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Session 46 | Navigating Managed Care:  Learn How Providers Can Effectively Put a Stop to Bad MCO Behavior Without Jeopardizing Referrals

Session Summary

Understanding how Managed Care Organizations (MCOs) are overseen by CMS and states, i.e., why and how they can be cited and sanctioned by each agency, gives providers a road map to remedying MCO bad behavior and protecting their revenue. In thi ssession, presenters will discuss how attendees should be negotiating new MCO Provider agreements. Learn which provisions MCOs rely on to avoid paying every claim, how to recoup alleged overpayments without a hearing, pass on rate decreases without notice, etc. Knowing these provisions and pushing back before signing off will increase revenue and decrease write-offs.