Challenges with ASC Insurance Contracting vs. Out of Network Billing

This webinar will discover the top trends ASC facilities are facing with contracting with Medicare and third party payers. You will get the tips and tricks to ensure your negotiations are successful. You will learn to weigh the pros and cons of contracting to decide if out-of-network billing may be the best route for your business.

Why Should You Attend:

By attending this session, you will feel confident when making a submission for a new contract. You will be able to understand the importance of risk and cost to payers during the contracting process. You will understand what payers look for, and how to effectively communicate with them. You will get tips and tricks for billing out of network and why this may be the best option for your bottom line. You will also learn how to read contracts and understand what your rights are for renewals.

This session will discuss:

• Length of time to expect for contracting
• What data is important to submit with your request
• Specific contract terms to watch for
• How to prove value to the payer
• How to negotiate “carve-outs”
• How to terminate a contract
• Out-of-network billing tips and tricks

Areas Covered in the Webinar:

• Myths about out of network
• Medicare contracting
• Mandatory documentation to be included
• Medicaid contracting
• Blue Cross contracting
• Triwest or Tricare plans
• Difference between TRICARE-certified and TRICARE-contracted
• Commercial payers
• Narrow networks
• Contract verbiage for narrow networks
• Impact of narrow networks on your bottom line
• What to include with your initial application
• How to prepare your negotiations
• How to negotiate carve outs
• Warning signs for contracts
• Pros and cons of out-of-network billing
• How to terminate a contract

Who Will Benefit:

• ASC Administrators
• Physician ASC Owners
• Billing Managers
• Credentialing Administrators/Support

Stephanie Thomas
Billing Director, CE Medical Group

Stephanie Thomas is the Billing Director for CE Medical Group, a third party billing and consulting firm. Stephanie has been in the medical field for nearly 20 years. Her experience includes Private Practice Administration, Medical billing for several specialties, Practice Management Consulting for numerous physicians and ASC’s across the nation.

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