At the conclusion of this activity the learner should be able to:
- Define the steps necessary for proper contracting and credentialing in an Urgent Care Setting.
- Choose reimbursement options based on availability and practice objectives.
- Distinguish and debate the pros and cons of Flat Rate and FFS agreements.
- Analyze contracts and fee schedules to determine best billing and payment practices.
- Appraise reports and compare to industry benchmarks.
1 Hour Audio with synced Power Point.
Recorded on September 29, 2016 at the Fall Urgent Care Conference.
In this 2 part series Tammy Mallow and Jay Tolia combine their many years of experience in Contracting, Credentialing, and Billing for Urgent Care Centers, sharing with you essential processes and secrets to success right from the beginning. Tammy presents Contracting and Credentialing processes in a timeline format that makes it easier to understand. She addresses various reimbursement options and will assist you in making the best choices for your practice. Jay will offer you an insider’s look at best billing practices and will share helpful hints in maximizing the revenue opportunities in your contracts that might otherwise be unidentified.
Faculty Bio:
Tammy Mallow has a wide variety of experience in the Urgent Care World. Ms. Mallow has lent her expertise in health plan contract negotiation and credentialing processes, urgent care business planning, and ongoing practice management for over 20 years. She previously held the position of Corporate Director and Consultant for the Schumacher Group where she worked specifically with community based models with a focus on Urgent Care. She also works periodically with Subsidium Consulting based in Atlanta. In her current role, as the Director of Contracting and Credentialing for DocuTAP, Tammy is responsible for the negotiations of health plan contracts for many Urgent Care Centers nationwide. She has been instrumental in provider enrollment strategies and in offering advisory services for the development of start up urgent care. Her hands-on experience as a Practice Administrator for a multi-site urgent care group in the mid-west has provided her with a unique insight to the overall operations of an urgent care center. This combined background of direct clinic experience and broad based consulting is incorporated in her lectures to bring a real life perspective to her audience. Tammy has worked with the UCAOA for several years as a conference faculty member, a webinar presenter, serving on various committees, and as a general resource in the industry. She is a graduate of Missouri State University, is a publish author on Practice Management and Operations, and is an active member and leader with several industry associations.
Jay Tolia is the President of iClaim, Inc. Mr. Tolia has 20 plus years of experience in the medical billing industry. Experience working on many facets of the billing industry from developing an entire Practice Management Software System, incorporating EDI standards, Data Analyses for Revenue Cycle Management, Billing and Coding for many specialties such as Primary Care, Urgent Care, Internal Medicine, Gastroentrology, Pediatrics, Endocrinology, Orthopedic Surgery, General Surgery, Colorectal Surgery, Gynecology, Ophthalmology, Occuloplastic Surgery, Psychiatry, Pathology, Radiology, Cardiology, etc. Being a President of a very successful medical billing business, Mr. Tolia has a vast experience of various facets of the medical billing industry. From startups to well established practices, Mr. Tolia has helped many practices to successful enterprises. Mr. Tolia has assisted many Urgent Care practices from the startup to fully established centers.
Credit Information:
Urgent Care Management Certificate
Earn 1 UCMC credit in Billing & Coding by listening to this recorded session.
Submitting for Credit:
If you would like to submit for either of the credit above, once you complete the activity you must submit for credit you will need to complete the 5 question exam. You must answer 3 out of 5 correctly to receive credit. Email education@ucaoa.org with questions.