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Panel Presentations

Business of Medicine/Practice Management

Office Coding, Billing, and Insurance Negotiation for New Practitioners

Sunday, September 29, 2024
8:00 AM – 9:00 AM EDT
Location: MBCC, 233
CME/MOC Credit: 1
Disclosure(s):
Stephen P. Cragle, MD, FACS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kayla B. Hicks, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Daniel R. Gold, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marc G. Dubin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Samantha J. Hauff, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: While coding, billing, and negotiating with insurance payers is not a glamorous part of practicing otolaryngology, it represents the cornerstone of reimbursement and maintaining your practice and physician income. Evaluation and Management (E/M) codes for physicians have undergone complete overhauls in 2021 (outpatient) and 2023 (inpatient and other sites) which bear careful examination and application. These codes, along with procedure (CPT) codes, are then submitted electronically to payers in order to receive reimbursement. Insurance plans, whether federal, state, military, or commercial, have arcane and confusing rules and intimidating claims review processes. Errors in coding, billing, or negotiating contracts with payers can have harsh economic consequences for an otolaryngology office.
This panel, comprised of managing partners in solo, small group, and large group practices, bring years of experience and detailed knowledge of the billing, coding, revenue cycle, and insurance contract negotiation process. Panelists will share strategies to achieve correct coding, improve billing & coding protocols, streamline clean claims submission, and negotiate fair contracts with payers.

Learning Objectives:

  1. Identify the types of payers in U.S. healthcare, the relative sizes of their pools of insureds, and their economic impact on medical practice.
  2. Describe current coding procedures for otolaryngology practices and contrast with previous coding mandates.
  3. Illustrate efficient methods for correct coding, efficient billing, and contract negotiation for an otolaryngology practice.

    Moderator(s)

  • SC

    Stephen P. Cragle, MD, FACS

    Partner
    St Cloud Ear, Nose & Throat Clinic
    Saint Cloud, MN, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    Resources

  • Kayla B. Hicks, MD

    Resident Physician, Otolaryngology-Head and Neck Surgery
    University of North Carolina
    Durham, NC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Panelist(s)

  • DG

    Daniel R. Gold, MD

    Partner
    ENT and Allergy Associates, LLP
    White Plains, NY, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Marc G. Dubin, MD

    Managing Partner
    The Centers for Advanced ENT Care a unit of ENT Specialty Partners
    Ruxton, MD, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Samantha J. Hauff, MD

    Owner
    Sunset ENT
    San Diego, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.