Payer-Provider Agreements: Maximizing Reimbursement and Minimizing Denials in Value-Based Contracts

Negotiating Favorable Contracts to Improve the Chance of Success in Value-Based Contracts

Recording of a 90-minute CLE webinar with Q&A


Conducted on Thursday, March 21, 2019

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will provide guidance on structuring payer-provider contracts. The panel will address key provisions to include in both value-based agreements, and any other payer-provider agreement. Topics will include limitations on retrospective review, eligibility and authorization guarantees, and dispute resolution.

Description

Contracting and renegotiating with payers is a complex process. Healthcare providers must carefully negotiate the terms and provisions in a payer contract to in order to maximize reimbursement and avoid denials claims.

Listen as our authoritative panel examines the key provisions to include in the payer-provider contract. The panel will also discuss value-based payment arrangements such as upside/downside risk arrangements and other “shared savings” structures, and best practices for structuring such arrangements.

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Outline

  1. Key provisions
    1. Eligibility guarantees
    2. Authorization guarantees
    3. Concurrent and retrospective review
    4. Appeals of medical necessity and administrative denials
    5. Takebacks and offsets
    6. Audits
  2. Value-based arrangements
    1. The emerging consensus on structuring value-based arrangements
    2. Best practices in value-based contracting

Benefits

The panel will review these and other notable issues:

  • What are the critical provisions that should be included in the payer-provider agreement?
  • How does the payer-provider agreement impact reimbursement for healthcare services?
  • What are best practices for structuring payer-provider agreements?

Faculty

Barnes, John
John C.J. Barnes

Partner
King & Spalding

Mr. Barnes specializes in managed healthcare arrangements. He advises clients on the structuring of risk-based managed...  |  Read More

Matheus, Gustavo
Gustavo E.I. Matheus

Member
Anderson & Quinn

Mr. Matheus represents providers of healthcare services in various areas relating to reimbursement and claims denials,...  |  Read More

Other Formats
— Anytime, Anywhere

Strafford will process CLE credit for one person on each recording. All formats include program handouts. To find out which recorded format will provide the best CLE option, select your state:

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