Effective Out-of-Network Workflow to Increase Reimbursement and Stay Compliant

Dreama Sloan-Kelly
From: Jun 07, 2022 - To: Dec 31, 2022
Recorded Webinar


Under-reimbursement, claim denials, and failed appeals letters have impacted several practices. You can reduce denials, manage appeals and recover lost revenue if you create a new and effective Out-of-Network workflow. This webinar will help you on creating an effective workflow to prevent losses and resolve your out-of-network revenue challenges. Dr. Dreama will go through what should be done when a provider receives an audit or overpayment demand, and how to object, appeal, hire an expert and make document requests. She will also address the state insurance laws regarding time frames to request recoupment. The Attendees will also be informed of the best practices to reduce the risk of fraud allegations.

Learning Objectives:-

  • Learn about eligibility, charge analysis, summary Plan description(SPD), and insurance benefits verification investigation
  • Learn effective techniques for Balance Billing
  • Know Federal Prompt Payment requirements
  • Learn the application of ERISA, ERISA requirements, and what happens when ERISA demands are not met
  • Strategies for In-Network vs. Out-of-Network claims

Areas Covered in the Session:-

  • Combat decreasing out-of-network revenue
  • Design and execute a successful appeal
  • Work within regulations that limit out-of-network revenue and caps on reimbursement
  • Create a workflow to enhance out-of-network revenue
  • Develop compliance tools to keep your practice/facility compliant and safe
  • Live Q&A Session

Who Should Attend:-

  • Physician
  • Nurses
  • Physician Assistants
  • Nurse Practitioners
  • Medical Assistants
  • Practice Manager
  • Office Managers
  • Billers
  • Coders
  • Auditors
  • CDI Specialists
  • Collection Staff
  • Front Desk
  • IT Specialists
  • HIPAA Privacy and Security officers.
  • Compliance Officers
  • Telemedicine System Vendors
  • Patient Accounts Personnel
  • Medical record supervisors
  • Health Information Management Administrators and Technicians
  • Other Personnel Interested in Billing Privileges with the Medicare Program

Training Options

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