Getting paid for Out of Network patient services is more difficult now than ever before. It is projected that 95% of your patients will fail to fully pay for their medical bill balances by 2020 (alarmingly, this is up from 68% in 2016 and 49% in 2014). Whether you choose to be out-of-network, or the payer drops you as they narrow their provider network, the result is the same – you are at the mercy of your patients to pay a larger and larger portion of their medical expenses. Even when you do get paid, it typically takes longer and can cost you four times more than when you receive payment directly from a payer you contract with. However, there is something you can do about it.
By making a few easy-to-implement modifications to how you manage your out-of-network patients, you can significantly improve the reimbursement you receive. The expert Owen Dahl, LFACHE, CHBC, LSSMBB, can help by showing you exactly how to significantly improve your out-of-network payments – from both patients and payers.
During this live session, Owen will walk you through what you and your staff can do to get more of your out-of-network patients and carriers to pay faster and at less cost to your practice.
- To define Out of Network
- To note which OON opportunities may work for you
- To understand the contracting process and why OON exists
- To identify if Out of Network is right for you
- To develop procedures for collecting the amount due
- To find the amount due to you for services provided
- To discuss how to improve collections when patients are OON
- To discuss communication with patients on why, what, and how they can deal with OON
Areas Covered in the Session:
- Out of network is a concept that many wish to have but the cost benefit may not be worth while
- Participating in contracts may be good and bad, how you know the difference and what might apply to the practice
- Why would a practice do this
- What are the processes necessary to be successful in being OON vs. being in network
- A plan may deselect the practice for reasons beyond their control which may force OON
- Analysis of the payer mix will assist in decision making regarding OON
- Understanding local market will assist in the decision making regarding OON
- What accepting assignment in Medicare and non-Medicare payer relationships
- Tactics in negotiation with payers will help make the decision, who has the strength in the relationship
- Communicating the OON position to the patient for their complete understanding is essential for success
- Medicare rules are different
- There will be a more complex billing scenario to manage
- Training staff
- Physician (Clinician) awareness of care decisions must be understood
- Discounts for paying patients is an option
Who Should Attend:
- Office Managers
- Practice Manager
- Finance Manager
- ASC Owners
- Credentialing Manager or Specialists
- Billing Manager
- Mid-Level Providers
- Non Physician Practitioner such Physician Assistants, Nurse Practitioners
- Healthcare Staff
About the Presenter:
Owen J. Dahl, MBA, LFACHE, CHBC, LSSMBB, is a principal of Owen Dahl Consulting, in The Woodlands, Texas. He has 53 years of experience in consulting, running a medical billing service and managing medical practices. He was also a hospital administrator. Owen speaks across the country on medical practice issues related to strategic planning, Lean and Six Sigma, culture, human resource management and the revenue cycle.
He is an adjunct professor at the University of New Orleans, the author of Think Business – Medical practice quality, efficiency and profit, contributing author of the popular book Lean Six Sigma for the Medical Practice and recently published Integration of Behavioral Health Into Medical Homes: A Rapid Implementation Guide. Owen received his Bachelor’s degree in Hospital Administration at Concordia College, Moorhead, MN and his Master’s from the University of Northern Colorado. He recently achieved his Lean Six Sigma Master Black Belt through Villanova University. He served in the USAF.
You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
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