Analyzing and Negotiating PPO Contracts

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Get a Better Understanding of PPO Reimbursement Rates by Analyzing Present Contract Rates and Strategies

As a consumer, you’re flooded with choices for medical insurance. What is the best that you want to grab? Preferred Provider Organization (PPO) seeks a 15-30% discount from charges to place a hospital in a network that is preferred. A PPO should not have any problems with contractual assurances that members will identify with at the time of making a reasonable trade. You need to understand the expected vs. actual reimbursement rates as it is critical to your revenue stream.

This session by PPO contracting expert, Prerna Marwah, MBA, will provide you a better understanding of reimbursement rates by analyzing present contract rates and strategies for successful re-negotiation. You’ll also get a complete checklist for contract analysis.

Session Objectives:

  • Understand why to conduct a reimbursement analysis
  • Confirm which insurance plans the physician actually is contracted with
  • Find out if you have signed multiple contracts which can hurt you
  • Determine which insurance plans and CPT codes to include in the analysis
  • Understand the key steps involved in conducting a fee schedule analysis
  • Perform a comparative analysis based on Medicare reimbursement as a benchmark
  • Use the fee schedule analysis data when: preparing for contract renegotiation; Strategic and operational practice planning
  • Understand how to start the negotiation process with insurances
  • Understand what to look for before signing contracts

Session Agenda:

  • Conducting a reimbursement analysis
  • AMA study
  • Rating your PPO contracts
  • Finding the percentage of patient types
  • Determining top 20-25 CPT® codes
  • Developing spreadsheets to submit to insurance plans
  • Negotiating contracts
  • Analyzing contracts
  • Making contract changes before signing
  • Contract checklist
  • To Dos
  • Measuring results
  • Resources

Who should attend? Physicians and Managers

Order Below or Call 1-866-458-2965 Today

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About Our Speaker

Prerna Marwah - Healthcare Management Programs Expert

Prerna Marwah MBA is an experienced Administrator and brings to the table a wealth of knowledge in contract management and negotiation, practice management, financial management, and healthcare operations. She has an intense understanding of the managed care systems including Medicare, Managed Care Organizations, IPAs and PHOs and its dealings with primary care physicians and specialists. Prerna received her Masters in Business Administration in 2001 and has been in...   More Info
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