The Attendees will learn about eligibility, charge analysis, and understanding the Summary Plan Description and its terms. There will be a discussion regarding low-payments and denial resolutions. The seminar will also address the application of ERISA, ERISA requirements, and what happens when ERISA demands are not met. The Attendees will learn about the appeals process and patient collections. We will also discuss the different strategies for In-Network v. Out-of-Network claims.
The Attendees will learn effective techniques for Balance Billing. They will learn about the Federal Prompt Payment requirements. The Webinar will discuss what recoupment and audit is, the reasons that insurance companies give as the basis for the overpayment demands, and what steps should be taken to defend against the insurance company’s overpayment demands. The Webinar will address the ERISA obligations and protections and the importance of a provider obtaining a valid Assignment of Benefits. It will also set forth the notifications which must be sent out by the insurance company when it conducts an audit and seeks recoupment.
The Webinar will go through what should be done when a provider receives an audit or overpayment demand, how to object, appeal, hire an expert, and make document requests. It will also address the state insurance laws regarding time frames to request recoupments.
The Attendees will also be informed of the best practices to reduce the risk of fraud allegations.
Areas Covered in the Session:-
Background:-
Out of network healthcare providers are now struggling to recover profits for their facilities and medical practices.
Why Should You Attend?
Out of network healthcare, providers will learn techniques designed to enhance their revenue and maximize revenue recovery.
Who Will Benefit?
Revenue cycle managers and staff, Healthcare facility and practice owners and managers, attorneys, and billing companies.
