Compliant & Consistent Cash Flow is
Everyone's Job

Join us for a transformative 4-part seminar session that will revolutionize your practice’s compliant financial processes, whether you operate on a cash-based model or engage in 3rd party billing. Just as a tall building requires a strong and deep foundation, your practice’s success relies on a solid financial framework. Without it, the consequences can be devastating, exposing the practice to unnecessary risk.

In this comprehensive training, you and your team members will learn how to establish a sturdy and repeatable foundation for your reimbursement processes, and how to do so compliantly. From the doctor to the front desk to the billing department, every team member plays a vital role in ensuring financial success, while following important regulatory guidance.

Led by Kathy (KMC) Weidner, a seasoned professional with 40 years of professional experience, this workshop goes beyond a traditional seminar or lecture. It adopts a hands-on approach, allowing attendees to “discite a faciendo” – Latin for ‘learn by doing.’ Through interactive workbook exercises and practical suggestions, you’ll gain valuable insights into achieving successful reimbursement, both from patients and insurance companies.

By the end of these sessions, you’ll be equipped with actionable steps to evaluate your systems and immediately implement your newfound knowledge in your office. Don’t miss this opportunity to transform your financial processes and enhance the revenue cycle of your healthcare practice.

Hours 3 – 4:  Billing

This section focuses on the foundational, compliant, and regulatory pieces that must be established prior to submitting electronic or paper claims.

• Learn how to create a ‘clean’ payable claim following Medical Review Policy for every payer
  • Medicare Part B – See how to utilize the MAC portal to locate diagnosis. Learn about proper diagnosis hierarchy, procedure coding and appending the correct modifier, the importance of Box 14 on the claim form and appropriate pointing of procedure to diagnosis.
  • Medicare Part C (Advantage) – See how to use online portals to locate forms for out of network services and billing restrictions. Learn about proper coding and modifier usage and when claims must be submitted or not, regardless of your network status.
  • Commercial Payers – See how to consult the Medical Review Policy to determine proper coding and modifier usage. Learn how to link fee schedules to charge entry to expedite over-the-counter collections.
  • Self-Pay – See how to identify the type of self-pay account for each patient. Not all are the same, and depending on the circumstances, current regulations require clinics to give more attention to these cases to be compliant.
• Implement the necessary steps to hand the baton from the front desk entry personnel through to the beginning of the billing process, including patient billing and compliant, risk-free payment plans

Hours 5-6: Collections

Whether collections are coming from the patient or a 3^rd Party payer, a compliant process is necessary for a proper follow-up process. At the end of this section, attendees will be able to:

• Dissect and apply a variety of Explanation of Benefits with the important skill of applying payments compliantly and managing follow-up.
• Decide after reviewing an EOB whether to appeal or not.
• Apply a bullet proof system for managing collections in the clinic for the following case types:
  • Medicare Part B – Interpret a Remittance Advice and decide which portion is billable to a patient.
  • Medicare Part C – Analyze the internal Medicare Advantage process and EOBs
  • Commercial Payer –Apply EOBs line by line and then learn how to determine whether a zero-pay line item is something that should be appealed.
• Scrutinize the entire process of patient and 3^rd party collections including the detective work that is necessary when trying to figure out why a claim has not been paid

Hours 5-6: Collections

Whether collections are coming from the patient or a 3^rd Party payer, a compliant process is necessary for a proper follow-up process. At the end of this section, attendees will be able to:

• Dissect and apply a variety of Explanation of Benefits with the important skill of applying payments compliantly and managing follow-up.
• Decide after reviewing an EOB whether to appeal or not.
• Apply a bullet proof system for managing collections in the clinic for the following case types:
  • Medicare Part B – Interpret a Remittance Advice and decide which portion is billable to a patient.
  • Medicare Part C – Analyze the internal Medicare Advantage process and EOBs
  • Commercial Payer –Apply EOBs line by line and then learn how to determine whether a zero-pay line item is something that should be appealed.
• Scrutinize the entire process of patient and 3^rd party collections including the detective work that is necessary when trying to figure out why a claim has not been paid

Hours 7-8:  Wrap Up

The essence of the revenue cycle is understanding each of its parts, and how compliance implications apply to each one. At the end of this sections, attendees will be able to:

• Recognize and correct non-compliant behavior in the revenue cycle
• Apply federal guidance when setting fees and elective discounts
• Conduct appropriate annual compliance training with all team members
• Construct and apply a legal Code of Conduct for all team members

Virtual Instructional Methods: 

• Power Point Presentation
• Interactive Hands On Training
• Interactive Q/A
• Case Studies