Search Results for: Payer Contracting

Unfortunately, getting and keeping your dentists enrolled and credentialed in both commercial and government insurance plans is a necessary evil – even with the ADA CAQH ProView online portal. The American Dental Association (ADA) collaborates with the CAQH ProView portal to make enrolling and credentialing your dentists easier – to reduce the administrative burden of[...]

Complying with recent changes when billing for out-of-network and uninsured patients is more complicated due to recent rule changes. Learn how to comply before the audits begin. Sign up for online training today.

About 83% of your non-Medicare/Medicaid claims are governed by ERISA regulations. However, payers don’t want you to know how to apply these rules to take control of your reimbursement. This training shows you how.

When done right, telehealth billing & coding can produce significant revenue for your practice. However, in 2023 there are multiple items that can halt your payments. Get proven tactics to successfully bill and code these services.

2023 CAHQ ProView changes are a nightmare. Unfortunately, if you want to keep your practice’s revenue flowing, your provider’s CAQH profile MUST be kept accurate, active and in compliance. This expert-led training will help.

You can get paid for denied out-of-network services. The catch is that you must master CMS’ recently implemented IDR process. Get proven strategies to correctly utilize this new process to overturn these previously unpaid claims.

When onboarding a new physician into your practice, your process must be flawless. A simple mistake can result in sever reimbursement delays – or worse, payer rule violations.  With this online training you’ll get it right the first time.

With a little help, you can comply with complex balanced billing laws, avoid a stressful audit and the massive violation penalties that can result. Stop making innocent mistakes that can lead to huge penalties and even jail time.

You must correctly incorporate the massive 2023 E/M changes to keep reimbursement flowing for prolonged services, ED visits and more. These expert, step-by-step coding tips will show you how.

Avoid delaying and losing reimbursements. Streamline your credentialing and enrollment process – more efficiently manage multiple providers and locations NPIs, Tax Ids, delegated agreements, and more. Proven online training.

CMS has plowed through their appeals backlog, opening their doors to reimbursing your claims FASTER. Get expert tips on winning appeals strategies that convince Medicare and private payers to give you the cash you deserve.

Split/shared and incident-to billing rules have always been confusing, and they’re about to get even more vexing, due to new 2023 rules. Collect 15% more for your APP’s services by mastering the new rules during this training.

Get the tactics you need to make utilizing the CMS PECOS online Medicare enrollment and credentialing system less confusing and more accurate. Attend this training for practical, expert advice so you get it right the first time.

Billing patient directly may be your best bet of getting paid for commercial payer non-covered services, but you should NEVER do so without the correct forms on file. Attend online training to master non-covered services billing.

Payers include excessive administrative burdens in managed care contracts that delay your reimbursements and add hours of extra processing time for your staff. Get negotiation tactics to cut these burdens & save time and money.

How you manage your outsourced medical billing vendor relationship can seriously increase your claims’ reimbursement and decrease your financial and legal risk. Expert Owen Dahl’s training will show you how.

The physician credentialing process is a complicated collection of hoops to jump through and moving parts to track. Get a step-by-step, proven process to help you keep cash flowing.

Any snag during the provider credentialing and enrollment process will slow down your ability to bill for your provider’s work and bring money into your practice. Discover the proven tips that can help you speed up the process.

Your practice is required to create and validate your provider directory listings or be faced with getting kicked off the panel. This online training will help comply with these No Surprises Act rules and keep your revenue flowing.

There is a lot riding on the accuracy of the claims you submit. Missing even one step in the billing process can result in dire consequences — significant reductions in claim reimbursement, increased denials, overpayments/recoupments, refunds, and ultimately audits that lead to massive fines and penalties. From pre-authorizing procedures and collecting copays to appealing claims[...]

Uncover language in your managed care contracts that can help your practice get paid more and avoid hidden pitfalls. Healthcare attorney Michael R. Lowe shows you how to make your managed care contracts work for you.

You depend on accurate medical coding to keep your practice’s reimbursement flowing — and though it’s not vital for everyone to know HOW to code, it is important to get a basic understanding of coding to preserve your income.

The 2022 E/M updates have added complexity to your billing process. This upcoming training will guide you through getting your claims right, reducing denials, and boosting payments.

Outpatient payer audits are skyrocketing in 2022. To survive you must be prepared. Get practical, real-word strategies to help you identify and resolve medical record hot zones in your practice – before you get audited.

Quickly overturn more of your rejected claims with proven Medicare appeal strategies. The key is mastering the nuances of the Medicare appeal process by cutting through the government requirements. Find out how…

By making you use virtual credit cards for your reimbursement payments, payers are passing their processing fees on to you. You can refuse and keep more of the money your practice is due. This training will show you how.

Stop the Office of the Inspector General (OIG) from requiring you to give back the telehealth reimbursements you received during COVID from Medicare and Medicaid.  Auditor are targeting these claims to recoup overpayments.

Properly coding for COVID testing is essential to getting paid what you deserve.  This training will help you more accurately code each COVID testing encounter right the first time, and to avoid over-coding and lost revenue.

