It’s easy for out-of-network (OON) healthcare providers to make critical mistakes that jeopardize their compliance with state and federal laws. For instance, many providers will tell patients that they accept any payment from their health plans as payment in full. But this practice is risky and may invite accusations of fraud from the health plans.
Recent lawsuits have put the spotlight on billing related errors such as overpayments, negligent misrepresentation, OON write-offs and balance billing, and ended in very real legal nightmares for practices. In addition, HHS is actively watching and waiting to catch billing errors and noncompliant practices. The bottom line is that failure to balance bill patients can lead to large recoupments, audits and litigation for fraud.
In this session, expert speaker Thomas Force, Esq. will instruct OON providers and their revenue recovery staff on how to maintain compliance and avoid litigation while collecting the proper amount of money from patients’ health plans. You’ll also learn about state laws relating to balance billing requirements for OON providers, as well as recent cases in which health plans sued OON providers who failed to balance bill their patients. He will also discuss the penalties for noncompliance and provide a patient-friendly sample balance bill letter and sample charity care policy.
Who Should Attend
Thomas J. Force, Esq. is a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries. He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare. Thomas is also the former CEO, general...
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