In this session, attendees will gain a broad understanding of common pitfalls and target areas of concern for out-of-network addiction treatment providers in obtaining payment from commercial insurance companies. The presentation will take a practical “nuts and bolts” approach that will identify ten strategies, tools, and approaches that attendees can implement right away, to improve their likelihood of success in maximizing reimbursement for services rendered. The session will put particular emphasis on proactive strategies that will leave attendees in their best possible position for success should legal disputes with commercial payors arise.
Presenters will discuss common problems and quick fixes for conducting effective verifications of benefits and pre-authorization calls, from creating a comprehensive “script” of items to address, to training staff for potential follow-up questioning; to maintaining effective, accurate, and complete records to maximize out-of-network reimbursement.
Presenters will analyze the most common roadblocks to effective communication with commercial insurance companies, and techniques for improving (and properly documenting) those paths of communication.
Presenters will explain the pro’s and con’s of litigation, including when a dispute with a commercial insurance company should be escalated to an attorney, and when it may be beneficial or even necessary to file a lawsuit in order to get paid for your work.