2023 AC - Tales from the Trenches: Third Party Payor Disputes

Karen George, Esq., Buchalter Business Law This session will cover several case studies of reimbursement disputes between healthcare providers and payers, addressing a range of issues related to medical necessity, coding, authorization, among others. Through these case studies, the presentation will highlight and explore key legal strategies that have been successful in resolving these disputes in favor of healthcare providers. Additionally, the presentation will discuss emerging trends and best practices for healthcare providers seeking to protect their interests and navigate complex legal disputes with payers. Overall, the goal of the presentation is to provide insights into the common legal challenges faced by healthcare providers when dealing with payers, and to provide valuable insights and practical guidance for successfully navigating these disputes.