Payer Contracting and Credentialing
Upcoming Conferences and WebinarsUpcoming Presentations
MGMA Medical Practice Excellence Pathways Conference
May 11-13, 2021 Digital Experience (DX)
Session Date and Time: Wednesday, May 12, 2021, 3:25-4:20pm EST
CON603: Recipe for Success: Mastering 15-Minute Payer Contract Reviews
Content area: Revenue Cycle Management
Intermediate | Traditional | Analysis
Speakers: Penny Noyes, CHC, president, HBN; Amanda Hilbert, director, payer contracting, HBN
Reviewing dozens of pages in old agreements or new proposals might seem daunting, but the key is to take a strategic look. In this session, attendees will learn how to assess a payer agreement, new or proposed, in about 15 minutes. The speaker will highlight key provisions, where you can typically find them, whether a payer can or might change the ugly stuff (or how to manage, if not), and how to jump-start a renegotiation or request for changes. Attendees will learn to quickly identify and assess issues with effective date, initial term, termination without cause, products, amendments, notice and rate exhibit. The session will also include a comprehensive checklist of other provisions to understand in contracting strategy.
This session will provide you with the knowledge to:
- Outline key provisions needed for a critical payer contract review
- Examine existing and proposed payer contracts for high-impact provisions
- Breakdown specific provisions for renegotiation in a payer contract
Past Presentations
2020 MGMA Financial conference, nashville
Watch the MGMA and HBN sites for updates on Penny Noyes’ Pre-Conference 6 hour Session on Payer Contracting – Negotiating Like A Pro as well as her concurrent sessions.
MGMA19
New Orleans
“H10: Commercial Plan Bundled Payments: A Year Later”
Tuesday, October 15 — 11:30am–12:30pm
Credits: ACMPE Credit: 1 | AACP Credit: 1.00 Core A, CPCO and CPMA | ACHE Credit: 1 | CME: 1 | CNE Credit: 1.00 | CPE Credit: 1.2 | CEU Credit: 1 Financial Management
Before leaping into building bundled payment programs, providers need to think beyond their delivery system and think like a payer as they take on risks associated with these programs. With 18 years on a payer side of the industry, the speaker will outline key considerations for bundled payment programs: provider types, timelines for the start and finish of services in the bundle, choosing prospective or retrospective payments, how claims will be submitted, underwriting, risk adjustments and more. In addition to the recap, the speaker will cover current findings, obstacles and wins to help attendees gauge whether they want to enter this arena, or what to expect if they already have.
This session will provide you with the knowledge to:
- Analyze the services and timeline to include in a bundled payment program
- Calculate the scope of the financial risk of the “bundler”
- Breakdown the practical issues surrounding communication, claims submission and payment disbursement to bundle parties
Pacific Northwest MGMA
Hotel Murano and the Greater Tacoma Convention Center
Preconference W2: Payer Contracting—Fee for Service and Value Based Negotiations—Tips, Techniques, & Language
Wednesday, May 8 — 1pm–4:15pm
1A: Payer Contracts Assessment and Renegotiation—Getting Started
Thursday, May 9 — 10:00am–11:15am
2A: Analyzing a Payer Offer and Modeling Counter Offers
Thursday, May 9 —11:25am–12:25pm
3A: Weird Stuff in Payer Agreements, Why it’s In There and What To Do About It
Thursday, May 9 —3:45pm–5pm
MGMA Online Payer Contracting Three-part webinar + reflections & takeaways
November 13–14, 2019
By HBN’s Penny Noyes and her colleagues Doral Jacobson and Nate Moore, aka “The Three Musketeers.”
Part I: Gathering and Analyzing Your Contracts — Presented by HBN’s Penny Noyes
Nov. 13, 2019, 12:00-2:00 pm ET (11:00 am CT, 10:00 am MT, 9:00 am PT)
Part II: Articulating Practice Value, Developing Contract Proposals and Building a Go-Forward Strategy — Doral Jacobson
Nov. 13, 2019, 2:30-4:30 pm ET (1:30 pm CT, 12:30 pm MT, 11:30 am PT)
Part III: Establishing a Contract Monitoring and Evaluation Process — Nate Moore
Nov. 14, 2019, 12:00-2:00 pm ET (11:00 am CT, 10:00 am MT, 9:00 am PT)
Part IV: Closing Session — Reflections and Takeaways — 3 Presenters Panel including HBN’s Penny Noyes
Nov. 14, 2019, 2:00-2:15 pm ET (1:00 pm CT, 12:00 pm MT, 11:00 am PT)
MO MGMA Osage Beach
Margaritaville Lake Resort • Osage Beach, MO
“Value Based: Overview, Agreement Terms & Validating Your Report Card & Bonus”
Thursday, April 11 — 11:15am–12:15pm and 1:15–2:30pm
Decision Health Webinar
“Bundled Payments: Think Like A Payer As You Build and Negotiate Bundles”
April 18, 2019 at 12:30 pm EST
MGMA 19 | The Financial Conference
Las Vegas, NV
2 SESSIONS
“PRE101: The Payer Contracting Process: Negotiating and Managing Like a Pro”
Sunday, March 3 — 8:30am – 3:00pm
“CON501: Avoid Denials Related to Credentialing & Product Participation”
Monday, March 4 — 2:15pm–3:15pm
DecisionHealth Billing & Compliance Summit
Las Vegas, NV
2 SESSIONS
“Bundled payments – Think like a payer as you build your program”
Tuesday, Dec. 4 — 3:45 pm – 5:00 pm
“Beyond the rates – Deal-breakers and key updates in payer agreements”
Wednesday, Dec. 5 — 8:00 am – 9:15 am
Strategies & Methods to accelerate reimbursement webinar
December 3, 2019 — 1:00 pm ET
(12:00 pm CT, 11:00 am MT, 10:00 am PT)
Presenters: Healthstream’s Cheryl Cisneros and Dawn Anderson accompanied by HBN’s Penny Noyes
This webinar is eligible for ACMPE, ACHE (live only), CPE (live only) and CEU credit. This webinar will be made available as a recording.
Does your organization struggle with reimbursement time frames? Payment delays can affect many outcomes of your medical practice, such as patient satisfaction and administrative efficiency. In this webinar, learn how you can develop strategic plans to overcome reimbursement complexities and identify new workflow processes that will benefit your patients and meet regulatory requirements.
In addition, attendees will gain invaluable metrics that reflect outcomes and opportunities for improvement. This webinar will also highlight a customer-focused case study that applies the principles discussed.
This 60-minute webinar will provide you with the knowledge to:
- Establish strategic plans to address provider enrollment industry challenges
- Assess how to decrease enrollment time frames that impact your organization’s ROI
- Evaluate metrics that will help you create an enrollment dashboard that communicates outcomes and provides opportunities for improvement
Thrive18 Verity National User Group
MGMA18 Annual Conference
Boston, MA
“Think Like a Payer: Building and Negotiating Bundled Payment Programs“
Monday, Oct. 1 — 11:00 am – 12:00 pm
Credits available:
ACMPE Credit: 1 | AAPC Credit: 1 Core A | ACHE Credit: 1 | CME Credit: 1 | CNE Credit: 1 | CPE Credit: 1.2 | CEU Credit: 1
OR Manager Conference
McLean, VA
“Steer Outpatient Business to your Facility”
Tuesday, Oct. 9 — 10:30 am – 11:45 am
