The course is paced for probing questions and problem-solving discussions and includes deep analysis of tough denials and appeals issues for hospitals and physicians and other healthcare providers.
The course is taught by Maria Todd, MHA PhD, an experienced hospital and medical group/IPA/PHO contract negotiator, and former provider relations coordinator at a large HMO, who is trained as a certified mediator and health law paralegal. Todd is Acting Executive Director of the Institute and the author of 9 health administration reference books including, the Managed Care Contracting Handbook, 2nd Edition: Planning & Negotiating the Managed Care Relationship (ISBN:
The hands-on workshop will teach participants how to use model contract language (supplied in materials) and proven successful arguments to overturn denials, a denials database will be supplied that can be implemented immediately upon return to the office. Todd will also share strategies to deploy when the contracts are with PPOs and not with the actual payors to work around privity issues, and learning to locate the looming perils and pitfalls in today’s volatile managed care and healthcare reimbursement reform marketplace. In addition, detailed handout of contract language, sample business rules and a model payer report card will be supplied with presentation materials.
"It has been harder for American healthcare providers to find post-graduate, professional training in denials management and successful appeals techniques for several years,” states Maria Todd. “Most of the long established professional associations have refocused almost all their attention on healthcare reform, accountable care organizations (ACOs) and other preoccupations leaving managed care and revenue cycle training behind.
Unlike finance majors, new workforce entrants in revenue cycle don't often receive this specialized training in colleges and university MBA and MHA programs. Worse yet, they may be replacing a predecessor who's skills may have been rusty, ineffective, disorganized, inadequate or incompetent. Many find to their exasperation, that the denials and appeals have not been worked, followed up, and are in desperate need of a new approach, and while the new hire may have been charged with the responsibility to do something about it, they don't know how or what to do or even how to open the discussion with payers to their advantage."
At the Institute, we offer the training and professional and post-graduate real-world training where students can choose to just focus on a particular skill such as hospital managed care contracting, physician managed care contracting, capitation, case rate development, physician integration, or direct-to-employer contracting. In some cases, the Managed Care Institute has been awarded an annual contract to provide all revenue management professional training and development solutions within the those respective departments.”
Todd is also the author of two other books on physician-hospital integration, including IPA, PHO, and MSO Development Strategies: Building Successful Provider Alliances (HFMA Healthcare Financial Management Series) (ISBN: 978-0786311194, released January 1997) and Physician Integration:
Her two medical tourism titles, Medical Tourism Facilitator's Handbook (ISBN: 978-1439812839, released November 2011) and Handbook of Medical Tourism Program Development:
The course is offered three times each year. Registration is limited to only 50 students per session. Beginning contract negotiators and analysts should register for the 3-day workshop offered in January, April, July, and October 2012. Other courses in Direct to Employer Contracting, IPA, PHO, ACO Organization, Managed Care Contracting Master Class, and a number of short courses and webinars will also be available as the Institute finalizes additional instructor contracts and course schedules in coming weeks.
To sign up for the courses, please enroll at http://managedcareinstitute.com
Travel information is available at: http://managedcareinstitute.com/
# # #
Established in 2007, the Managed Care Institute has been a provider of managed care and revenue cycle training and professional development for healthcare organizations across North America and in Europe, Northern Africa, South American and Asia.