Product type:

AllBooksEventsOnline CoursesWebinarsPackages
Medical Group Management Association

Certificate Program: Payer Contracting - on demand

Webinar -

Contracting

SKU: O21OLCERT02

Overview

If you experience issues registering for this program, please email or call the MGMA Service Center at 877.275.6462 ext. 1888 to register.

------------------------------------------------------------

The certificate program consists of three 2-hour session plus the closing session; the entire event will be 6 hours and 15 minutes, held November 18-19. This program is eligible for ACMPE, ACHE and CEU credit. 
 
This online event will give you the skills to analyze your contracts, strategically develop contract proposals and create a monitoring and analysis process. Register for the Payer Contracting Certificate Program to gain the skills you need to create better outcomes for your practice.

Agenda Overview
Part I: Gathering and Analyzing Your Contracts
Part II: Articulating Practice Value, Developing Contract Proposals and Building a Go-Forward Strategy
Part III: Establishing a Contract Monitoring and Evaluation Process
Part IV: Closing Session — Reflections and Takeaways


ACMPE Certificate Approved Seminar  

Completion of this program is exclusively eligible for the Payer Contracting Certificate through the certifying body, the American College Of Medical Executives (ACMPE). Certificates are widely accepted throughout the industry and offer valuable immersions that share knowledge and enhance skills.   

More about the ACMPE Certificates   

ACMPE: 6

ACHE: 6

CEU: 6


Continuing Education Information
 
Delivery method: Self-paced study | Internet Activity Enduring Material
Learning level: Advanced - Education that builds on an intermediate curriculum, designed to help you synthesize and evaluate complex concepts to create outcomes-based solutions.
Learning format: Traditional 
Prerequisites: The ability to apply the topic or knowledge area. 
Advance preparation: None
Duration: 120 minutes each seminar part
 
Seminar Series Maximum clock hours*
ACMPE: 6  | ACHE: 6 | CEU: 6
            

If you wish to claim continuing education credit and the certificate of completion, you must pass the associated exam required by the accrediting organizations. Registration for the exam is included in the certificate program.

  • ACMPE, medical practice administrators in certification and Fellowship through ACMPE
  • ACHE, American College of Healthcare Executives Qualified Education
  • CEU, generic continuing education unit
 
Official Continuing Education Statements and Availability
 
 American College of Medical Practice Executives (ACMPE)
This program is approved as a live learning event for ACMPE continuing education hours. A cumulative total of 50 ACMPE continuing education credit hours is among the requirements for attaining the Certified Medical Practice Executive (CMPE) credential. To maintain CMPE or Fellow status, you must earn 50 hours of qualifying credit hours every three years, of which 30 hours must come from MGMA national, state or local offerings, including 12 from a live learning event.
 
Learn more about the ACMPE certification program.
 
One ACMPE credit is earned for every 60 minutes of educational content, rounded down to the nearest 0.25.

Participants of pre-approved seminars are eligible to receive content specific Certificates through MGMA’s certifying body, the American College of Medical Executives (ACMPE).   

Certificates are the industry acknowledged achievement for time inclusive opportunities to complete an entire course or seminar and have provided paperwork for your resume or employer of completion without on-going requirements to continue demonstrating a skillset. Certificates offered through ACMPE build skills and knowledge in a specific area of practice.   

Eligible for ACMPE Certificate.
 
ACHE Qualified Education
By attending the Online Payer Contracting Seminar offered by the Medical Group Management Association, participants may earn up to 6 ACHE Qualified Education Hours toward initial certification or recertification of the Fellow of the American College of Healthcare Executives (FACHE) designation.
 
One ACHE credit is earned for every 60 minutes of educational content, rounded down to the nearest 0.25.

Continuing Education Units (CEU)

A certificate of attendance will be provided to healthcare professionals requesting generic CEUs for professional development, certifications through other professional associations or specialty societies.
 
One generic CEU credit is earned for every 60 minutes of educational content, rounded down to the nearest 0.25.

 

Part I: Gathering and Analyzing Your Contracts
Available for: ACMPE: 2 | ACHE: 2 | CEU: 2
Advanced | Traditional
 
Most practices know what is required to accomplish due diligence on their contracts but dread the thought of systematically gathering payer agreements and fee schedules, analyzing the findings, and developing and executing a strategy to renegotiate agreements. The challenge of being faced with so many hard-to-find puzzle pieces in the quest to accomplish even the first steps of finding the agreements, amendments and relevant schedules can quickly overwhelm a practice and derail it from its goals. This session will share turnkey processes that will get you headed in the right direction and on task even when obstacles are in the way. The primary focus of this session will be on building your foundation—the gathering, analysis and strategy development stage of your payer contracting project. 
 
