Out-of-network (OON) billing continues to create confusion, denials, underpayments, and compliance risks for providers. Provider must have knowledge about insurance billing even they have not joined an insurance plan. Not knowing can hurt both your clients and you. Your client’s reimbursement request may be rejected/denied by a health plan due to many reasons. And yes, even out-of-network providers can have treatment reviewed — and notes requested — by a health plan whenever a client submits a superbill. So if you don’t know how out of network billing works, clients may not be reimbursed, or their treatment may stop being covered, leading to treatment dropout. Out-of-network (OON) billing can significantly impact your revenue, compliance risk, and patient satisfaction. Whether you’re a physician practice, ASC, behavioral health provider, or specialty clinic, understanding how out-of-network billing and reimbursement works is critical to protecting your bottom line.

This interactive Q&A-style webinar, will help to address your real-world challenges and provide practical, experience-based guidance on navigating out-of-network reimbursement successfully.

What You’ll Learn:

• What is an out-of-network provider?
• How do provider become an out-of-network provider? Do they need to register somehow?
• Do all clients with health insurance have some coverage of out-of-network provider?
• As an out-of-network provider, is it possible to bill insurance directly for the client, collects from insurance and bill clients the remainder?
• What is “Courtesy Billing” and how does this work?
• What is “Superbill”? What should be on superbill? How often should I give clients superbills?
• What do provider need to do if health plan reimburses him instead of the client?
• Can you be audited or have your records requested if you are out-of-network?
• Are there documentation requirement for out-of-network provider?
• How to deal with not losing the new clients being an out-of-network provider?
• What are the most common reasons for out-of-network claim rejected?
• How can your increase your visibility as an out-of-network provider?
• Are you required to provide out-of-network options to clients?
• What tips do you have for billing where insurance is not involved – that is for private-pay clients?
• How to set fees and operating solely as out-of-network provider who sees self-pay patients?

Who Should Attend:

• Physicians
• Non-Physicians Providers
• Behavioral and Mental Health Providers
• Medical Billing Specialists and Managers
• Medical Coding Specialists and Managers
• ASC and Facility Billing Teams
• Medical Auditors
• Revenue Cycle Manager and Staff
• Practice Managers
• Claim Reviewers
• Office Managers and Administrators
• Clinical Operations Staff
• Compliance Officers
• FQHC/RHCs
• Critical Care Providers
• Qualified Healthcare Practitioners
• Healthcare Executives, Directors and Supervisors

Don’t miss this opportunity to master Out-of-network billing and reimbursement rules and requirements to become more accessible for clients while ensuring you’re fairly compensated service provided.