Live Webinar: 

Beyond the Per-Diem; Capturing Outliers & Exclusions in Medicare Advantage

    Are you failing to identify a $49,000   financial risk?

    Learning Objectives
    Identify common Medicare Advantage outliers, exclusions, and carve-outs that may qualify for reimbursement outside the standard SNF rate. Recognize opportunities before admission by connecting the patient’s clinical needs with payer-specific contract terms. Verify authorization and payer requirements before providing high-cost services, medication, supplies, or equipment. Document and communicate effectively so the clinical record supports additional reimbursement. Track the claim from authorization through payment to ensure approved additional reimbursement is actually collected
    What We Offer

    What's included in this Live Webinar?

    Step-by-step guides, tools and resources

    Our easy to use guides, tools and resources will reinforce education and support ROI.

    Live Learning Experience

    Engaging, expert-led webinars that turn complex managed care challenges into practical strategies your team can use immediately.

    Accessible AFTER the  Webinar

    The slides and all tools, resources and guides will be available to you for one year from the webinar date.

    Mary Hirsch 

    For more than 20 years, I’ve worked in the Skilled Nursing Facility industry, with much of my career focused on managed care, case management, contracting and reimbursement.

    I’ve seen the same challenge repeatedly: having a managed care contract does not mean an organization is maximizing its value. Revenue can be lost at almost every point—from contracting and benefits verification to authorization, concurrent review, reimbursement levels, outliers and exclusions, denials and billing.

    I founded MK Hirsch Advisors to help SNFs close those gaps and am looking forward to working with you.
    Patrick Jones - Course author