Louise Guy, RN
Managing Partner, Argenta Advisors and Argenta TEC
Louise is a registered nurse with extensive experience in healthcare delivery systems focusing on clinical care, clinical and capital sales, third-party reimbursement methods, operations and strategic business planning. For the past fifteen years, Louise has directed her efforts toward the areas of reimbursement, patient advocacy, medical policy, pricing, government relations, and managed care sales. In 2001, she co-founded Argenta Advisors (formerly Certus Healthcare). Prior to establishing Argenta, Louise spent six years in the biotechnology industry, where she successfully established reimbursement for both FDA and non-FDA approved products. She interfaced directly with senior officials at the Centers for Medicare and Medicaid Services (CMS), as well as with corporate medical directors for health plans across the country.
Louise also brings ten years of experience as the manager of medical review and utilization management at BlueCross BlueShield of Massachusetts (BCBS MA). During her tenure at BCBS MA, Louise was responsible for medical operations across all product lines.
Other industry experience includes field support and management at three medical technology companies.
Louise maintains a current Massachusetts RN license and received her nursing education and training at Rhode Island Hospital and Community College of Rhode Island.
Carla Monacelli
Managing Partner, Argenta Advisors and Argenta TEC
Carla has worked in the field of reimbursement, healthcare policy, and government relations for over 19 years. In 2001, she co-founded Argenta Advisors (formerly Certus Healthcare), and in 2007 co-founded Argenta TEC Advisors. In 2007 she co-founded mgine6 , a subscription based reimbursement database for government payers.Prior to establishing Argenta, her career experience included lobbying for a top Minnesota law firm and payer relations and reimbursement strategy for multiple clients at a large Washington DC healthcare consulting firm, as well as at the Minnesota Council of Health Plans.
Carla has developed and implemented strategic reimbursement plans for both biotechnology and medical device companies. She has been involved with the launch or reimbursement strategies for over 60 technologies, including three Orphan Drugs.
Carla has recruited, trained, and managed field reimbursement specialists. Her experience has also included management and sales force reimbursement training; health plan education and advocacy, including Medicare, Medicaid, private health plans, worker's compensation, and self-insured corporations; development of reimbursement tools; and lobbying and grassroots advocacy program development.
Carla holds a bachelor's degree in political science from the University of Minnesota. She is an adjunct faculty member at St. Cloud State where she is a co-lead instructor for the Master of Regulatory Affairs Health Policy and the Medical Technology Industry and lecturer on developing and implementing a comprehensive strategy for the Reimbursement classes. She is also a past co-chair of Life Science Alley's Reimbursement Special Interest Group.
Brent O’Connell, MD, MHSA
Chief Medical Officer, Argenta Advisors
Dr. O’Connell has been employed by Highmark, one of the nation’s largest insurers, for fifteen years. During that time, he held various positions including Medical Director, Vice President & Medical Director, and Vice President and Senior Medical Director. He has extensive experience with all plan operations and medical and payment policy. He was responsible for all medical policy for the company during his time of employment. He served as the Chairman of the BlueCross BlueShield Association’s (BCBSA) Medical Policy Panel for six years and a member of the BCBSA Technology Evaluation Center’s Medical Advisory Panel for four years. He was appointed as a member of the Medicare Coverage Advisory Committee (MedCAC) in 2006.
A native of northeastern Pennsylvania, Dr. O’Connell earned his medical degree from Jefferson Medical College in Philadelphia. He completed his pediatric residency program at Polyclinic Medical Center in Harrisburg and was board certified in pediatrics in 1975. Dr. O’Connell received his master’s degree in Health Service Administration in 1998
Elizabeth Brown, MD
Medical Director, Argenta TECDr. Brown has spent over 20 years in technology assessment and coverage policy development, working for national payers such as Aetna, the BlueCross BlueShield Association and WellPoint Health Networks. She spent ten of those years leading the medical policy department at the BlueCross BlueShield Association, where she was responsible for developing and maintaining all medical policies, as well as reviewing over 200 different technologies every year.
Dr. Brown also has extensive experience in writing continuing medical education material for both the AMA and the National Comprehensive Cancer Networks, where she served as a Senior Oncology Advisor.
Dr. Brown earned her medical degree from the University of Illinois and completed her pathology residency at Rush Presbyterian St. Luke’s Medical Center, where she served as chief resident.
Fiona Wilmot, MD MPH
Medical Director, Argenta TECAs one of the Medical Directors at Argenta TEC, Dr. Wilmot advises in matters of health coverage, reimbursement and marketing strategy for the life science industry.
