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COVID-19 has prompted a need for creative interactions between payers and providers. This discussion explores managed care contract negotiation strategies in order to facilitate the capture of all possible reimbursements and receivables. This presentation focuses on supporting practices on the payer contracting journey by defining a step-by-step process to build an effective strategy. You must master all nuances before terminating a payer contract. Breach of contract, unclear termination terms, confusing notice periods, and other missteps could cost your practices heavy penalties.

Learning Objective

• Learn how to develop effective payer proposals.
• Identify data and resources needed to craft a practice value proposition.
• Devise an effective renegotiation strategy.
• Construct a plan to position your practice for future payment models.
• Utilize tools effectively in the payer contract negotiation process
• Determine resources evaluate practice market position
• Define a methodology for creating a practice value proposition

Areas Covered in the Session

• Payer Contracting Strategy Development
• Gathering Contracts
• Develop a value proposition
• Complete transparency grid
• Prepare for negotiations
• Determine proposal scenario
• Identify hassle factor
• Engage in negotiations
• Evaluate termination implications
• Utilize the Action plan template
• Create a contract Quick Reference Guide

Suggested Attendees

• Medical providers who are involved in the payment process of their practice
• Physicians
• Practice Managers
• Billing Managers
• C-level Executives
• Office Managers
• Medical Billers
• Medical Coders
• Office staff and Billing Managers
• Medical Billing Companies
• Providers’ Office Staff
• Hospital Revenue Cycle Staff

About the Presenter

Kate Gilman CPC, CPCO has almost two decades of experience in the healthcare industry. She is an expert coder, compliance officer, and trains healthcare providers all over the country. Kate utilizes her expertise to uncover ways to improve billing and coding inefficiencies, training staff, and ensuring compliance while achieving maximum results and revenues for her clients. Kate’s successes include small and large practices, ranging from primary care to specialists and surgeons. She is known for helping providers feel confident in their coding and peace of mind with their compliance practices. Kate’s acute attention to detail, deep understanding of coding and billing, and proactive approach make her an indispensable asset to all her clients.