Navigating the Reimbursement Minefield: Strategies, Trends and Tips In Provider-Payor Conflict
Date & Time: Sunday, August 2, 2020, 9:00 AM – 10:00 AM EST
Presenter: Harry Nelson
The addiction treatment/behavioral health landscape is changing rapidly and companies that fail to develop a proper reimbursement roadmap will be at a severe disadvantage. Attendees will gain an understanding of the latest trends in payor audits, prepayment reviews, and special investigations, including risks, primary areas of focus and emerging areas of concern for both in-network and out-of-network addiction and behavioral health providers in obtaining payment from insurance companies. The presentation will provide strategies, tools, and approaches that providers can implement to reduce risk and improve success in maximizing reimbursement for services.
Learning Objectives:
- Describe the leading trends and perspectives shaping the transformation of behavioral health and addiction treatment reimbursement, and the principal challenges and risk issues
- Develop a comprehensive approach to ensure effective, accurate, and complete records to minimize audit and recoupment risks and maximize reimbursement
- Discuss dispute resolution strategies and the pros and cons of reimbursement litigation, including when and how a dispute with a commercial insurance company should be resolved informally or escalated to an attorney and when filing a lawsuit may be beneficial or necessary to be paid for services rendered