Thomas J. Force
The Balance Bill Requirement for Out-of-Network Healthcare Providers
Recorded Webinar
Dec 03, 2020 - To: Dec 10, 2020
 60 Minutes


Why Out-of-Network Providers Must Balance Bill their Patients


During this webinar, we will discuss the current legal and regulatory environment associated with balance billing. Mr. Force will instruct OON providers and their revenue recovery staff on how to maintain compliance and avoid litigation while collecting the proper amount of money from patients and their health plans. This session will explain how you may avoid compliance pitfalls and litigation by health plans in 2018 and beyond. There will be an analysis of litigation pertaining to out of network healthcare providers, “fee forgiveness”, “balance billing” patients, and health plan audit strategies.


Areas Covered:-


  • The definition of Balance Billing & Fee Forgiveness
  • The requirements of balance billing for out-of-network providers
  • The danger of not collecting from insurance, deductibles or otherwise balance billing out of network patients
  • Techniques to balance bill patients without offending or alienating them
  • How to write patient-friendly balance billing letters and the best time to send them
  • The exceptions to balance billing requirements, penalties for noncompliance & recent case law
  • Review of dispute resolution for emergency services
  • Review of dispute resolution for non-emergency "Surprise Bills"
  • Best practices to avoid audits and litigation
  • The importance of the Charity Care Program/ Financial Hardship Policy


Why Should You Attend?


By attending this informative session, you will learn strategies that will assist your practice in avoiding health plan audits and litigation based upon fee forgiveness and failure to balance bill patients. You’ll learn how to effectively balance bill your patients and the implications of being non-compliant.

Attendees will get a comprehensive overview of what a provider needs to be doing, now, to remain compliant, including best practices to avoid balance billing audits and recoupment by insurers.

After attending this session, you’ll be prepared to optimize your collections with effective balance billing techniques. You’ll understand ERISA rules and guidelines, as well as state mandates, on how to handle balance billing. You’ll be able to strengthen your balance bill letters and protect your practice without losing patient volume.


Who Should Attend?


  • Medical Practices – Owners and Revenue Cycle personnel
  • Medical Facilities- Owners and Revenue Cycle personnel
  • Healthcare Consultants
  • Healthcare Attorneys
Training Options
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