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In-Network vs Out-of-Network Billing: Tips and Tricks for Optimal Revenue

Presenter Kate Gilman, CPC, CPCO
Broadcast Date 4/24/2024 Add this to your calendar!
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
In-Network vs Out-of-Network Billing: Tips and Tricks for Optimal Revenue Webinar

Learn more about this event

Many practices continue to lose money due to lack of knowledge and understanding of the provider enrollment status with insurances, which plans the practice is in network and out of network with, and what information is needed on the administrative side to get properly reimbursed for the services performed, while staying compliant with commercial and federal insurance regulations.

The goal of this webinar is to review the difference between in-network vs out-of-network status with commercial and federal payers; review the life cycle of the claim; review what appeal process means and how it differs for in vs out-of-network participation with insurance plans; briefly review the process for Single Case agreements for out-of-network providers and what attachments are needed. Also, review ways of setting up protocols for successful billing processes for in and out-of-network providers.

Learning Objectives/Agenda

• Review what the difference is between in and out of network billing.
• Review in and out of network policies and products.
• Review federal plans requirements for out of network.
• Review appeal processes for in and out of network services.
• Review ways how to set protocols for successful billing for in and out of network providers.

Why is this topic important?

This topic is important to make sure that supporting staff for medical providers understands proper processes for in and out-of-network billing to reduce or avoid unnecessary denials and maintain accurate revenue for services performed.

Who would benefit from this topic?

• Medical Billers
• Billing Managers
• Medical Office Managers
• Medical Practice Managers
• Credentialing specialists
• Authorization specialists

What is the presenter's background/expertise on this topic?

Ms. Gilman has over 2 decades of experience in the healthcare field, where they provide education and training to medical practices on proper billing, credentialing, and prior authorization processes.

Kate Gilman, CPC, CPCO

About The Author

Kate Gilman, CPC, CPCO

Kate has over two decades of revenue cycle management experience in the healthcare industry. She is an expert at uncovering and correcting all billing inefficiencies and errors, while streamlining operations to achieve maximum results. Kate’s successes include small and large practices, ranging from primary care to specialists and surgeons. She is known for keeping accounts receivables as low as possible, while ensuring collections are optimized. Kate’s acute attention to detail, deep understanding of coding and billing, and proactive approach, make her an indispensable asset with all her clients.

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Two ways to register for this event

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