Currently Empty: $0.00
Navigating the Complexities of Balance Billing: Copays & Deductibles Insights
$249.00 – $255.00
Navigating healthcare costs can be daunting, especially when confronted with the complexities of balance billing and high deductibles. High deductible health plans and other financial hurdles often create confusion and stress for patients, making it necessary for healthcare professionals to understand the strategies for managing these costs effectively.
In today’s complex healthcare environment, healthcare providers must navigate the challenges of financial responsibilities and legal obligations. One of the most pressing issues for providers is the management of balance billing and the associated liability when it comes to waiving copays and deductibles. While seemingly patient-friendly, these practices can lead to significant legal and financial repercussions if not approached correctly.
Healthcare providers are under increasing pressure to deliver high-quality care while also managing the financial aspects of their practice. Balance billing, the practice of billing patients for the difference between what their insurance reimburses and the total cost of care, is a common occurrence that can create confusion and tension between providers and patients. Patients may struggle to understand why they are receiving a bill, particularly when they assume their insurance would cover the total cost of care. This can lead to confusion and difficulty in resolving billing disputes.
Compounding this issue is the temptation to waive copays and deductibles to assist patients financially. However, doing so can expose providers to significant risks, including allegations of fraud and violations of insurance contracts.
Balance billing can lead to non-compliance in several ways. It can create financial barriers for patients, deterring them from seeking necessary medical care due to the fear of incurring additional out-of-pocket expenses. Patients may also feel they have been mislead about their financial responsibility if the costs were not clearly communicated upfront. This can result in patients disputing the charges, or avoiding future interactions with the healthcare provider.
Transparent financial discussions ensure that patients are fully informed about the costs associated with their care, which can help them make better healthcare decisions and manage their financial responsibilities more effectively. Clear financial communication can lead to better patient satisfaction, improved collections, and reduced administrative costs to healthcare organizations.
Learning Outcomes:
- Gain knowledge of how to effectively communicate financial information with patients
- Understanding Balance Billing: Learn the intricacies of balance billing, including when it is permissible and when it may violate federal or state laws
- Understand the impact of the No Surprises Act and other relevant legislation on balance billing practices
- Learn the legal implications of waiving copays and deductibles
- Explore alternative strategies for assisting patients with their financial obligations that do not expose your practice to legal liability
- Understand the impact of high deductible health plans
- Learn strategies on how and when to collect patient responsibilities upfront
- Understand the Truth in Lending Act and its effect on your practice
Areas Covered in the Session:
- Effective financial communication
- No Surprises Act
- Implications of waiving copays and deductibles
- Self-pay discounts
- Understanding and staying compliant with payer contracts
- Truth in Lending Act
- Balance billing – know when and how to correctly bill the patient
- High-deductible health plans
- Balance billing in-network vs. out-of-network
- Live Q&A Session
Recommended participants:
- Healthcare Administrators
- Physicians
- Practice Owners
- Non-Physician Practitioners
- Medical Office Managers
- Billers and Coders
- Medical Assistants
- Nurses
- Agency Owners
- Clinical Supervisors
- Directors of Nursing
- Quality Improvement/ Quality Assurance Managers
- Compliance Officers
- Clinicians
- Administrative Staff
- Out-of-Network Providers
- C-level Executives
- Office Managers and Staff
- Billing Managers
- Medical Billing Companies
- Insurance Companies
- Hospital Revenue Cycle Staff
- Credentialing Staff
- Medical Providers who are Involved in the Payment Process of their Practice
Presenter Biography:
Jan Hailey, MHL, CMC, CMCO, CMIS, CMOM, CMCA-E/M, has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan’s affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has led comprehensive interdisciplinary teams working closely with providers, management, staff, communities, and payers to develop strategies for process improvement, quality gap closures, and patient experience.
Jan has a Master of Health Leadership degree and five professional certifications in office management, coding, insurance processing, auditing, and compliance. She is a WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group member and has also been instrumental in Workforce Development Initiatives.
Additional Information:
After registration, You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to talk and hear clearly
Can’t Listen Live?
No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact: Toll-Free No: +1 800-757-9502 Email: cs@waymoreeducation.com
