OON reimbursement is on the decline since many health plans have changed their reimbursement rates from a usual and customary formula to a percentage of Medicare.
Durham, NC (PRWEB) May 18, 2016
AudioEducator is the country's top training provider for healthcare professionals in medical coding, billing and compliance. In upcoming months, AudioEducator has lined up some informative training session for the medical coding and billing professionals on various specialties. Every conference is designed to give complete compliance know-how and practical, easy-to-apply advice.
On Thursday, May 26, AudioEducator will host a live audio conference “The Nuts and Bolts of Being an Out-of-Network Medical Practice in the 21st Century” with Thomas J. Force, Esq., where he will discuss best practices and methods out-of-network providers can use to maximize claims payments by insurers and patients. Though improving out-of-network reimbursements could help providers maximize revenue and cut costs, there is not a one-size-fits-all approach for every facility, and it may be difficult for providers to assess reimbursement rates from each payer on their own.
Out-of-network providers receive payment for services directly from the patients—and patients receive out-of-network payments from their insurance company if certain conditions are met. Though going OON can bring higher reimbursements, it may also lead to increased claim scrutiny and higher patient cost sharing. However, currently OON reimbursement is on the decline since many health plans have changed their reimbursement rates from a usual and customary formula to a percentage of Medicare.
In this 60-minute session, Thomas will discuss the challenges providers face while obtaining adequate reimbursement when out of network. He will shed light on ERISA and how this act obligates insurers, plan administrators, benefit providers and patients with certain rights. Find out ways to avoid raising a red flag; policies to implement; and forms to use. Learn about appeals process—time frames, applicable bases for no benefit and low benefit determinations; disclosures and how to stay out of trouble; balance billing, recoupments, and more!
AudioEducator is the country’s leading source of knowledge and training for professionals in medical coding, billing and compliance. It conducts conferences and webinars with nationally renowned experts, consultants and legal experts who provide a fresh perspective on healthcare issues and trends. AudioEducator offers important updates, regulatory knowledge and compliance information on the latest coding and billing in 24+ medical specialties. It has provided thousands of healthcare professionals the opportunity to get answers to their most complex questions directly from experts.
To know more visit: http://www.Audioeducator.com/