The Basics of Managed Care: What You Need to Know-The Basics of Managed Care: What You Need to Know (Recording)

Video Transcription

Video Summary

In this webinar, Joe Bartlett discusses the basics of managed care and what providers need to know. He explains the importance of understanding the basics of managed care participation due to the increasing number of consumers with hearing aid coverage. Joe covers a range of topics, including the role of managed care in managing costs, utilization, and quality. He also provides information about Medicare and the different parts of the Medicare program. Joe highlights the importance of having a compliance plan when working with health plans and the need to negotiate contracts to ensure fair reimbursement. He also emphasizes the importance of verifying coverage and understanding the patient's responsibility before starting any treatment. Joe provides tips on submitting claims, including the need to be specific and follow the appropriate codes. He also addresses the issue of balanced billing and the varying requirements for billing services. Joe concludes by discussing fraud, waste, and abuse, as well as the importance of compliance and oversight in managing insurance claims. Overall, the webinar provides valuable information and guidance for healthcare providers navigating the field of managed care.

Keywords

managed care

providers

basics

Medicare

compliance plan

reimbursement

coverage verification

claims submission

balanced billing

insurance claims