As a healthcare provider, outsourcing your medical billing can make things run smoother and more efficient, but if you’re not careful, it can also open the door to some serious compliance and financial risks. In this session we will break down what you really need to know before signing up with a third-party billing company. We’ll cover what to look for in a billing partner, terms that need to be in your contract, common red flags to avoid, and how to keep oversight in place after the contract is executed.

Whether you're thinking about outsourcing for the first time or just want to take a fresh look at your current setup, this session will give you the tools to protect your practice and make smart, informed decisions.

Webinar Objectives

Attendees will leave this session with a strong foundational understanding of how to evaluate and select a billing company with compliance and performance in mind, navigate the contracting process to protect your practice, meet regulatory requirements, and define mutual expectations.  This session will also include discussions about how to identify red flags in a billing company that could put your revenue or compliance at risk.

Webinar Agenda

• Recognize important legal and compliance requirements involved in contracting with third-party billing companies
• Identify critical elements that must be included in a billing company contract (e.g., PHI access, performance metrics, termination clauses)
• Understand common compliance risks and audit vulnerabilities associated with third-party billing relationships
• Explore best practices for billing company vetting, contract negotiation, and ongoing monitoring
• Recognize internal controls to ensure documentation integrity, proper coding, and revenue cycle transparency when outsourcing billing

Webinar Highlights

• Discuss important third-party billing compliance considerations such as HIPAA, False Claims Act, OIG guidance, and state-level requirements
• Unpack key contract clauses, language examples, and what to avoid in third-party billing contracts
• Identify examples of red flags as it pertains to improper, noncompliant, or fraudulent billing practices
• Discuss ways to monitor, audit, and maintain oversight and control of the revenue cycle management
• Highlight real-world case examples of third-party billing relationships with healthcare providers and what went wrong

Who Should Attend

• Medical Coding Specialists
• Medical Billing Specialists
• Medical Auditing Specialists
• Private Practice Physicians
• Managed Care Professionals
• Operations Leadership
• Practice Administrators
• Office Managers
• Compliance Officers/Committees  
• Chief Medical Officer
• Medical Practices
• Accountable Care Organizations
• Medical Societies
• Medical Associations

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