AHC Helps Hospitals Resolve Discounted Insurance Payments

An increasingly common and often confusing tactic used by payers is the act of applying "usual and customary" discounts to healthcare claims, leaving the balance to be either written off or placed as a burden on the patient. Shirley Dawson, Senior Research Attorney for AHC Healthcare Receivables Management recently discussed how the healthcare community can utilize a payer-specific approach and resolve these claim reduction issues. Her seminar, "Managing Usual and Customary Denials: A Legal Perspective", was presented at the HFMA Tri-State Institute in Tunica Resorts, Mississippi on January 18. The conference was attended by over 200 of the healthcare industry’s top financial experts from Arkansas, Tennessee, and Mississippi.

Representative provider organizations in attendance included:

Baptist Memorial Health Care
DeTar Healthcare System
Forrest General Hospital
Memorial Gulfport
Methodist Healthcare
St. Jude Children’s Research Hospital
St. Vincent Health System
UAB Health System
….and many others

Session attendees received education on the various tactics employed by payers, state statutes, federal regulations, case law, correct guidelines utilized in determining "reasonableness" of charges for each payer type, and appropriateness of patient involvement in each payer situation.

Having completed over 230 educational seminars in 2006, AHC continues their commitment to the healthcare community by providing complimentary, on-site healthcare reimbursement education. Interested parties who wish to learn more or schedule a complimentary workshop for their hospital business office staff, may contact AHC at (888) 511-7901 or visit www.ahcinc.com.