Learn what is popping up in payer contract language and fee schedules and discover effective approaches to negotiating with payers. Payers are attempting to control their provider networks to bring more stability to their bottom lines, and this can have massive operational and financial ramifications for your practice. If your specialty is considering anything cutting edge such as office-based labs, watch out for limitations on new technology, prohibitions on pass-through billing, and payers attempting to limit private practice acquisitions through non-assignment clauses. This session will cover the compliance requirements for your practice, including verifying the Medicare exclusion database. Additionally, get useful tips on avoiding terminology that could negatively affect your practice’s finances, such as notice of material changes, term language lock-ins, all product participation requirements, penalties for non-timely demographic updates, and so on.
Learning Objectives:
Point out new language relevant to billing operations that directly and adversely impact revenue, as well as more favorable language in your commercial agreements
Distinguish compliance and credentialing requirements imposed in updated language being used by payers
Breakdown real-life examples of new payer contract language that could impede a practice’s strategic growth plan
.jpg "Marcia L. Brauchler, MPH, FACMPE, CPC (she/her/hers) photo")