Health (Payments)

 

• Assisted in developing new and innovative payment structures with managed care payers and provided advice regarding payment programs such as Health Resources and Services Administration (HRSA) 340B, the various Medicare Parts, Medicaid and the Children's Health Insurance Program (CHIP).

 

• Legal support for payer contract management through improvements in contract templates and terminology and assessing payer performance through analytics, to maximize revenue for healthcare providers.

 

• Improving non-litigation claim denial management strategies to recoup lost payment revenue, increase collections for nonperforming accounts and maximize reimbursements.

 

• Legal support for healthcare revenue cycle management (RCM), assistance in managing the administrative and clinical functions associated with claims processing, payment, and revenue generation, facilitating the identification, management, and collection of patient service revenue.

 

• Legal support for audits to improve the efficiency of RCM charge capture and coding, claim submissions, encounter utilization review and case management, payment posting, appeals and collections point of service registration counseling collections, remittance processing and rejections, scheduling and pre-registration, third party follow-up.

 

• Research, reports and presentations to management regarding the implications for healthcare RCM of the transition from fee-for-service to value-based care reimbursement.

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    Last updated 210509_1452