Join this information-packed webinar with, out of network veteran attorney Thomas J. Force, J.D., Esq. to learn about eligibility, charge analysis and understanding the Summary Plan Description and its terms. During the webinar Mr. Force will discuss on low-payments and denial resolutions. The webinar will also address the application of ERISA, ERISA requirements and what happens when ERISA demands are not met. The attendees will learn about the appeals process and patient collections. Thomas will also discuss the different strategies for In-Network v. Out-of-Network claims.
The Attendees will learn the effective techniques for Balance Billing. They will learn about the Federal Prompt Payment requirements. The Webinar will discuss what a recoupment and audit is, the reasons that insurance companies give as the basis for the overpayment demands and what steps should be taken to defend against the insurance company’s overpayment demands. The Webinar will address the ERISA obligations and protections and the importance of a provider obtaining a valid Assignment of Benefits. It will also set forth the notifications which must be sent out by the insurance company when it conducts an audit and seeks recoupment.
Mr. Force will go through what should be done when a provider receives an audit or overpayment demand, how to object, appeal, hire an expert and make document requests. He will also address the state insurance laws regarding time frames to request recoupments.
The Attendees will also be informed of the best practices to reduce the risk of fraud allegations.
This program will teach you how to:
Out of network healthcare providers/revenue cycle managers/practice owners and managers who are now struggling to recover profits for their facilities and medical practices; billing company staff and healthcare attorneys. Hospitals, out-of-network ASC’s, practices, surgery centers. And medical associations and societies.
As a state and federally licensed attorney in both New Jersey and New York, Mr. Force has over 30 years of experience in the healthcare and insurance industries. His success as a Wall Street insurance litigator and his tenure as General Counsel for a New York-based Accident and Health Insurance Company where he served as Chief Compliance Officer propelled the founding of The Patriot Group. The Patriot Group is a full service revenue recovery company that provides billing, collections, and follow-up services as well as assistance with managed care appeals, managed care contracting, credentialing and compliance.
Mr. Force is nationally recognized as an expert in revenue collection techniques, managed care contracting and appeal strategies. Mr. Force remains an active member and frequent speaker on managed care and collection techniques for the Health Finance Management Association, the Suffolk County Bar Association, and other organizations. A United States Marine, Mr. Force received the prestigious Meritorious Mast Award for Leadership in 1987. Mr. Force is also co-Chairman of the Health and Hospital Committee of the Suffolk County Bar Association. He is co-founder of the Healthcare Reimbursement Attorneys Network, a national association of attorneys that represent physicians and hospital clients. Mr. Force also works closely with the American Medical Association and various state Medical Associations.
Recorded Webinar -
Lessons Learned from the Cigna and Aetna Cases Against Humble Surgical Hospital
Recorded Webinar -
How to Defend Against Insurance Company Recoupments, Repayment Demands, and SIU Audits