Prior to joining Argenta, Dr. Wilmot ran the Glas Group, a healthcare consulting firm whose clients included biotech companies, technology assessment bodies, and University based organizations. She also recently served as the Medical Director of Policy, Pharmacy and Therapeutics for Blue Shield of California using Evidence Based Medicine to develop medical and pharmaceutical coverage policies for 2.7 million covered lives. Additionally, Dr. Wilmot has held positions at Aetna, a Northern California IPA, and has worked clinically as a hospitalist as well as in the outpatient setting.
Dr. Wilmot graduated from Stanford University with distinction in English Literature and proceeded to earn her medical degree from the Boston University School of Medicine. She received an MPH from the University of California, Berkeley and is Board Certified in Internal Medicine.
Jolayne Fisher, MBA, CPC, CPC-H, CPC-P
Senior AdvisorFor the past 19 years, Jolayne has worked in the health care industry years in a variety of sectors, including a world-leading medical device company, a large commercial payer, and a national physiatry management services organization. With this broad experience, she has built unique expertise in medical device and drug optimization strategies for product reimbursement.
Jolayne spent two years at a world-leading medical device company and was responsible for development and implementation of coverage and payment strategies, as well as services and tools designed to resolve reimbursement issues and facilitate adoption of therapies by physicians, hospitals and payers. In addition, Jolayne served in various roles within a large regional health plan for eight years. During that period, she led policy development in the areas of claims reimbursement and adjudication, technology and benefit assessment, benefit appeals, clinical case management, and fee schedule implementation.
As a consultant and Certified Professional Coder (CPC, CPC-H, CPC-P), Jolayne focuses on developing and executing successful strategies in the areas of coding, coverage, and payment for the commercialization of new products into the marketplace. Her expertise includes conducting product and payer market analyses, clinical trial positioning, provider/society collaboration, healthcare policy, CMS interface and strategic implementation. She has successfully established numerous government payment mechanisms for MS-DRGs, APCs and RVUs in addition to obtaining CPT, ICD-9-CM and HCPCS codes for emerging technologies in the medical device, pharmaceutical and biotechnology industries.
Jolayne holds a BS from the College of St. Catherine and a master's degree in business administration from the University of St. Thomas.
Robin Galinsky, MBA
Senior AdvisorRobin has more than 15 years of progressive healthcare management and leadership experience, including the areas of reimbursement, managed care, customer service, and marketing and sales support. She has a diversified background, having worked for a national PPO, a start-up medical device company, a large pharmaceutical company and a global biotechnology company. In her former roles, Robin was responsible for the development and oversight of reimbursement activities to support product adoption, increase market acceptance, overcome barriers to patient access, and secure coverage for the commercialization and launch of biological products and medical devices.
During her tenure at Serono as Manager of Medical Reimbursement, Robin was responsible for the strategic planning, tactical execution and ongoing operational management of reimbursement support and patient assistance (PAP) programs for self-injectable growth hormones in three distinct therapeutic markets (HIV wasting, pediatric/adult growth hormone deficiency and short bowel). Additionally, Robin was instrumental in helping to develop and launch call centers to support Serono’s multiple sclerosis drug and fertility products.
Robin holds a Bachelor’s degree in biology from Clark University in Worcester and a Master’s degree in Business Administration (M.B.A) in the areas of finance and healthcare management from University of Massachusetts, Amherst.
Scott Shields, MBA
Senior AdvisorScott has thirteen years of experience conducting coding assessments and managing reimbursement strategic planning for emerging technologies in the pharmaceutical, biotechnology, and medical device industries. His background includes conducting coverage, coding, and payment analyses; communicating with CMS staff on behalf of clients; designing market research survey instruments; performing competitive intelligence; and conducting product-appraisal interviews with payers, physicians, and hospital administrators. Scott has depth of experience with both private and public payers.
Scott has run his own consulting firm, has worked for leading healthcare consulting firms, and was a vice president in the reimbursement and advocacy division at a top law firm. Scott also founded the Trauma Survivors Network, a national support service for trauma survivors, with the American Trauma Society.
He earned an M.B.A. in Finance and a B.A. in International Relations and Pre-Medicine from American University.
