The Medical Billing Assessment: How to Increase the Revenue of an Out-of-Network Practice

Event Information
Product Format
Prerecorded Event
Conference Date
Thu, Apr 19, 2018
60 minutes
Product Description

Strengthen Your Out-of-Network Workflow and Increase Reimbursement

Out-of-network revenue is down 25 to 50 percent across the board in the United States – as plans transform from UCR to Medicare-based, and audits by insurers intensify. For the out-of-network provider who wants to survive in these difficult times, this session by industry veteran Thomas J. Force is a must-attend event.

With this session, you will have an opportunity to evaluate your out-of-network revenue recovery workflow. Force will take you through a proper and effective workflow beginning at patient contact with the practice, through eligibility, bill submission, payment or denial, effective appeal techniques, collection of patient cost share, and exhaustion of administration remedies. You will get concrete examples and steps to strengthen your workflow, and additional remedies to recover enhanced revenue.

You will learn winning strategies to help your out-of-network practice establish proper and effective workflow to enhance revenue – all while remaining compliant and safe. You will also be able to perform proper eligibility and effectively appeal low reimbursed claims, ultimately increasing revenue for your out-of-network practice.

Session Highlights

This session will cover:

  • State of the industry, especially for out-of-network practices
  • Cost share and patient responsibility
  • Reimbursement models
  • Collection hurdles
  • Compliance and fraud
  • Billing results and revenue keys
  • Compliance and risk management
  • Effective appeal strategies
  • Low reimbursements of out of network claims
  • Balance billing issues

Session Agenda

  • Evaluating performance
  • Eight dimensions to evaluate your revenue cyclé with
    • Pre-service
    • Billing clean claims
    • Post-service (0-30 Days)
    • Payment vs denial (30-60 days)
    • Appeals process (30-60 days)
    • External appeals and regulatory complaints (90-120 days)
    • Reporting
    • Litigation
  • Reminders and best practices

Who Should Attend

  • Out of network practice and facilities billing staff
  • Out of network practice and facilities eligibility staff
  • Out of network practice and facilities owners and physicians
  • Health care attorneys
  • Hospital revenue cycle teams
  • Health care consultants

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

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About Our Speaker

Thomas Force - Compliance Coding Expert

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 counsel and...   More Info
More Events By The Speaker

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