How to Use PPS Model Contract Check List: Negotiation of Key Provisions in Payer Agreements

NOTE: This webinar was delivered live on SEPTEMBER 20, 2017 - 2:00 pm - 3:30 pm (Eastern).

PPS Member discount will show at checkout page.

The purpose of the Checklist is to provide a reference tool for therapists when reviewing and negotiating provider agreements with commercial payers and health plans. The tool offers general guidance concerning key contracting provisions and provides examples of both payer­friendly and provider friendly terms.

The goals of the session are to: encourage therapists to carefully review and understand the proposed provisions before executing payer agreements; explain the more important terms and conditions commonly included in such agreements; provide examples of language to beware of and explain the potential implications; and facilitate the negotiation of these provisions by offering alternative or additional language.

Upon completion of the course, the participant should be able to:
  1. Describe the proposed provisions before executing payer agreements.
  2. Explain 6 important terms and conditions commonly included in such agreements.
  3. List 6 examples of language to beware of and explain the potential implications.

Meet the Speaker(s):

Angela Smith, JD. Angela Smith regularly assists health systems, hospitals and other providers in the review and negotiation of managed care and commercial payer contracts, and she assists clients in developing strategies for navigating and adapting to the changing landscape of commercial payment and reimbursement. She also regularly assists in negotiations regarding the acquisition of various technology products and services. Angela is a seasoned appellate litigator who has assisted a variety of health care providers in resolving a wide range of disputes involving accreditation, business, commercial reimbursement, Medicare reimbursement and risk management issues.

Rick Katz. Rick received a BS degree from California State University, Northridge (CSUN) and obtained his Physical Therapy certification from CSUN/UCLA. He went on to receive a Master’s Degree in Exercise Science from CSUN in 1985 and his DPT from EIM Institute in 2013. He currently works for ATI Physical Therapy as a Vice President of Payer Contracting and Operations. Rick is a faculty member at CSUN. He is an expert consultant for the California PT Licensing Board. He is the Chairperson of the California PT Association’s Payment Policy Committee; member of CPTA Board of Directors and the Private Practice Section’s Payment Policy Committee.

Holly Johnson PT, DPT. Holly Johnson graduated from University of Kentucky Physical Therapy Program in 1986 and received her transitional doctoral degree in PT from AT Still University in 2005. She has practiced over 30 years in her out-patient private practice PT Pros in Eastern Kentucky. She is the chief operating officer of seven PT Pros clinics. Her experience ranges from orthopedic manual PT to sports medicine, industrial rehab, pediatrics, women’s health and geriatric with expertise in chronic pain management and dry needling. She has many years’ experience in industrial marketing and consultation with a current WorkSteps and Work Well certifications. Since 2011 she has developed and trained PTs to assist in a Global Health Outreach multi medical professional mission trip to Nicaragua. Currently, she is developing and implementing the PT PROs orthopedic mentoring program for new doctoral graduates, as well as mentors new PT Pros clinic directors in coding, billing, and clinical operations. She has served as the KY. Chapter payment policy chairmen since 2008, and PPS payment policy committee member since 2013.

Completion Instruction

Return to the Learning Center and complete the session evaluation.

Course Code:

LMS-E235

APTACategory

Category1

cert_CA approval

CPTA2018-19

cert_Insert Up To

No

cert_No IACET

No

cert_NY approval

Yes

cert_Transcript stmt

No

cert_TX approval

2008027TX

CEU Approval and Certification - PPS

As a Component of the American Physical Therapy, Private Practice Section online courses are accepted by the following physical therapy licensure boards, as allowed by the type of course requirements in state regulations: AL, AZ, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, MI, MN, MS, MO, MT, NE, NH, NY, NC, ND, OK, OR, PR, RI, SD, TN, UT, VT, VA, WA, WV, WI, WY.

The Private Practice Section is accredited by the California Physical Therapy Association (Provider # CPTAAP-12) and the Texas Physical Therapy Association (Provider # 2008027TX). Thus, Private Practice Section course credits are accepted in California and Texas.

PPS online courses are NOT approved in AK, AR, LA, MD, NV, NM, NJ, OH and PA.

PPS issues CEUs/CCUs based on the following definitions: 1 CEU = 10 contact hours/10 CCUs. .1 CEU = 1 contact hour/1 CCU. 1 contact hour/1 CCU = 60 minutes of structured educational activity.

Completion Instructions

Return to the Learning Center and complete the session evaluation.

Date published

08/08/2017

Date recorded

09/20/2017

Delivery method

Webinar

Brought to you by

Private Practice Section

#Lessons:
1How to Use PPS Model Contract.mp4
Overview
Type:E-Learning Course
Credits:0.1
Credit Categories
Learning Time:1h  30m
Domains:marketing, telehealth, business planning, operations, finance
Enrollment
Price:$155.00
Available discounts:
  • Non Member
    $155.00
    (until 12/31/2030)
  • Member
    $120.00
    (until 12/31/2030)
  • Private Practice
    $89.00
    (until 12/31/2030)
* Prices in US Dollar