Negotiating Insurance Contracts

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Identify Language, Terminologies and Hidden Information in Your Insurance Contracts and Understand How it Impacts Your Overall Practice

Do you really know what your insurance contracts say? Do you understand all the legal terminologies? How do you decide what contracts you should re-negotiate? Many times we don’t know how or what to do in insurance negotiations.

This webinar by expert speaker Melody S. Irvine will help you look and understand specific language, and terminology you may want to reconsider. It will also give ideas of who and what can assist you in making sure your practice is receiving the maximum reimbursement for services performed.

You will be able to identify language, hidden information such as silent PPO’s, and know how this could affect your overall practice, as well as terminologies that could affect the contract.

Session Highlights

  • Skills needed for the contract as well as the contract language
  • Identify language and hidden information such as silent PPO’s, and terminologies that could affect the contract
  • Identify who needs to be involved in insurance negotiations from your office, the insurance company or payer
  • Get insights on Antitrust Laws
  • Understand how to negotiate the contract such as alternatives, patient education and discover a win-win situation for all parties
  • Know your market: what type of services do you provide that other providers or facilities don’t
  • Language of contracts: Physician and Payer responsibilities and evergreen clauses
  • What kind of reports to run and how to determine which insurance company needs your attention
  • How to identify those that do not cover costs and has the most financial burden
  • Successful and unsuccessful negotiation: What you need to know?
  • Crosswalk ICD-9 to ICD-10 to see how insurance companies will pay

Presentation Snapshot:

  • Important things we need to know about our contracts
  • Negotiating a good deal
  • Proper Reimbursement
  • Top CPT Codes
  • Investigate the MCO or Payer
  • Language of Contract
  • Other Possible Factors
  • Policy Manual Review
  • Medicare Fee-Schedule
  • Insurance Company Representative
  • Letter to Patients/Health plan
  • Educating your patients
  • Physicians not accepting Insurance

Who should attend?

  • Compliance officers
  • Billing managers
  • Coders
  • Office managers and providers

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About Our Speaker

Melody S. Irvine - Medical Billing and Coding Expert

Melody S. Irvine, CPC, CPMA, CEMC, CFPC, CPB, CPC-I, CCS-P, CMRS, AAPC Fellow, has 38 years of experience in the medical profession. She is the founder of Career Coders Online Medical Billing and Coding School with a specialty in physician auditing. Her extensive background includes director of coding, auditing, compliance, urgent care and billing for a forty-eight multi-specialty physician practice as well as a previous...   More Info
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Dear Valued Customers


We regret to announce that ProEdTech LLC and all its affiliate brands will cease operations on April 1, 2019.


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