Description

Physicians and other healthcare providers that have experienced contract termination or non-renewal must understand all available opportunities to get back in. I will present the information that will help them win their reinstatement with the insurance. Doctors are often frightened to fight with the insurance especially if they are at fault either with the medical errors or missed important credentialing requirements which led to the contract termination. My goal is to give them the confidence to fight for their spot back. We will discuss rules, regulations, and insurance requirements to create a plan that will help them get back.

Learning Objectives:-

Increase Revenue/Reimbursement

• Get back to seeing patients with all insurances. Get all patients back and new ones. No longer will you be limiting your practice with the insurance you accept. Once your reinstatement is complete, new opportunities for a large network of patents and referral leads will be generated. 
• Learn if provisional enrollment can help you to start the reinstatement process, which leads to seeing patients again
• Understand how nonrenewal, revalidation, ReCredentialing can affect your practice revenue

Improve Compliance with Regulations/Laws

• Understand your reinstatement rights after exclusion due to OPMC cases 
• Learn how to get your contract back after missed revalidation 
• Learn about Medicaid, and Medicare regulations when it comes to managed care reinstatement. 
• Find out how to remove yourself from the exclusion list 
• Learn about multistate insurance reinstatement impact on your practice ability

Reduce the possibility of Audits, Penalties, and/or Fines

• Understand insurance requirements stated by the insurance: 60 and 90 days regulations
• Understand the available rules and regulations which can reduce your attorney billing, we will teach you how to be in complete control of your reinstatement process
• Learn of the courses you can take that will help with personal assurance to be considered as a good standing provider with the payer

Areas Covered:-

• Reinstatement doesn’t require getting an attorney, this is a number one misconception 
• Discuss all leading reasons for reinstatement: OPMC  case, nonrenewal, ReCredentialing, Medicaid related enrollment
• Reinstatement is a very common process for doctors that been practicing and billing insurance companies for at least ten years. This can happen to any provider even with the best license record, learn how to avoid it from happening to you. 
• Don’t be afraid to let the insurance company know that you want to return 
• The appeal process is important and must be performed, don’t be distressed by the situation, there are rights for healthcare providers that allow you to continue fighting for your right to participate. 

Who Should Attend?

Any provider or practice administrator with basic credentialing experience will be able to pick up on the topic and be able to apply the presented material immediately.