Payers are attempting to control their provider networks to bring more stability to their bottom line. However, this can have massive operational and financial implications for your practice. In this session, learn common elements of payer contract language and strategies for addressing fee schedules with payers. For example, if your specialty is considering anything cutting edge, watch out for limitations on new technology, prohibitions on pass-through billing and attempted limits on private practice acquisitions through non-assignment clauses. The speaker will provide actual language from payer agreements and helpful reminders about the traditional language terms that can have an adverse financial impact on your practice, such as notice of material change, term language lock-ins, all product participation requirements, and penalties for non-timely demographic updates.
Learning Objectives:
Point out new language relevant to billing operations that directly and adversely impact revenue.
Collect the new, relaxed E/M documentation standards for your commercial agreements.
Examine new payer contract language that could impede a practice’s strategic growth plan in areas such as expanded ancillary services, practice acquisition, and new locations.
