Part 2 of 3: Strategies to Best Navigate Your Relationship with 3rd Party Payers

Strategies to Best Navigate Your Relationship with 3rd Party Payers

You sometimes hear it called, "playing the insurance game" and the idea of playing this type of "game", intimidates some providers, motivates others and causes uncertainty and frustration to just about everyone.  Join this segment as we discuss the foundation and fundamentals to understanding how third party payers/networks work, what their expectations are, and how to communicate with them in their own "language", from payer-to-payer.  Learning points include:

• The foundation of coverage - determining if your claim should be covered/allowed
• Getting to know your payers - discussing specific qualifying criteria for coverage
• The language of coding - payer specific (high level) and how to learn their guidelines
• In-network vs out-of-network - what that means to you, your billing and your patients
• Denial management - Determining if your denials are appeal-able
• What your EOBs/ERAs are telling you
• The impact to your practice and your patients