Insurance Considerations for the OMS: Effectively Handling Claims When Out-of-Network

Thomas J. Force, Esq., President of Patriot Group and The Force Law Firm, PC, discusses the challenges OMSs face in filing claims and/or receiving reimbursement when they are not participating in their patient’s insurance network. Topics discussed include techniques to maximize out-of-network revenue, appeals drafting, compliance and audit prevention, insurer settlement negotiation, reversal of denials, defense of refunds and recoupment attempts.