Optimizing Revenue: Master Third-Party Payer Management in Healthcare Setting

Course Description:

Are you looking to enhance your medical office's efficiency and revenue by better managing third-party payer relationships? Join this comprehensive webinar, where you will be guided through critical aspects of dealing with third-party payers.

Provider contracts with third-party payers are complex agreements that encompass various components. These typically include the scope of services and covered benefits, detailing which services are included and under what conditions. Reimbursement rates and payment processes are also key, outlining how providers will be compensated for their services. Quality measures and performance standards are often stipulated to ensure that providers meet certain benchmarks. Understanding these terms and provisions is vital for maximizing reimbursement, preventing denials, and maintaining a smooth revenue cycle.

Provider credentialing is critical to the success of your medical practice. Credentialing involves verifying and assessing healthcare providers qualifications, competence, and professional background. This procedure ensures that healthcare professionals are adequately educated, trained, and licensed to provide safe and ethical care. The importance of provider credentialing lies in its role in patient safety, legal and regulatory compliance, insurance reimbursement, and provider network management. By thoroughly vetting the credentials of healthcare providers, medical facilities can maintain a high standard of care, mitigate risks associated with unqualified practitioners, and uphold the trust of patients and the community at large.

Key topics covered in this webinar include credentialing with third-party payers, where you will understand the credentialing process and learn best practices for timely and accurate credentialing to avoid delays in patient care and reimbursements. We will delve into the contracting process and how to secure the best contracts, providing insights into identifying and securing the most favorable contracts for your practice. Understanding the key components of contracts is essential, and you will learn to identify terms and conditions that can impact your practice’s operations and revenue.

Stay compliant by understanding the rules and regulations in contracting, learning to navigate regulatory requirements to avoid legal pitfalls. Discover effective negotiating techniques to secure the best possible terms in your contracts and learn how to approach negotiations with confidence and strategic insight. We will explore the best negotiation strategies to maximize your practice’s benefits, teaching you how to address payer concerns. Additionally, you will identify opportunities to increase revenue with your current payer mix and learn strategies to manage and optimize revenue from Out-of-Network patients.

Attending this webinar will enhance your understanding of third-party payer dynamics, improve your practice’s financial health through better contracts and negotiation strategies, ensure compliance with regulations, and avoid costly errors. This webinar is ideal for medical office managers, healthcare administrators, billing and coding professionals, physicians, and practice owners. Don't miss this opportunity to gain valuable insights and practical strategies for effectively managing third-party payers in your medical office.

Learning Objectives:

Learn the various components of payer contracts
Understand the credentialing process
Learn effective negotiating techniques
Know when to sign a contract and when to walk away
Understand the benefits of joining a payer network
Learn how to optimize revenue from Out-of-Network patients
Understand the importance of timely credentialing

Areas Covered in the Session:

Credentialing with Third-Party Payers
Contracting Process and Securing the Best Contracts
Key Components of Contracts
Rules and Regulations in Contracting
Negotiating Techniques
Best Negotiation Strategies
Increasing Revenue with Current Payer Mix and Out-of-Network Patients
Live Q&A session

Suggested Attendees:

Healthcare Administrators
Physicians
Non-Physician Practitioners
Medical Office Managers
Billers and Coders
Medical Assistants
Nurses
Agency Owners
Clinical Supervisors
Directors of Nursing
Quality Improvement/ Quality Assurance Managers
Compliance Officers
Clinicians
Administrative Staff
Out-of-Network Providers
C-level Executives
Office Managers and Staff
Billing Managers
Medical Billing Companies
Insurance Companies
Hospital Revenue Cycle Staff
Credentialing Staff
Medical Providers who are Involved in the Payment Process of their Practice

About the Presenter:

Jan Hailey, MHL, CMC, CMCO, CMIS, CMOM, CMCA-E/M, has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has led comprehensive interdisciplinary teams working closely with providers, management, staff, communities, and payers to develop strategies for process improvement, quality gap closures, and patient experience.

Jan has a Master of Health Leadership degree and five professional certifications in office management, coding, insurance processing, auditing, and compliance. She is a WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group member and has also been instrumental in Workforce Development Initiatives.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

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Sandie Fowler, Out of Network Billing Staff

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Tina Duffy, Compliance Officer

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