How to Get Paid for Out-of-Network Care in 2018

Event Information
Product Format
Prerecorded Event
Conference Date
Wed, Jun 13, 2018
60 minutes
Product Description

Top 10 Tricks to Ensure That you are Paid Appropriately for Out-of-Network Care

It is important for the physician practices to stay updated with the latest healthcare revenue collection trends to improve their medical billing services.

Join this session, where industry veteran Stephanie Thomas will discuss what it means for your practice to be out of network, and the pros and cons of in-network billing. Thomas will review the 10 steps for successful out-of-network billing, including verification of benefits and medical necessity. She will also provide a review of contract verbiage and guidelines, and what they really mean.

This session will offer the tips and tricks of how to get patients to pay their portion with ease. You will learn how to identify specific pros and cons of an out-of-network situations. Thomas will go over the appeals for major payers, and how they like the information to come over.

You will learn the top-10 tricks to ensure that you are paid appropriately out of network. Medical necessity denials will be a thing of the past, this session will take you through some specific examples of notes and how to spell out medical necessity to ensure you are paid the first time.

After attending this session, you will gain knowledge of how to work with out-of-network patients and how to help them understand their insurance benefits. You will be able to understand insurance contracts, not get lost in the wordy contracts, and gain experience of how to decipher hidden meanings. You will discover tips and tricks of getting authorizations, even when out of network. You will be able to follow up claims with ease as you will learn how to be extra aggressive with payers to get your desired results. You will also be comfortable with appealing claims and proving medical necessity for claims.

Session Highlights

This session will cover:

  • Verification of out-of-network benefits
  • Financial agreements
  • Authorizations
  • Patient cost sharing
  • Contract negotiations
  • In network vs Out of network

Session Agenda

  • Difference between INN and OON
  • Ten crucial steps for successful OON billing
  • Elements of a balance bill letter
  • ERISA, ERISA exempt, or state?
  • Balance billing
  • Patient responsibility
  • OON billing options
  • Recoupment

Who Should Attend

  • Office management
  • Administrators
  • Billing department
  • Physicians and mid-levels

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

Stephanie Thomas

Stephanie Thomas has 20 years of experience doing medical billing and coding in a variety of specialties. She has earned her credentials as both a Certified Professional Coder® (CPC®) AND a Certified Pain and Anesthesia Coder (CANPC®).

Billing is Stephanie’s passion. She has made it her mission to work with practices across the country to help them ethically and more efficiently maximize their reimbursements. She does this...   More Info
More Events By The Speaker

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