Payer Contracting Virtual Workshop: Demystifying Managed Care Contracts

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Payer Contracting Virtual Workshop: Demystifying Managed Care Contracts

Product Code: YZHHA091218

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Payer Contracting Virtual Workshop: Demystifying Managed Care Contracts

Calendar
 

Presented on:
Wednesday, September 12, 2018
12:00-3:00 p.m. Eastern

Presented by:
Tanja Twist, MBA/HCM

Level of Program:
Intermediate

Negotiating payer contracts can feel intimidating, but it doesn’t have to be if team members are armed with the right tools to demystify contract rates and terminology. Breaking down the intricacies of managed care contracting is essential for facilities when reviewing and negotiating the terms of a contract.

During the first part of this three-hour workshop, expert speaker Tanja Twist, MBA/HCM, will share her real-world experience navigating the challenging world of payer contracting negotiations, including analyzing current contract performance and understanding the bottom line when it comes to contract rates.

The second part of the workshop will focus on understanding how to mitigate the impact of policies and manual directives on payer contracts.

The final part of the workshop will cover strategies for involving team members in payer contracting, including educating teams on the contract terms that impact their roles. Each part of the workshop will include a case study and Q&A session.

At the conclusion of this program, participants will be able to:

  • Identify contract rates, terms, and language that can increase margins
  • Evaluate contract performance through an analysis of denials
  • Recognize when services are paid for in accordance with contract terms
  • Describe best-practice techniques to prepare for contract negotiations
  • Explain the contract negotiation process
  • Discuss post-negotiation contract management, including distribution, education/training, and monitoring


Who Should Listen?

  • Revenue cycle directors, managers and staff
  • Patient financial services directors, managers, and staff
  • Revenue integrity directors, managers, and staff
  • Managed care contractors
  • Billers
  • Finance directors, managers, and staff
  • Business office directors, managers, and staff
  • Hospital payer contractors
  • Reimbursement managers
  • Case management directors, managers, and staff


Agenda

  • Part I: Contract negotiations
    • Analyzing current contract performance before entering negotiations
    • Understanding the bottom line when it comes to contract rates
    • Gathering key stakeholders
    • Analyzing current contract performance
    • Hiring external help or going it alone
    • Case study
    • Live Q&A
  • Part II: How policies and manual directives impact contracts
    • Understanding how the language of a contract can negate your negotiated rates
    • Interpreting the payer’s medical policies and provider manual directives
    • Mitigating the impact through contract language
    • Case study
    • Live Q&A
  • Part III: Teamwork in contracting
    • Educating team members about contract terms that impact their roles
    • Managing contracts through distribution, education, and matrices
    • Case study
    • Live Q&A


Tools

  • Contract timeline chart
  • Payer language samples—what works and what doesn’t
    • Appeals
    • Timely filing
    • Credit balances
    • Medical policies
  • Checklist to aid in preparing for negotiations with a payer


Meet the Speaker

Tanja Twist, MBA/HCM

Tanja Twist, MBA/HCM, has over 25 years of experience in healthcare revenue cycle management, with a focus on reimbursement and denial management. Twist has served as director of patient financial services and overall operations officer for large and small hospitals, as well as professional providers and provider groups. She advocates for hospitals and providers nationwide, providing revenue cycle management services supported by a deep knowledge of state-specific issues and unparalleled expertise in Medicare, Medicaid, and commercial reimbursement.

Twist has a bachelor’s degree in business management and a master’s degree in business administration with a certification in healthcare management. She is a nationally recognized speaker on governmental recovery programs, commercial denials, and best practices to avoid audits. Twist is on the board of the Western Region chapter of the American Association of Healthcare Administrative Management, was a board member for the Workgroup for Electronic Data Interchange, and is an active member of the Southern California chapter of the Healthcare Financial Management Association.


Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version is also available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $399 value! 

PLEASE NOTE 
Participation in the webinar is just $399 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.

*This webinar is excluded from the Loyal Listener Library subscription