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Challenges With ASC Contracting Vs. Out Of Network(OON) Billing

This session will discover top trends ASC (Ambulatory Surgical Center) facilities are facing with contracting with Medicare and third-party payers. Participants will learn to weigh the pros and cons of contracting, in order to decide whether out of network billing is the best route for your business. The expert speaker Stephanie Thomas will also give you tips and tricks which will help you ensure that your negotiations are successful.<br><br>Session Objectives:<br><br>Participants will be able to:<br><br>Understand the importance of risk and cost to payers during the contracting process<br>Understand what payers look for, and how to effectively communicate with them<br>Tips and tricks for billing out of network and why this may be the best option for your bottom line<br>Learn how to read contracts and understand what your rights are for renewals<br>Feel confident when making a submission for a new contract<br>Know the length of time to expect for contracting<br>What data is important to submit with your request<br>Understand specific contract terms to watch for<br>Know how to prove value to the payer<br>Know how to negotiate “carve-outs”<br>Know how to terminate a contract

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Challenges With ASC Contracting Vs. Out Of Network(OON) Billing

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Presentation Transcript


  1. LIVE WEBINAR Challenges with ASC Insurance Challenges with ASC Insurance Contracting vs. Out of Network Contracting vs. Out of Network Billing Billing By: Stephanie Thomas CPC, CANPC 1

  2. Objectives Objectives • Contracting • Out of Network Billing • Patient Billing Experience • Terminating a contract • Tips for success 2

  3. Contract or not to contract… Contract or not to contract… 3

  4. Myths about out of network Myths about out of network • The days of OON are over • Being in network with all payer maximizes reimbursement • ASC cannot be out of network if provider is in network • Patients would rather choose an in network facility • Providers will choose to take cases elsewhere 4

  5. In or out of network? In or out of network? Medicare-Recommended Medicaid Blue Cross Triwest or Tricare plans Commercial payers-Approach with caution Know more about the webinar… 5

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