Did you know that 89% of medical practices in the US face significant revenue loss each year due to inefficient payer contracts and credentialing issues? And when it comes to claim payment retractions, nearly 23% of practices experience ongoing challenges that directly impact their bottom line. These statistics are not just numbers. They're a wake-up call.
This is where this new 3-part Webinar Series, meticulously designed to empower practice managers like you, can help. In this series, you’ll gain actionable insights from three top-tier experts:
- David J. Zetter, with credentials like PHR, SHRM-CP, and countless more, will unravel the complexities of stopping payers from reclaiming your hard-earned payments under ERISA.
- Doral Jacobsen, MBA, FACMPE, will guide you through strategies to negotiate higher-paying third-party payer contracts, a critical skill for boosting your practice’s revenue.
- Tracey Tokheim will demystify credentialing and enrollment, ensuring you get approvals and payments faster and with less hassle.
This is not just another set of webinars. It's a transformative journey for your practice. If managing your practice's revenue cycle feels like navigating a labyrinth, you're not alone. Let our experts lead the way, turning challenges into opportunities for growth and efficiency.
Read below for more details on each webinar in this series and begin your journey towards revenue optimization and streamlined practice management.
SAVE 15% INSTANTLY!
Order your 3-Part series in the next 5 days, and you'll save an additional 15% off the total cost. Discount is already reflected. No code necessary. Or, if you prefer, you can order each session individually at the regular rate. ORDER TODAY!
PART 1: Stop Payers from Taking Back Your Claim Payments with ERISA
Attend the live session on Tuesday, November 5th at 1:00pm ET OR,
Order the On-Demand Recording to Watch at Your Convenience.
Payers don’t want you to know how much control you really have regarding your claims’ reimbursement. They don’t want you to know that by applying ERISA regulations, you can force your payers to:
- pay your claims more quickly,
- stop downcoding your office visits,
- overturn claims that were previously denied,
- expand inadequate appeal deadlines, and
- return recouped funds previously taken from your practice.
Payers know that approximately 83% of your non-Medicare/Medicaid claims are governed by ERISA regulations. For these claims, insurance companies also know that their timely filing deadlines of 90-120 days don’t apply, that they can’t legally recoup funds you’ve been paid and that in most cases, your claims can’t be downcoded without your input. However, they do it anyway because no one is pushing back.
Well, if you are tired of feeling like payers are holding all the cards, David Zetter, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP, can help. On Tuesday, November 5th at 1pm ET, David is going to break down the complexities of ERISA regulations into plain English. He’ll walk you through only the pieces you need, and then provide you with actionable advice on how to use it.
By attending this 90-minute online training, you’ll learn how to utilize the applicable portions of ERISA regulations to have more control of your payer requirements and reimbursements. If you’ve experienced even one of the scenarios below, and want to “push back” to change futures outcomes, this upcoming online training is for you:
- Without warning, the payer takes back reimbursement from your future claims.
- Your claim is downloaded with no request for progress notes or doctor review.
- Your claim is refused because it arrived past the payer’s timely filing period.
- Your reimbursement is reduced because the payer bundled your services.
- Your payment is sent to the patient by mistake, and you’re expected to collect from them.
- Your appeal is denied because it reaches the payer past their 90-day deadline.
- Your claim is downcoded and the payer refuses to tell you why, or who authorized it.
- Your claim is denied for “investigational or experimental” services.
- You’re told to comply with state balanced billing laws when federal ERISA rules apply.
- You are denied assignment of benefits for being a non-contracted provider.
PART 2: Negotiate Higher-Paying Third-Party Payer Contracts
Attend the live session on Wednesday, November 6th at 1:00pm ET OR,
Order the On-Demand Recording to Watch at Your Convenience.
Third-party payers don’t want you to know the truth. They don’t want you to know that you CAN get paid more and that it’s easier than you might think.
Payers have one goal in mind – to pay you less. They do this by making the contract negotiation process as confusing as possible (i.e., outdated fee schedules, confusing contract language, etc.).
