensive practical HEALTH & LIFE experience, and the necessary people skills required to navigate the business and underwriting needs of his clients.




ACTUARIAL DESIGNATIONS

  • Fellow of the Society of Actuaries
  • Member of the American Society of Actuaries
  • Member of the International Institute of Actuaries
  • Member of the Southeastern Actuarial Conference
  • Past Member of the Society of Actuaries Examination Committee
  • Past Member of the Group Large Claim Committ

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