Balance Billing Requirement
for OON Practices
Virtual Boot Camp
Presented By: Thomas J. Force
Pre-recorded (180 Minutes)
Nuts and Bolts of Balance Billing for OON Practices
The rise in out-of-network clashes between payers and providers has led to a growing number of balance billing cases. Practices and facilities are struggling to keep up. Yet, many of us still don’t realize that strategies that worked for out of network (OON) providers in the past may no longer be effective today. To succeed in such an environment, you must know the latest state laws on balance billing requirements for OON providers, and have access to proven insider tips on how to handle denials and appeals, and also remain profitable.

Find out how in this boot camp with industry veteran Thomas J. Force. Learn how to turbocharge the efficiency of your patient collections process without losing their trust. Get the skinny on ERISA rules on how to handle balance billing like a pro, reduce denials, manage appeals, and recover lost revenue (hint: insurers don’t want you to know this!). But that’s not all: you’ll also learn a few winning strategies to strengthen your workflow and increase revenue for your OON practice – while remaining compliant and safe.

Why you should attend

After attending this in-depth boot camp, you’ll be able to strengthen your out-of-network workflow, enhance revenue, and confidently handle denials and appeals.

Session Details
Session 1: The Balance Bill Requirement for Out of Network (OON) Healthcare Providers: Why OON Providers MUST Balance Bill their Patients

Length: 60 Minutes

In this informative session, industry veteran Thomas J. Force will discuss proven strategies to improve the efficiency of your patient collections process. From implementing effective policies to providing tips on how to hold patients accountable, Force will walk you through what it takes to be successful. He will also show you how to reduce your patients’ balances before and after treatment, while complying with state and federal laws. You will learn how to avoid litigation, how to collect the proper amount of money, about the latest state laws on balance billing requirements for OON providers, as well as about the recent cases in which health plans sued OON providers who failed to balance bill their patients.
Session 2: Balance Billing for OON Practices: Manage Denials with Effective Appeals

Length: 60 Minutes

Many revenue recovery strategies that worked for out-of-network (OON) providers in the past are no longer effective today. Join this informative session with industry veteran Thomas J. Force, Esq. to improve your revenue cycle workflow. Get a comprehensive overview of what an OON provider needs to be doing, now, to earn proper reimbursement—including best practices to address fraud audits, recoupment by insurers, and balance billing challenges. Plus, Force will equip you to defend against denied and under-reimbursed claims by improving your appeals letters. You will discover field-tested techniques, best practice tools and resources to help your practice effectively appeal claims- and improve your bottom line. Force will walk you through what it takes nowadays to excel at revenue recovery. From denial prevention to stronger appeals, he’s going to share inside techniques and strategies to help your organization recover more revenue in a shorter amount of time.
Session 3: The Medical Billing Assessment: How to Increase the Revenue of an Out-of-Network Practice

Length: 60 Minutes

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, because you will learn how 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.
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
  • Healthcare attorneys
  • Hospital revenue cycle teams
  • Healthcare consultants
About Our Speaker

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 ser...Read More

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