The more challenging it is for you to negotiate your third-party payer contracts, the more likely you are to give up. In fact, this is precisely what they are counting on. However, if you know how, you can get payers to cough up the extra reimbursement you deserve.
There are ways to break through the payer contracting wall. You can get them to respond to your requests and, yes, increase your rates if you know how to get them to work with you and kick-start discussions.
This is where third-party payer contract negotiation expert Doral Jacobsen MBA, FACMPE, comes in. On Wednesday, November 6th at 1 pm ET, Doral will walk you through how to build and deploy a successful payer contracting strategy step-by-step. You’ll get proven communication scripts, and you’ll even receive a guide to develop your practice’s own value proposition. Armed with these tools, you’ll be able to engage payers and secure increased rates much more quickly and easily.
Here are just some of the proven third-party payer contract negotiation tactics you’ll be able to utilize after attending this expert-led online training:
- Create and implement your practice’s negotiation strategy
- Proven verbiage that helps you tell your practice’s story and speed negotiations
- Complete a market and provider assessment that shows payers why you deserve more money
- Establish a third-party payer proposal process to effectively evaluate offers
- Pinpoint the exact questions you must ask during early payer discussions
- Identify the precise steps you must take to create your practice’s unique value proposition
- Tried ‘n’ true templates that accelerate your work and get results
- Tips to convince payers to pay you based on the value your practice provides to the network
- More easily navigate the negotiation process
- How to speak the payers’ language, so you win the terms you need to succeed
- Learn how to quantify the value your practice adds
- Get your negotiation requests approved using proven post-denial request timeframes
- Determine how to incorporate administrative burden discussions into your negotiations
- Secure higher rates with tips to write results-clinching payer proposals
- Methods that remove harmful clauses like penalties for non-network providers
- Define why you outshine the competition to clinch better coverage
- And so much more…
PART 3: Credentialing/Enrollment 101, Get Approved/Paid Faster & Easier
Attend the live session on Thursday, November 7th at 1:00pm ET OR,
Order the On-Demand Recording to Watch at Your Convenience.
The stakes are high when it comes to correct provider enrollment and credentialing. Missteps can lead to termination from payer networks, lost hospital privileges, and a steep decline in both new patients and revenue. This holds true whether you're dealing with government payers like Medicare/Medicaid or private commercial carriers. Even a single oversight can trigger serious financial setbacks.
But here's the good news: with the right guidance, you can sidestep these costly delays and keep your revenue stream steady.
That’s where Tracey Tokheim, a leading expert in provider enrollment and credentialing, can help. In her upcoming 90-minute online training session on Thursday, November 7th at 1pm ET, Tracey will demystify the enrollment and credentialing process. She’ll equip you with the knowledge to get approvals right the first time, ensuring quicker reimbursements.
During this invaluable session, you’ll discover:
- Proven strategies to overcome enrollment barriers
- How to quickly identify and address application red flags
- Techniques for tracking enrollment activities to avoid missed deadlines
- Mastery of electronic database applications
- Clear hand-off procedures to prevent details from slipping through the cracks
- Effective expirables management to stay compliant
- Streamlined methods for checking application statuses
- Insights on whether all patient plans require provider credentialing
- Ways to expedite payments for newly licensed non-physician practitioners
- A comprehensive Initial Application Process Checklist
- Solutions to common reference errors
- And so much more!
Past Webinar Reviews:
“I attended David’s webinar and learned a lot from it!”
– Tina Borden, Evergreen Family Medicine
“The webinar was wonderful! Tracey spoke very clearly and was easy to understand. Very informative!”
– Marcia Crittenden, Optical Biller, Foxfire Systems Group
“The webinar was well planned out. The flow of information was organized and easy to follow.”
– Linda Habib, Sports Medicine & Joint Replacements Specialists Corp.
“The speaker was very good and the GoTo Webinar's platform was extremely user friendly.”
– Taylor Williams, CenClear
100% Satisfaction Guaranteed or a Full Refund.
The post 3-Part Series: Stop Revenue Leaks Due to Recoupments, Contract Negotiation Pitfalls and Credentialing Errors appeared first on Healthcare Training Leader.