What you need to know to hold payers accountable, achieve maximum reimbursement,
and generate more revenue for your pathology practice.
- Thomas J. Force, Esq. Founder, President & Chairman of the Board
The Patriot Group, Lindenhurst, NY
The increasing cost of treatments and procedures coupled with reduced reimbursements from payers are combining to put a major squeeze on many pathology practices.
What’s worse, with the tightening of provider networks, more and more labs are being classified out-of-network. To increase your chances of collecting all the money that’s due you from both payer and patient, and to receive payment in a timely and accurate fashion, it is vital that you implement some best practices before, during, and after providing services. What’s also important is the skills necessary to appeal claims in a timely fashion, and to the proper authorities.
When you register to attend “Essential Steps to Maximize Your Lab’s Revenue: Best Practices Dealing with Commercial Payer Processes and Policies, and Managing Compliance, Audit and Recoupment Issues” on Wednesday, January 31, 2018, you will hear from Thomas J. Force, Esq., a noted expert in the field, who will help you and your lab staff understand the various policies and patterns of underpayment payers are now using to reduce reimbursements, and to give you a comprehensive set of steps you can take to stop this trend of significant reduction of revenue.
Hear about the all of the areas your pathology practice needs to address in order to be on the path to maximizing revenue. Learn the 3 major components you must address to hold insurance companies accountable, particularly to maximize your revenue on an out-of-network basis. These components include doing the proper eligibility research and documentation, the concept of “Phantom” out-of-network coverage, the importance of building a charge analysis database, and why – and when – you should order a Summary Plan Description.
You’ll get strategies and techniques that will prepare you to properly deal with under-reimbursed and denied claims, recommendations for appeal success, how to apply ERISA when appropriate, and the right way to handle patient collections (particularly when in out-of-network situations, the payer sends the reimbursement check directly to the patient). Not being aware of these best practices will severely limit your ability to contest denied and under-reimbursed claims and optimize payments in the current climate.
You’ll also learn valuable insights on compliance, audit prevention, and defense. Take away from the session effective techniques for balance billing. Understand your rights regarding prompt payment, and the steps to take when faced with audits, take-backs, and recoupments. In addition, you’ll be provided with a list of best practices to reduce your risk of fraud allegations, including disclosures and follow-up strategies.
This is an essential session for pathologists, pathology practice administrators, and billing managers alike, and will provide you with an armamentarium of important and unique insights you can put to work right away. For one low price—just $195 (through 1/25/18, $245 thereafter)—you and your entire team at one location can take part in this fast-paced, insightful webinar. Best of all, you’ll be able to connect personally with our speakers when we open things up for questions from the audience.
Register now to guarantee your place!
Your Distinguished Presenter
Thomas J. Force, Esq. is a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries. He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare.
Force is also the former CEO, general counsel and chief compliance officer of a small New York-domiciled health insurer, a former chief operating officer, general counsel and chief compliance officer of a large East Coast billing, collections and healthcare consulting company, and a former co-chair of the Health & Hospital Law Committee of the Suffolk County Bar Association.
Thomas is a nationally recognized expert and frequent speaker on managed care issues, managed care contracting, managed care appeals, ERISA and out-of-network reimbursement issues. He recently presented on ERISA-related issues to the American College of Osteopathic Surgeons in Las Vegas and to the Medical Society of New Jersey.
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Here is just some of what you’ll learn during this in-depth 90-minute conference:
- How to properly review and document eligibility
- Employing current best practices when dealing with out-of-network claims
- Techniques to appeal denied and under-reimbursed claims
- How to handle external appeals and independent medical reviews
- Prevention, security from, and defense against audits
- Writing the effective appeal letter/objection letter in the event that you are audited
- Patient forms and disclosures essential to appeals and fraud audit defense
- ERISA protections, and obligations of plan administrators to you
- Understanding the prompt payment law and insurers’ obligations
- Balance billing and recoupment strategies