AUDIOCONFERENCE ON TAPE
sponsored by Managed Care Contracting & Reimbursement Advisor
presented on June 15, 2005
Learning how to use denial data to get better payments from managed care companies is an important key to a hospital's financial success.
Listen to this 90-minute audioconference and learn how to negotiate with payers using a back-to-basics approach that defines and addresses your hospital's problem areas and strengthens processes. Our speakers will frame the issues and provide strategies to make denial data work to your advantage. <
YOU'LL GET THESE BONUS TOOL TO USE IMMEDIATELY!
Appeals flow chart Sample contract clauses Denial matrix Six ways to use denial data to improve managed care contracts TAKE A LOOK AT THE AGENDA
1. Introduction: Provider frustration
framing the issue: the current managed care climate typical situations that lead to denials 2. Terminology of denial
defining a denial and its sources looking at problems (including underpayments; primary and secondary payers; technical vs. clinical denials; bundling; denials or outdated payments for new procedures or new technologies; "paperwork" denials—when the claim is pended or rejected because of claim documentation issues) understanding the process to identify improvements 3. Data collection
using data to your advantage tips and strategies (tracking, trending, reporting; working with other departments) appeals to bring the denial full circle creating or enhancing a denial database 4. Contract negotiations: the rules of engagement
evaluate your contract performance prepare your contract performance report card for the negotiation strategies to get your contracts changed use your data to negotiate sample contract changes developments in payment A question-and-answer session follows the presentation.
Participants will learn how to
develop multiple ways to track denials identify the payment and denial problems that affect cash flow use a back-to-basics approach for addressing denials analyze denial data categorize denial types identify improvement opportunities MEET THE SPEAKERS
Robin Fisk, Esq, has 17 years experience in the health law field representing healthcare providers, insurers, managed care organizations, physicians and hospitals, including negotiating managed care contracts from both sides of the table. She also advises clients on regulatory compliance, and Medicare payment appeals, as well as more general business issues.
Christine F. Collins, CHAM, is the director of patient access services at the Brigham and Women's Hospital in Boston. She is a seasoned expert in access management and has actively participated in professional access management associations both locally and nationally. She has served in many capacities on the board of directors of the National Association of Hospital Access Managers, including president.
WHO SHOULD LISTEN
Managed care directors and managers, PFS and business office managers, finance executives, revenue cycle managers, group managers, utilization management staff, compliance officers, case managers, and patient access staff.
PROGRAM MATERIALS:
Program materials will be provided via e-mail with PDF links.
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