You can get payers to increase your rates if you know the proven tricks that help you engage insurers and win contract negotiations. This online training gives you the tools you need to secure higher rates and better terms.

If you want to get paid, prior authorizations are a necessary evil. They put an intense burden on your practice, staff, patients, and you.  You can reduce the time they take and improve your overall approval rate with some expert help.

More accurately code your Remote Patient Monitoring (RPM) claims and protect your practice against auditors looking to recoup payer reimbursements. Expert strategies to overcome this year’s RPM confusing rules changes.

Attorney provides practical advice on how you can reduce Medicaid audit triggers at your practice, more effectively respond to Medicaid audit notices and documentation requests to significantly reduce overpayment demands.

Getting your mid-sized to large practice designated as a credentialing delegate with payers means you can eliminate enrollment delays, get paid faster, and avoid re-enrollment disasters.

Proven negotiation strategies to use before you sign your next physician/hospital service agreement. This expert training will help you get paid more and protect yourself and your practice against federal and state violations.

Commercial payers are taking their enrollment and credentialing deadlines more serious than ever. Missing a deadline by even a day can have serious consequences for your practice.  

Stop self-pay billing mistakes from leaving your practice exposed to serious financial and legal penalties. This training can help you protect your practice by complying with with confusing self-pay billing rules. Sign up today.

Payer auditors are closely scrutinizing telehealth claims, and mental health is at the top of the list. This training will help you audit proof your telehealth mental health claims and walk you through how to fix the ones  already filed.

Get proven strategies to help you write an appeal letter template that will get more of your denied claims overturned and improve the reimbursement you receive.   Register for this expert-led online training today to find out how.

Time based coding may make it easier to calculate the level of your office visit, but do it wrong and you’ll lose thousands in reimbursement and get audited. Find out how to make time based coding work for you.

You don’t have to settle for the terms and payment amounts in your payer contracts. Implement these proven strategies to negotiate a better deal, keep the plans you what and know when it’s time to get out. Signup today.

Out-of-network collections are complicated. Successfully negotiating with payers, communicating with patients and getting paid what you are due is possible if you know how. Sign up for this expert-lead online training to find out how.

Master proven strategies to get payors to overturn your contract deactivation.  This expert-led online training will walk you through each step and help you head off lost patients by reactivating your contract.

Get expert advice to master E/M and surgical modifiers to get paid more of what you deserve and avoid getting audited and fined. This online training gives you practical advice you can put into action immediately.

Don’t fall prey to CMS auditors intensely scrutinizing surgical modifier claims. They are digging to uncover recoupments (and earn commissions). Protect your practice, sign up for this step-by-step surgical modifier training today.

Applying E/M modifiers incorrectly can seriously cut your revenue, especially considering this year’s massive 2021 E/M changes.  Don’t file another E/M claim without ensuring you’ve got it right. Sign up for this online training today.

Terminating a payer contract may feel like you’re slaying a dragon but do so for the wrong reasons and you could unintentionally slash your revenue too. Get the strategies you need to decide when you should walk or stay.

Payers report that they’ve overpaid for telehealth services. To combat this, auditors are picking through thousands of telemedicine claims to take back these overpayments. Find out how to protect your telehealth revenue.

National expert provides easy-to-implement provider credentialing and enrollment tools to help you improve data accuracy and avoid lost reimbursement due to delays in applications, payer approval, and hospital privileges.

Stop letting your payers dictate contract terms. Learn how to analyze and renegotiate your payer contract to improve your overall reimbursement, speed up payments and reduce surprise rate changes.

You’re going as fast as you can to implement telemedicine, but without the right technology and workflows, your daily operations will be much slower – and lower reimbursed – than they need to be.

Learn how to more successfully negotiate and renegotiate your payer contracts to improve your practice’s reimbursement and volume of patient referrals. Two healthcare attorneys show you how.

Get proven appeal strategies to help you overturn more third-party-payer denials and avoid claim reimbursement reductions. During this live online training, healthcare attorney tells you how.

Avoid common CMS 1500 Claim Form error that lead to delayed payments or completely rejected claims. Expert biller provides you with step-by-step advice that will get you paid faster and more accurately.

Expert prior authorization strategies to help you reduce your workload and improve your reimbursement. This A-Z training will help you identify areas you can improve within your current processes and your payments.

Without a recall strategy, many of your patients would never schedule their next visit. This lack of recurring patient care puts your practice at risk of losing hundreds of thousands of dollars in lost revenue…

Getting and keeping your providers enrolled in the most popular payer networks is the only way to ensure the success of your practice. However, it can be complicated and time consuming, but it doesn’t have to be…

There is a lot riding on the accuracy of the claims you submit. Missing even one step in the billing process can result in dire consequences – significant reductions in reimbursement, increased denials, and ultimately…

As Medicare and private payers continue to go after reimbursement paid in error, the chances you’ll get audited has increased. Auditors can dig through your previously filed claims for a “look back period” of 6 YEARS…

Open the doors of those “closed” and “narrowed” insurance panels that will most benefit your practice. Don’t walk away from payers when they deny you access to the patients you want. Use these proven tactics to get…