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Advanced Payer Contracting - Part I & II (CUCMP)
Keyword(s)
CUCMP, Payers, Contracts
Part I
- Distinguish between common misconceptions in payer contracting and facts
- Evaluate your current payer/plan participation list and how to access and interpret payer market share.
- Differentiate between the different types of payer agreements and which might be best for your urgent care.
- Implement a formal tracking process for your business.
- Define various payer reimbursement strategies.
Part II
- Interpret payer contract content, locating key terms and pitfalls.
- Discuss the right times for re-negotiation and describe strategies that you may employ.
- Verbalize important elements of the False Claims Act and how it applies to our industry
- Catelog contract type variances to make best choices for your clinic/s.
- Aquire better understanding of Dual Contract options and availability
Credit Information
2 CUCMP
Description
Recorded for the 2019 Spring Convention
Total of 2 hours and 12 minutes (Part I - 1 hour & 3 minutes, Part II - 1 hour & 9 minutes) Synced audio and PowerPoint
Course Description: There are complex nuances to payer contracting that urgent care leadership often are not familiar with. Join Tammy Mallow for Part I of Advanced Payer Contracting. Tammy will go beyond the beginning stages of payer contracting, getting into the details. She’ll discuss narrow and closed networks, and how your urgent care can utilize out-of-network strategies. You’ll learn about the different types of agreements you might consider: options for urgent care operations, primary care vs. urgent care operations, mixed-payer list, and dual-contracting. And, you will be presented with information on the effect on reimbursement these important choices offer.
In Part II of Advanced Payer Contracting, Tammy Mallow will lead participants into a deep dive into contract content, reviewing important language to be aware of, and the pitfalls that might be lurking in the legalese. Additionally, Tammy will cover re-negotiation strategies and alternatives.
Speaker: Tammy Mallow has a wide variety of experience in the Urgent Care World. She has practical experience as a Practice Administrator as well as national consulting experience. She works periodically with Merchant Medicine Consulting group. 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. Tammy has worked with UCA 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 published author on Practice Management and Operations, and is an active member and leader with several industry associations.
Disclosures:
None
Credit:
2 CUCMP
Before submitting for UCA's Certified Urgent Care Management Professional (CUCMP) designation program
credit, learners must be approved applicants. Please click on More Information to learn about the CUCMP program.
To obtain CUCMP credit learners must earn a score of 75% (6 out of 8 correct) on the test, complete the survey, and have attended at least one of the two webinars live. You will be allowed 3 attempts to pass the test.
Please email cucmp@ucaoa.org if you have any questions.
Courses in package:
| Title | Credit Hours | |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 | ||
| 4 | ||
| 5 |