Linda Hurd
Senior AdvisorLinda spent her early career at the Prudential Insurance Company, where she served in a number of key senior management positions. Her responsibilities included contracting, wellness reform programs such as Maternity Watch™ Pre-Term Birth Prevention Program and Pre-Admission and Concurrent Review Services (PACRS™), and operations. Following her tenure at Prudential, Gode played significant roles in several medical start-up companies in the Minneapolis area. As President and COO of Medicord, Inc., a medical device company dedicated to the development of a female infertility device known as the OvuCord™, she was responsible for private placement fundraising efforts and building the start-up business operations. The OvuCord was ultimately sold to the BD Thermometer Division. Linda then joined Kinesis Medical, Inc. where she helped develop and launch the Orthotrac™ Medical Device, a device developed to help patients suffering from HNP of the lumbar spine. She developed the reimbursement strategy for the product, ultimately securing HCPCS level II coding for the device through work with CMS (Medicare). At company acquisition by Orthofix, Inc. in September 2001, Linda joined the Orthofix team and worked on the reimbursement strategy for their orthopedic product lines.
Linda holds a Nursing Associate Degree from Iowa Central College. She has also completed Carlson School of Management programs and attended University of St. Thomas Human Resource Business and Labor Law course curriculum programs.
Joe Gardill, MS
Senior AdvisorJoe has worked in the health care industry for over 17 years and has broad experience working in health care reimbursement, practice administration, financial management, project management, contract management, and business development. Joe has long-term experience in developing reimbursement strategies for both new and existing technologies, including:
Obtaining and implementing new CPT, HCPCS, and APC codes;
Leading efforts to secure approval of new technology by the BlueCross BlueShield Association Technology Evaluation Center (TEC);
Orchestrating issuance of CMS Program Transmittals to Medicare Carriers and Intermediaries to correct improper denials;
Reversing negative coverage policies of health plans; and
Obtaining and expanding coverage and reimbursement for new technology to 150+ health plans companies.
Among the experiences in billing and collections, Joe was a director of reimbursement for a national DME and pharmaceutical infusion and supply company. He has experience with MSO operations, multi-specialty practice administration, and technology project management and implementation.
Joe has a M.S. in Finance from Loyola College. He is a former Treasurer and Chair of the Technology Committee for the Maryland Medical Group Management Association.
Diane Kunz, RN, BSN, CCM
Senior AdvisorDiane worked in a clinical setting as an intensive care nurse for twenty-two years. She entered the workers’ compensation arena in 1994, and earned her accreditation as a Certified Case Manager. In that capacity, she was responsible for assisting injured workers to obtain the necessary treatment to allow them to safely return to work, as well as working with third-party carriers to obtain reimbursement for recommended treatments.
Diane earned her Bachelors of Science in Nursing from the University of Akron.
Kristina Seracen, MA
Reimbursement Policy AdvisorKristina has worked in the field of medical technology reimbursement for over two years. She has worked with the payer and medical society community on a national and regional level, as well as with key stakeholders in the medical community to guide implementation of payer-focused strategies and programs. She works closely with providers in petitioning health plans to reimburse for new technologies or procedures.
Kristina earned a master's degree in mental health counseling at Seattle University.
Phillippa Edmiston
Reimbursement Policy AdvisorPhilippa has over 30 years of experience in health care administration and reimbursement, including a strong emphasis on managed care contracting. Among her credits includes negotiating, implementing and managing a five-year exclusive capitated contact with Health Net of California.
Philippa has been responsible for implementing regional and national contracts with major health plans, capitated medical groups and worker’s compensation insurance companies. She has worked with health plans designing and implementing disease management programs resulting in better patient access, improved disease outcomes and cost containment within a managed care environment.
Philippa holds a Bachelor of Science in Public Health Administration.
Nancy Miele
Reimbursement Support AdvisorSince joining Argenta Advisors, Nancy has developed and supported support line programs for a number of medical technology companies. She is an expert in coding and billing/appeals support, research and monitoring of insurance company policies for designated technologies/procedures, sales and reimbursement field team support, customer reimbursement education, and assisting customers in obtaining positive reimbursement for medical technologies and procedures.
Nancy has over 14 years of experience in the medical field. Nancy ran a support line for a medical device start-up company in the urology field, where she worked with payers, government agencies, and physician offices to establish reimbursement for a novel medical device. She has also worked in physician offices, giving her an excellent understanding of physician billing in particular.
Catherine Janey
Policy Research AdvisorCatherine joined the Argenta team as a policy researcher since 2004. As a member of the team, Catherine has conducted policy research on numerous technologies across all payers. She works closely with the Argenta strategic integration team and provides research on payer policy trends. Catherine earned a degree in political science from the University of Minnesota