This session will set the stage for the content in Part II of the education series: How to initiate a negotiation, what makes your practice special, and how to model and test an offer so that you have a clear understanding of why it is so important to start with a solid foundation.
 
This 2-hour program will provide you with the knowledge to:
  • Assemble payer agreements, amendments and fee schedules
  • Prepare payers’ schedules in need of renegotiation
  • Develop renegotiation strategy
 
Part II: Articulating Practice Value, Developing Contract Proposals and Building a Go-Forward Strategy
Available for: ACMPE: 2 | ACHE: 2 | CEU: 2
Advanced | Traditional
 
This session will build upon the contracting foundation established in Part I. Once a practice has tracked down contacts, agreements and fee schedules, the contracting process enters the next phase: Developing proposals and crafting your practice value proposition. The first focus of this session will be on identifying your specific negotiation targets, including identifying top CPT® codes, comparing rates, evaluating proposals and methodologies across your book of business and establishing targets for negotiation. The instructor will then use this analysis to construct proposals, including sample verbiage and recommended strategies. The session will provide insight into the alternative payment model landscape for practices to consider and position as part of the negotiation process. Additionally, this session will focus on developing the practice value proposition, providing templates to use to start the process of articulating the value during the negotiation process. The final focus will include recommended go-forward strategies to integrate the contracting practice into the core financial management strategy.
 
This 2-hour program will provide you with the knowledge to:
  • Develop payer proposals
  • Create practice value proposition
  • Devise a renegotiation strategy
 
Part III: Establishing a Contract Monitoring and Evaluation Process
Available for: ACMPE: 2 | ACHE: 2 | CEU: 2
Advanced | Traditional
 
The concluding session addresses contract monitoring and evaluation. The first hour will be a hands-on workshop demonstrating the Microsoft Excel VLOOKUP function as a tool to analyze payer performance. A sample dataset will be provided for all attendees to manipulate during the session. The session will then demonstrates how to track and analyze payer performance through contract monitoring, providing methods for ensuring that the rates negotiated match payment rates.
 
NOTE: It is recommended that attendees have access to two monitors for the first portion of this session. There will be a demonstration as well as hands-on work.
 
This 2-hour program will provide you with the knowledge to:
  • Construct key methods to evaluate contracted rates with payment rates
  • Manage payer agreements for payment compliance
  • Develop spreadsheet for contract monitoring
 
Part IV: Closing Session — Reflections and Takeaways
 
All three speakers, Penny Noyes, Doral Davis-Jacobsen and Nate Moore close out the session with reflections and takeaways.

Part I: Gathering and Analyzing Your Contracts

Penny Noyes

Penny Noyes, CHC

President, Health Business Navigators

Penny Noyes brings four decades of healthcare related experience to medical practices on both the payer/MCO and provider sides of the industry. Since 1999, when Ms. Noyes founded HBN, she has been working with a variety of healthcare-related clients who require assistance with payer contracting and credentialing. She has written and executed business plans, renegotiated managed care agreements, provided market exposure, improved client revenue and increased the bottom line. She is sought after by numerous organizations to provide opinions on hot issues for periodicals and to do educational seminars on the topics of payer contacting and credentialing as she brings her "roll up the sleeves," candid approach to material presented.

Ms. Noyes has held various leadership positions throughout her career in healthcare. She served as Senior Vice President of Business Development for a venture capital backed start-up, U.S. HealthWorks, a practice management company specializing in occupational medicine where she was able to negotiate both improved reimbursement and achieved delegated credentialing with all payers for nearly 100 clinics in 7 states representing nearly $100 million in annual revenue. Prior to that she spent 11 years at Allmerica Financial, an $11 billion insurance and financial services company, where she was an Assistant Vice President responsible for product development of health plans nationwide, as well the contracting and credentialing of 180,000 providers nationwide. While at Allmerica she also led a project related to the development of PHCS in collaboration with 17 other health insurance companies. Earlier in her career she worked at Blue Cross of Massachusetts for 6 years on development and marketing of fully insured and self-funded health plans and HMO products, including some of the earliest Medicare risk based plans.



