Managed Care Contracting, Negotiation, and Reimbursement
Chicago, IL — December 10–11
Get 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. Also included is a review of the driving forces in managed care, including healthcare reform, specifics on payer initiatives, public policy, and patient service imperatives shaping change.
After this seminar, you'll be able to:
- Review insurance, PPO, and ERISA plan contracts to maximize reimbursements and minimize denials.
- Recognize problematic contract terms that impact 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.
General knowledge of reimbursement and contracting principles.
Tools and takeaways
- List of contracting and negotiation principles
- Sample of a managed care contract
Ellen E. Stewart, FHFMA, JD
Partner, Berenbaum Weinshienk PC
Continuing education: 14 CPE credits
What You Need to Know About HFMA's Seminars