Successfully Overcome Insurance Company Stall Tactics
Using the Law!
Dates: New Dates will be posted soon.
Location: Webinars are not location based. In-Services can be scheduled upon request.
Learn how to successfully overcome these and other stall tactics…
- “We paid you in error…we want our money back…”
- “We never received your claim…”
- “You’re past filing deadline…”
- “Claim is pending…” You’ll be amazed what you’ll learn about this one!
- “We’re shorthanded…”
- “We need our own claim form before we can process…”
- “We’re waiting on a response from patient…we’ve sent 14 letters…”
- “It’s in line for payment…”
- “It’s in audit/review…”
- “Pending receipt of accident report, medical records, student status, information from patient, etc.…”
- “Pending determination of primary v. secondary…”
- “Your charges are above reasonable and customary…”
- “We’re denying for lack of medical necessity…”
- “It’s pending investigation…”
- “Even though you have an assignment, we paid the patient… get your money from him/her…”
- “We’re self insured…” “We’re ERISA…” “We can do whatever we want…”
- “So what if we verified benefits, we’re still not paying…”
Receive all pertinent parts of the 2014 Texas Insurance Code:
- Including Texas Department of Insurance Rules defining what a “clean claim” actually is – How to use the rules to your advantage and avoid the potential pitfalls.
This workshop will EMPOWER you to resolve the most difficult claims!
- ♦ No more “pending” due to student status, medical records, OTHER INSURANCE INFORMATION, accident reports, information from patient, etc. TDI Rules regarding refunds and recoupments!
- ♦ Enforcing your assignment of benefits
- ♦ Even when you’re non participating
- ♦ Federal Rules governing ERISA claims processing 29CFR 2560.503-1
- ♦ How to make insurance company pay every time they deny medical necessity!
- ♦ STOP insurers from “second guessing” your doctor! (And make them pay for it!)
- ♦ There really is… NO SUCH THING AS PENDING!
PRACTICAL SOLUTIONS TO EVERYDAY PROBLEMS:
• How to get your claims paid promptly
• How to Prove Your Fees Are Reasonable and Customary
• How to Prove MEDICAL NECESSITY
• Dealing with exclusions in coverage
• Dealing with “termed coverage”
• When to Refund Money…When to Just Say No!
• How to handle Recoupments
• Proving Receipt of Claims WITHOUT Certified Mail
• Arguing That Claims ARE NOT Past Filing Deadline
• Workers Compensation Act and Prompt Payment of Claims
• ERISA – What Is It? How to Enforce Prompt Payment Even With Self-funded/Self-insured
• Affordable Care Act and in Today’s Healthcare Environment
- Study /Reference Aids
- Summary Card of TDI Rules
- Outline of All Laws
- Seminar Workbook
About your instructor:
Rick A. Elina, JD has been conducting educational training, seminars and lectures spanning 3 decades. A law school graduate holding the degree of Juris Doctor, Rick has provided training and consulting services for clients such as All Saints Medical Center, Columbia Healthcare, HCA, HealthSouth, Methodist Health System, Parkland Hospital (Dallas County Hospital District), St. Lukes Medical Center, and Tenet just to name a few. Added to this distinguished list, are numerous IPA’s and thousands of healthcare practitioners who have benefited from Rick’s expertise.
In addition to conducting his popular seminar “Successfully Overcome Insurance Company Stall Tactics Using the Law” in 42 states, Rick has lent his expertise in drafting legislation resulting in significant changes in the law. The author of numerous articles on a variety of health care related topics including, ERISA, Worker’s Compensation and EMTALA, Rick has also served as a former H.F.M.A. faculty member.
Rick is a well-informed and enthusiastic speaker whose lectures emphasize applying relevant state and federal laws to everyday practical situations.
NOTE: RESERVATIONS ARE REQUIRED.
SATISFACTION IS GUARANTEED OR YOUR MONEY BACK!
Should you have questions, you may call (214) 797-7232 or email us at Seminars@ClaimRemedy.com