HCIN.SecureStreamingStore.com My Account  Cart Contents  Checkout  
  Home » Catalog » TX HCSSA ADMINISTRATOR » HCSSA ADMIN CE » 2974 My Account  |  Cart Contents  |  Checkout   
Categories
  HCSSA ADMIN CE-> (658)
    NEW - 2015 (19)
    NEW - 2016 (17)
    NEW - 2017 (22)
    NEW - 2018 (16)
    Clinical (10)
    Coding (2)
    Financial (22)
    HIPAA (5)
    Home Care Business (37)
    Hospice (34)
    Human Resource (28)
    OASIS (3)
    Orientation (7)
    Pediatrics (12)
    Regulatory - Medicare (39)
    Regulatory - Texas (36)
    Risk Management (9)
    Sales & Marketing (12)
OASIS (2)
Speakers
What's New? more
Building Workforce Across Generations: Are You Ready to Compete? [1HR]
Building Workforce Across Generations: Are You Ready to Compete? [1HR]
$30.00
Quick Find
 
Enter program number, topic or keywords to find the program you are looking for.
Advanced Search
Information
Privacy Notice
Conditions of Use
Contact Us
What People Are Saying
Customer Reviews verified by SoTellUs
Solution Graphics
Contracting with MCOs: Benefit vs. Pitfalls [1HR]
[2974]
$30.00


[2974] Contracting with MCOs: Benefit vs, Pitfalls

Education-Training Credits:

  • 1.0 Hr(s) HCSSA Administrator/Alternate

Summary:The pros and cons of working with MCOs in and out of network.

HCSSA Topic(s) Addressed:

  • §97.259[d][4]agency responsibilities
  • §97.260[a][3]basic principles of management in a licensed health-related setting
  • §97.260[a][7]financial management

Faculty:Spears, Jan

Program Description: This program presents the pros and cons of working with MCOs in and out of network. As traditional payor sources implement payment reductions, new payment models or move exclusively to Managed Care, home health agencies are once again looking at the best way to work within the Managed Care arena. Some MCOs can pick and choose their provider networks based upon geographical area, STARs reporting, and pricing models. Medicaid MCOs typically offer below market value contracts. Although the MCO must follow the home health rules, the payer can establish additional requirements such as prior authorization, timeframes for physician signatures, etc. that can be more stringent than the traditional counterpart. The avenues for appeals are cumbersome and often leave the provider “holding the bag.”

Learn how to package your agency for quality, cost and satisfaction in advance of seeking contracts with the MCOs in your area. Delivering care in accordance with MCO requirements requires process modifcation for order development, authorization management and billing. In addition, the presenter touches on best practice processes to improve coverage and reduce days outstanding on your claims. Presentation Date: 11.15.2016

Learning Outcomes(s): Participants will actively engage in the activity and indicate an intent to change or enhance their practice by delivering care in accordance with Managed Care Organization (MCO) requirements while incorporating best documentation practices in order to ensure coverage and reduce days outstanding on agency claims.

About the Presenter:
Jan Spears
is Co-owner and Chief Executive Officer of MJS & Associates. She has more than 30 years’ experience in the health care field. Ms. Spears has owned and operated a multimillion dollar home health care company as well as consulted for over 300 homecare providers in 25 states. As a full time consultant for the past 15 years, Ms. Spears has successfully merged clinical and financial strategies into successful operational plans for numerous providers nationwide. Jan serves as a Medicare coverage expert for health care facilities who are undergoing audits by federal contractors through all levels of appeals. She has authored several publications and heads a team of more than 25 consultants at MJS & Associates.

[2974] Contracting with MCOs: Benefit vs, Pitfalls

Available Options:
Subscription Type & Duration:
This product was added to our catalog on Tuesday 15 November, 2016.
Reviews
Customers who bought this product also purchased
Growing your Home Care Business
Growing your Home Care Business
Reporting ANE: Identifying Risks, Responding to Complaints [1.25HR]
Reporting ANE: Identifying Risks, Responding to Complaints [1.25HR]
Increase Svc Value:Tips for Successful Participation in Medicare Value-Based Payments [1.25HR]
Increase Svc Value:Tips for Successful Participation in Medicare Value-Based Payments [1.25HR]
Achieving Regulatory Efficiencies [1HR]
Achieving Regulatory Efficiencies [1HR]
QAPI: Closing the Loop on Agency Performance [1HR]
QAPI: Closing the Loop on Agency Performance [1HR]
HCSSA Regulatory Compliance for Administrators [11/2017][3.5HR]
HCSSA Regulatory Compliance for Administrators [11/2017][3.5HR]

Copyright © 2018 HCIN.SecureStreamingStore.com
Powered by osCommerce