(Recorded Webinar) Paid-Claims Issues
Seventh in the Medicaid University series, this session will discuss a growing issue in the Health Center/Medicaid relationship: the paid claims problem. Many states require an MCO to pay for some part of a Health Center claim before the state will make a wrap-around payment on that encounter. While on its face this requirement makes sense, it creates a significant risk of underpayment: MCO payment methodologies are not designed to determine whether a face-to-face visit took place, which is the fundamental “trigger” for a PPS payment to a Health Center. There are many situations, for example, MCO credentialing, where the MCO will not make a payment but a billable (and payable) visit took place. We will discuss these paid claims issues and strategies to address this issue.
To purchase the full Medicaid University Webinar Series, click here.
NACHC and Feldesman Tucker Leifer Fidell, LLP have joined up to create a “Medicaid University,” your one stop shop for all things about the Medicaid FQHC PPS and Alternative Payment Methodologies (APMs). This series will provide participants with the tools they need to help develop a strong strategy in working with their state and Medicaid partners.
This series of seven webinars will focus on the fundamentals of the Medicaid FQHC payment, covering current law and policy and how it is being applied in the states. Each webinar will address a specific topic, focusing on the policy and legal landscape, and attendees will hear from health center and PCA leaders on their successes and challenges in their states, providing insights to help strengthen your state-based strategies.
Ryan Grinnell-Ackerman (Michigan Primary Care Association)
Ryan currently serves as the Director of Operations and Policy overseeing the Michigan Primary Care Association’s (MPCA) operations and enabling services team and leads the PCA’s public policy and government affairs activities. Ryan holds a Master of Public Administration degree from Western Michigan University’s School of Public Affairs and Administration, where he focused his studies on public policy, government relations, program evaluation, and mixed methodology data analysis in the nonprofit and public sectors.
Susan Sumrell (NACHC)
Susan is the Deputy Director of the State Affairs team at NACHC. Her work focuses on Medicare and Medicaid policy issues - reviewing and analyzing federal and state regulations and policies affecting health centers and advising, state primary care associations, and health centers and NACHC staff on these policies.
TED WATERS (FTLF)
Serving as Managing Partner of the firm since 2003, and a member of the Health Law and Federal Grants practices since 1992, Ted is a national authority in the area of federal grants, particularly in the health and community service spheres. He advises clients on all aspects of program requirements, including issues such as cost-based reimbursement, governance, grant administration, cost reporting, and administrative issues and routinely handles challenging issues such as government audits, internal investigations, and litigation. Ted's priority is to help each organization carry out its mission by offering practical, down-to-earth counsel and to ensure that legal challenges do not distract from that focus. [Full Bio]
Certificates of Attendance: We verify attendance upon completion of a webinar (live or recorded version) and will only issue certificates in the name of the account holder enrolled in the course. If you need to document attendance for someone other than the account holder, we provide blank Certificates of Attendance for a supervisor to sign and certify that a different individual viewed the course.
Group Attendance: Due to the online nature of webinars, we cannot verify participation by more than one person. For groups, we provide an attendance record form and blank Certificates of Attendance to record attendance at a group viewing session and document each individual's participation. We recommend that a supervisor or colleague sign the certificate to certify attendance.
Read more about maintaining an attendance record in our FAQs.
- 1.25 Certificate of Attendance
Recorded webinars are available for 180 days after the date of purchase or date of the webinar. Once posted to your account, you can view this webinar anytime on-demand during the access period identified in your purchase confirmation. For additional information on viewing and accessing webinars, view our full terms and conditions here.
If you pay by credit card or PayPal, you will be able to access the recorded webinar immediately (unless the live webinar has not yet occurred). If you pay by check, we will grant access to the recording when we receive your check. You will receive a confirmation email once access is granted. FTLF reserves the right to suspend access to the webinar if payment is not received within 30 days. For more information on payments and registration, please visit our FAQ page.
No refunds will be provided for recorded webinars. FTLF can transfer a registration to someone else within your organization or, provided you have not already viewed the webinar, transfer the registration to another on-demand program. Where the registration fee for the new webinar is higher, you must also pay the difference between the original course and the new course registration fee at the time of transfer. Administrative fees may also apply. If your organization purchased a webinar under the account of a staff member who no longer works for your organization, please Contact Us. View our full policy on refunds and cancellations here.
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