The compliance problem faced by out of network healthcare providers today is fee forgiveness. Most out of network healthcare providers avoid balance billing for fear of receiving patient complaints, reprimand from hospital CEOs where they have privileges and losing patients to in-network facilities. There is a way to balance bill patients in a manner that will not jeopardize your practice’s revenue stream. The health plans are targeting out of network practices that don’t balance bill, and suing them for insurance fraud. This important presentation will help the practitioner stay compliant and avoid being audited or sued by the health plans.
Participants in the presentation with expert speaker Thomas J. Force, Esq. will learn how to avoid compliance pitfalls and litigation by health plans relating to failure to balance bill patients or otherwise collect patient coinsurance and deductibles. A case-by-case analysis of health plan litigation against out of network health care providers relating to “fee forgiveness” will help participants understand why “balance billing” of patients is necessary, while learning health plan audit strategies.
In this program, you will learn:
By attending this informative session, you will learn strategies which will assist your practice in avoiding health plan audits and litigation based upon fee forgiveness and failure to balance bill patients. You will be provided disclosure and other patient forms, and practice policies which will assist out of network practices to remain in compliance with state federal laws. Best practices for compliance will be discussed.
Who should attend
- Jim Sheldon-Dean
Thomas J. Force, Esq. is a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries. He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare. Thomas is also the former CEO, general counsel and...
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