Change Location × San Francisco

    Recent Locations

      Reimbursement Explained in Fremont


      • Reimbursement Explained Photo #1
      1 of 1
      February 6, 2020

      Thursday  10:00 AM - 11:30 AM

      39658 Mission Blvd
      Fremont, California 94539

      Map
      Performers:
      • No Performers Listed
      EVENT DETAILS
      Reimbursement Explained

      Overview:

      Healthcare reimbursement systems can be complex and difficult to understand. Each payor may use a different method to reimburse providers, or they may use a variation of a commonly used method. This course will provide a foundation for understanding the common reimbursement systems in use today.

      We start with Medicare's reimbursement systems of RBRVS, DRGs, and APCs because many other payors use modified versions of these systems. We then discuss other payor types such as HMOs, PPOs, and ACOs and how these organizations use other reimbursement methods such as capitation, per diems, and carve outs. Finally, we discuss the key data elements needed to adjudicate claims according to each scheme, and we discuss the financial incentives (and disincentives) associated with each method.

      Why you should Attend: This webinar is beneficial for anyone who works with medical claims and who wants a better understanding of the differences between charges and allowed amounts, how health plans and payors adjudicate claims, and how providers and payors use reimbursement methods to align incentives to manage cost and quality.

      This session is also useful for provider and health plan contract managers and directors who want to build on their understanding of reimbursement mechanisms and who want to improve their contract negotiation skills.

      Areas Covered in the Session:

      Prospective Payment Systems: DRG and APC based reimbursement
      Typical hospital contracting structures: per diem, per stay, carve outs, case rates, minimum/maximums, etc.
      Physician fee schedules and fee maximums, RBRVS, RVUs and capitation
      Major payor types (Medicare, Medicaid, HMO, PPO, ACO, etc.) and how they reimburse providers

      Who Will Benefit:
      Health Plan and Provider CFOs
      Analysts
      Provider Contract Managers
      Claim Examiners
      Reimbursement Directors
      Payment Integrity Managers
      Revenue Managers
      Rich Henriksen - MentorHealthSpeaker Profile
      Rich Henriksen is the Chief Executive Officer and Founder of Nokomis Health. Rich has 30 years of experience in healthcare systems, coding, billing, and reimbursement. He has led managed care departments and provider contracting units at a variety of organizations, including hospitals, clinics, and health plans.


      Event link: https://www.mentorhealth.com/webinar/-801898LIVE?channel=eventful-FEB_2020_SEO
      Contact Info:
      Netzealous LLC - MentorHealth
      Phone No: 1-800-385-1607
      Fax: 302-288-6884
      Email: mentorhealth84@gmail.com
      Website: http://www.mentorhealth.com/

      Cost: Payment required - https://www.mentorhealth.com/webinar/-801898LIVE?channel=eventful-FEB_2020_SEO

      Categories: Conferences & Tradeshows

      Event details may change at any time, always check with the event organizer when planning to attend this event or purchase tickets.