How to Contract With a Billing Company? Understand Merits of Internal Vs. Outsourced Billing & RCM Team

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Session 1. How to Contract With a Billing Company

As a healthcare provider, outsourcing your medical billing can make things run smoother and more efficient, but if you’re not careful, it can also open the door to some serious compliance and financial risks. In this session we will break down what you really need to know before signing up with a third-party billing company. We’ll cover what to look for in a billing partner, terms that need to be in your contract, common red flags to avoid, and how to keep oversight in place after the contract is executed.

Whether you’re thinking about outsourcing for the first time or just want to take a fresh look at your current setup, this session will give you the tools to protect your practice and make smart, informed decisions.

 

Session 2. Internal Vs Outsourced Billing – How To Ensure An Efficient RCM Team?

Efficient and effective billing and revenue cycle management services have become a necessity. Profit margins are shrinking in the private sector due to reduced payor allowances, increased regulation, and payor red tape. Operating efficiently is more a matter of survival than it is good business sense.

At the same time, government payors and commercial insurance companies are increasing enforcement efforts through medical record and billing audits which can lead to significant financial penalties. Compliant documentation and billing are legally required.  How can you ensure that your revenue cycle management and compliance are being handled appropriately?

Join Vicki Myckowiak for an intensely practical webinar on the best way to handle your RCM and billing compliance.  Topics will include the pros/cons of using an outside billing company, reasonable billing and collection expectations, contracting with billing companies, and methods to ensure effective billing and compliance.

Must Attend For
✓ Medical Coding Specialists
✓ Medical Billing Specialists
✓ Medical Auditing Specialists
✓ Private Practice Physicians
✓ Managed Care Professionals
✓ Operations Leadership
✓ Practice Administrators
✓ Office Managers
✓ Compliance Officers/Committees
✓ Chief Medical Officer
✓ Medical Practices
✓ Accountable Care Organizations
✓ Medical Societies
✓ Medical Associations
✓ Physicians
✓ Practice Administrators
✓ Hospitals
✓ Billing Companies
Session 1. How to Contract With a Billing Company

Session Highlights

  • Discuss important third-party billing compliance considerations such as HIPAA, False Claims Act, OIG guidance, and state-level requirements
  • Unpack key contract clauses, language examples, and what to avoid in third-party billing contracts
  • Identify examples of red flags as it pertains to improper, noncompliant, or fraudulent billing practices
  • Discuss ways to monitor, audit, and maintain oversight and control of the revenue cycle management
  • Highlight real-world case examples of third-party billing relationships with healthcare providers and what went wrong
Session 2. Internal Vs Outsourced Billing – How To Ensure An Efficient RCM Team?

Session Highlights

  • Merits of internal billing and RCM
  • Merits of outsourcing billing and RCM
  • Negotiation tactics for outsourced billing company
  • Specific contract terms and pressure points
  • Tactics to ensure compliant billing and collection
Session 1. How to Contract With a Billing Company

Session Agenda

  • Recognize important legal and compliance requirements involved in contracting with third-party billing companies
  • Identify critical elements that must be included in a billing company contract (e.g., PHI access, performance metrics, termination clauses)
  • Understand common compliance risks and audit vulnerabilities associated with third-party billing relationships
  • Explore best practices for billing company vetting, contract negotiation, and ongoing monitoring
  • Recognize internal controls to ensure documentation integrity, proper coding, and revenue cycle transparency when outsourcing billing
Session 1. How to Contract With a Billing Company

Session Objectives

Attendees will leave this session with a strong foundational understanding of how to evaluate and select a billing company with compliance and performance in mind, navigate the contracting process to protect your practice, meet regulatory requirements, and define mutual expectations.  This session will also include discussions about how to identify red flags in a billing company that could put your revenue or compliance at risk.

 

Session 2. Internal Vs Outsourced Billing – How To Ensure An Efficient RCM Team?

Session Objectives

Health care providers and facilities depend on billing and revenue cycle staff to ensure the financial viability of their medical practices.  This webinar will walk providers through the decision-making process of who should do their billing, appropriate expectations for billing services, and the most important considerations for contracting with a billing company. Attendees will leave the webinar with practical information they can use when contemplating next steps for their compliant billing and effective revenue cycle management.

User

Presenter

Vicki Myckowiak

Ms. Myckowiak has been practicing healthcare law for 30 years and focuses her practice on representing physician practices on issues including compliance programs, Medicare audits, commercial payor audits, billing service contracting, managed care contracting, informed consent, HIPAA, fraud and abuse investigations, reimbursement, and third party payor coverage issues.  Ms. Myckowiak also works extensively with third party billing companies.  Ms. Myckowiak frequently writes and speaks on trends in health care law including fraud and abuse, government enforcement efforts and regulatory initiatives, contracts, audits, and compliance programs.

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