“Finally Friday!” Compare & Contrast: Commercial v. Medicare

FRIDAY March 27, 2015:

Commercial v. Medicare:

How & Why They Differ

Industry Veterans Reveal How They Handle
Commercial Payor Audits and Denials
and Why It’s So Different from Medicare

Watch for the Handouts

There's more to it than the size and shape...

There’s more to it than the size and shape…

The focus of most of our shows has been on the policies and regulations of Medicare, as promulgated by CMS. While CMS is often the largest single payor for many hospitals, it is certainly not the only one, and in some hospitals, perhaps not even the most “troublesome” program for reimbursement. We’ve had various guest speakers express that the commercial payors are more difficult to deal with than Medicare.

With that in mind then, we’ve asked two industry veterans to come on the show and discuss some key lessons they’ve learned about dealing with the commercials, so we can compare and contrast the different systems and processes.

Dr. Scott Robertson - Physician Advisor at Dignity Health

Dr. Scott Robertson – Physician Advisor at Dignity Health

Scott Robertson, MD, MBA, Chief Physician Executive & VP Physician Integration at Dignity Health in San Luis Obispo, California, joins us to give his insights and experience, from his past four years as a Physician Advisor.

Also joining us will be Jessica Gustafson, Esq., our legal expert and veteran of tons of appeals for hospitals and physicians nationwide, combating both commercial and government payors.

No crystal balls, no dice… only real-world experience, anecdotes and advice on this show.

Ok, well, we *might* make a few predictions, given some recent news, but the rest of the show is all quality advice and knowledge being offered.

We’ll all be talking about such things as:

  • Timelines & Guidelines – how do they differ from Medicare?
  • Pre-Denial Discussions: how can you best use them?
  • What are theTop 3 Mistakes hospitals make with commercial payors?
  • Is documentation of medical necessity “different” for commercial claims?

Be sure to listen in and join the discussion!

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Handouts for This Week's Show

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REPLAY of This Week's Show

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