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Payer Contract Negotiations

Presenter Kate Gilman, CPC, CPCO
Broadcast Date 3/22/2023
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
Payer Contract Negotiations Webinar

Learn the art of negotiating payer contracts to help you maximize revenue and provide financial stability in your healthcare organization. This webinar will explain the nuances of payer contract negotiations, so you better understand how to make an agreement that works for both providers and payers.

Learn the art of negotiating payer contracts to help you maximize revenue and provide financial stability in your healthcare organization. This webinar will teach you how to identify the most common payers and CPT® codes used for reporting medical services. You’ll be able to manage current payer contracts/agreements and create an action plan for negotiations; set an expected timeline for negotiation strategies and projects; satisfy provider and patient interests; meet with decision-makers for concurrence on strategy; and gather payer contracts and the resources needed to craft a practice value proposition.

Developing an effective payer negotiation strategy starts with believing in yourself and being confident that you have what it takes to make more money for the services your healthcare organization provides. This webinar will explain the nuances of payer contract language, so you better understand how to make an agreement that works for both provider and payer. And when necessary, you can determine when termination is the best recourse. With this webinar, you’ll set your timeline for every step, identify necessary data, send letters of proposals, and review the contracts you receive, and negotiate when needed, so your healthcare organization will enjoy financial results that ensure you get paid for the medical services your medical practice provides.

The webinar ends with a Q&A session to help answer common questions that arise during payer contract negotiations.

Learning Objectives/Agenda

• Help your practice increase revenue and make more money for rendered services through payer contract negotiations
• Develop effective negotiation strategies and timelines
• Understand payer contract language, such as amendments, timely filing, prompt pay, overpayment, underpayment, termination, merger, arbitration, network requirements, etc.
• Gather current payer contracts and determine which contracts need to be negotiated
• Review ways to manage current payer contracts and agreements
• Identify the data and resources you’ll need to craft a practice value proposition plan and create a quick reference guide proposal letter

Why is this topic important?

Healthcare payer contract negotiations are important for many reasons. Negotiating favorable rates will ensure financial sustainability because the rates agreed upon in contracts directly impact a healthcare provider’s revenue. Payer contracts also determine which patients have access to a provider’s services. Being in-network for many payers can increase a provider’s patient volume. Contract negotiations can also impact patient care because some include performance incentives that encourage providers to improve quality of care, which can lead to better patient outcomes. Contracts also provide predictability for both the provider and the payer. They set clear expectations for payment amounts, dispute resolution, and other key aspects of the provider-payer relationship. During negotiations both providers and payers can negotiate rates that are sustainable for their business models, while still providing access to quality care for their patients.

Who would benefit from this topic?

• Medical Practice Owners
• Medical Providers
• Practice Managers
• C-level executives
• Consultants
• Health insurance payers

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

Gilman 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. Gilman’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. Gilman’s acute attention to detail, deep understanding of coding and billing, and proactive approach, make her an indispensable asset with all her clients.

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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