Learning Objectives:
• To hear updates and ask questions from the Department of Healthcare and Family Services about the Illinois Medicaid Program
• Learn about Medicaid rates and polices as it applies across the country from the Health Policy Institute
• Be provided a legislative update on Medicaid issues
LEARNING OBJECTIVES:
1. Understand the scope of electronic prescribing and how it works
2. Gain a clearer picture of the differences between ePrescribing and traditional methods
3. Learn to discern among the range of software on the market
Session 1: Understanding Benefit Designs and Plan Types
• Basics of plan designs
• Self-funded and fully funded plans
• Contract limitations and options (including assignment of benefits)
• Network leasing (including IL law change impact) and third-party administrators
Session 2: Coding and Claims Best Practices
• Frequently found claim errors
• Coding skills for common procedures
• Documentation guidelines
• Appeals and prior authorizations (legal requirements for payments)
Session 3: Participation and Contract Considerations
• Assessing your participation position
• In-network vs. out-of-network experiences
• Impact of adjustments including non-covered services