Recoupment for Unsupported Services and Failure to Balance Bill Out of Network Patients—What’s Your Best Defense?

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Health Plan Recoupment Defense—Fight Back!


Recoupments by health plans against healthcare providers are becoming more and more common. Healthcare providers need to know, how to handle them.

This webinar with expert Thomas J. Force, Esq. will provide clear cut strategies to help fight audit and recoupment. Specifically, he will discuss the two most common types of recoupment

  • Allegations for which medical records do not support the services.
  • Failure to collect coinsurances, deductibles and balance bills from patients.

Thomas will review the applicable federal and state laws, along with the recent case law in the area of recoupment. He will also provide instructions for preparing the initial and final recoupment objection letters. Plus, there will be a discussion on the need for experts in this area.

Session highlights:

  • You have just received a take-back demand or refund request – What do you do?
  • Get an understanding of basic ERISA obligations
  • Summary of ERISA federal law and how this important law can help fìght audits and recoupment
  • Discussion on state law and how this can help limit the scope of audits and recoupment
  • Recoupments due to Failure to Balance Bill OON patients: What you should do?
  • Recoupments for Unsupported Services: What you should do?
  • Why is the recoupment brought by the SIU Unit?
  • Get instructions on preparation of initial and fìnal objection letters
  • Learn to prepare fìnal appeal letters
  • Learn how to prepare balance bill letters to patients
  • Strategies on how to win and defèat audits and recoupment
  • Providers’ right for a full and fair review
  • Review of recent cases and the lessons learned

Who should attend

Healthcare Providers, Hospital and Provider Revenue Cycle Personnel, and Attorneys

Ask a question in the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Thomas Force - Compliance Coding Expert

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...   More Info
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