Learn how to gain an advantage with commercial payers by negotiating contract language that works more in your favor, resulting in more consistent payment at the best possible rate.
Do payers have the upper hand with your hospital? The language in commercial payer contracts drives crucial aspects of your revenue cycle, including the determination of admission status and how much you get paid for a patient’s care. Despite the best efforts of your contract managers, you may not be able to obtain the agreed-upon rate. Often the culprit is how the contract is worded — you may be getting the short end of the stick.
This exclusive RACmonitor webcast will empower you to turn the tables more in your favor. From case management experts Tiffany Ferguson and Marie Stinebuck, you’ll gain tried-and-true guidance with critical aspects of your payer contracts, including negotiation of contract language, recommendations for a regular contract review process and how to ensure that your revenue cycle team understands payer requirements.
Many clinical revenue cycle teams struggle with how to dispute a peer-to-peer appeal. Or perhaps they accept an observation rate, knowing full well that the case met inpatient criteria. Frequently, the problem stems from not understanding contract language, or the contract is simply written in a way that renders the hospital defenseless against payer guidelines and rules. Don’t settle for business as usual…learn how to achieve greater leverage in your payer contracts!
Director of utilization review, director of case/care management, director/vice president of revenue cycle, contract managers, chief financial officer and physician advisors.
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