Memphis, TN - May 7-8
Summary
This seminar provides an in-depth understanding of the managed care system within the context of the current U.S. healthcare system, including bundling charges, paper and provider audits of pre-payment and post-payment issues, global fees, capitated payments, and special issues relating to physician contracting. This seminar also covers contracting tips and best practices for addressing medical decision-making models, quality measures, and payment related to same.
After this seminar, you'll be able to:
- Review insurance, PPO, and ERISA plan contracts to successfully maximize reimbursements and minimize denials.
- Recognize problematic contract terms affecting both reimbursement and operations.
- Discuss capitation per diem and percentage of charges rate, understand the assumed risks, and develop strategies for managing and sharing those risks.
Prerequisites
General knowledge of reimbursement and contracting principles.
Tools and takeaways
- List of contracting and negotiation principles
- Sample of a managed care contract
Faculty
Ellen E. Stewart, FHFMA, JD
Partner, Berenbaum Weinshienk PC
Continuing education: 14 CPE credits
Level: Intermediate
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