Amanda Hilbert

Amanda Hilbert

Director Payer Contracting Analysis & Negotiations, Health Business Navigators

Amanda is a graduate of Western Kentucky University and University of Kentucky Law School, J. David Rosenberg College of Law. She has been working at Health Business Navigators since her law school graduation in 2015 and, since that time, has become one of the country’s most seasoned and knowledgeable payer contracting specialists.  As an attorney she is a member of the Kentucky Bar Association and the Bowling Green/Warren County Bar Association, but does not currently engage in private practice nor act in the capacity of providing legal advice. Instead, she has become known for her diligence in the obstacle-ridden process of gathering payer agreements and fee schedules, analyzing  key data and contract terms that have been collected and verified, and turning the new found information into the foundations of successful payer contracting strategies and the associated negotiations, including determining the impact of payer offers and modeling counter offers, as well as reviewing final contracts or amendments to determine if they reflect the negotiated terms.



Part II: Articulating Practice Value, Developing Contract Proposals and Building a Go-Forward Strategy

Doral Davis-Jacobsen

Doral Davis-Jacobsen, MBA, FACMPE

Doral Davis-Jacobsen, MBA, FACMPE, is a Partner at Prosper Beyond LLC, a specialized healthcare consulting firm nestled in beautiful Asheville, North Carolina. Doral is a seasoned healthcare consultant with over 20 years of experience serving healthcare providers ranging from solo practitioners to large academic medical centers. She is a popular speaker and author, always looking around the corner to help her clients prepare for “what’s next.” Doral is known for assisting practices with next generation managed care contract negotiations, payment reform and revenue cycle. She is a Fellow in the American College of Medical Practice Executives. Doral serves as the Chair for the North Carolina MGMA Payer Contracting Committee 2019. Doral has written numerous articles on medical practice revenue cycle, managed care contracting and payment reform and is a frequent speaker at national, regional and local healthcare forums. Doral is a co-author of MGMA’s book, Transitioning to Alternative Payment Models: A Guide to Next Generation Managed Care Contracting, published in October 2016.





Part III: Establishing a Contract Monitoring and Evaluation Process

Nate Moore

Nate Moore, CPA, MBA, FACMPE

President, Moore Solutions Inc.

Nate Moore, CPA, MBA, FACMPE, speaks, consults, records and writes about business intelligence in medical practices throughout the country. Nate’s book, Even Better Data, Better Decisions: Advanced Business Intelligence for Medical Practices, is an MGMA best seller. Nate’s consulting focuses on using SQL Server to mine and leverage medical practice data into actionable knowledge.

Nate creates a series of powerful Excel Videos at mooresolutionsinc.com demonstrating how to use Microsoft Excel in a medical practice. Excel Videos have been viewed thousands of times by practice managers across America. Nate also moderates the Excel Users MGMA Community, the online resource for practice administrators to collaborate about Microsoft Excel.

On Demand Refund Policy 
On-demand programs are available for one full year from the purchase date, unless otherwise specified. Registration and exam fees will not be refunded for this program unless approved by the program manager. 

On Demand Cancellation Policy 
If for any reason MGMA must cancel this on-demand program prior to the expected expiration date, MGMA will notify participants by email of the cancellation no less than five business days prior to the cancellation. Full refunds will be processed within 90 days of the cancellation. Registration and exam fees cannot be refunded if the program or exam has been started or completed.

Contact the MGMA Service Center for cancellations or refunds:
Toll-free: 877.275.6462, ext. 1888
Email: service@mgma.com

Complaint resolution policy
Please contact the MGMA Service Center toll-free at 877.ASK.MGMA (275.6462) for issues or concerns with this program.

X

Shopping Cart

Your cart is empty

Subtotal:
Click here if your organization is tax exempt
X

A State Sales tax exempt certificate must be on file and taxable items cannot be ordered online. For immediate assistance during normal business hours of 7:00am to 5:00pm MT M-Th and 7:00 am to Noon MT on Friday, please call toll-free: 877-275-6462, ext. 1888

X

Checkout

Use two letter code for US states
Use three letter code for country
Use two letter code for US states
Use three letter code for country

Grand Total:
Use two letter code for US states
Use three letter code for country
Saved credit card is required for opt-in to autorenew.

Questions? Contact the MGMA Service Center for assistance during checkout or review our return policy for more information.
X

Confirmation

,
,

Total:
Payment:
Balance:
 

Thank you for your purchase! If you purchased an event, you will be receiving a follow-up email from our Learning Management System regarding the product/event purchased and no further action is required.


Loading...