Are Your Ready for the October 1 Marketplace Launch?

NJAAHAM Presents:

BUCKLE UP!

ARE YOUR READY FOR THE OCTOBER 1 MARKETPLACE LAUNCH?

WHAT YOU NEED TO KNOW PLUS PROVEN STRATEGIES FOR ENHANCING CASH

THURSDAY SEPTEMBER 19, 2013

DoubleTree by Hilton, Tinton Falls-Eatontown

700 Hope Road

Eatontown, NJ 07724

732-544-9300

8:15 am - 9:00 am Registration

9:00 am - 9:30 am Chapter Update -Kaaren Corallo, CPAM, Pres. NJAAHAM

Committee Updates-NJAAHAM Board

General Sessions 9:30 – Noon

ACA Enrollment: The Hospital Role in Maximizing Coverage

With the October 1 open enrollment date quickly approaching, hospitals need to gear up to educate staff and patients about the new health insurance options under the Affordable Care Act (ACA). As healthcare providers, hospitals play an integral role in assisting patients with enrollment into new plans that are offered in the Health Insurance Marketplace, as well as the expansion to the Medicaid program.

Speaker: Jennifer Barrett Sryfi, MHA

Director, Community Programs

New Jersey Hospital Association/HRET

Educational Review: The Commercial Payment System AKA “The Snowden Report”: What They Don’t Teach You in School and What the Insurance Industry Works Hard to Suppress

There are three simple rules: 1) ERISA determines your payment, not your network contract, 2) RAC MSP’s MUST be paid, and 3) NEVER agree to the recoupment of an overpayment. Other items to be discussed are the size of the healthcare market, review of the “Double Blind” contracting system, and “The Emperor Has No Clothes” – why there is no “insurance policy” behind that member card.

Speaker: F. Scott Winslow

CEO

Claims Recovery Company, LLC

Veteran’s Administration (VA) Overview and Update

There is considerable confusion among much of the non-VA providers about VA claims, how they are paid, how the program works. The discussion will provide background information on the VA program and how to navigate through to get claims processed correctly.

Speaker: Susan Redmerski

Manager, Non-VA Provider Reimbursement

Veteran’s Administration

12:00 – 1:00 – Lunch

General Sessions 1; 00 – 3:30

Contracting Strategies to Prevent and Reverse Silent PPO Abuse

This session will identify current managed care trends as it pertains to the access of Silent PPOs and inappropriate discounting. Providers will learn to identify inappropriate PPO behavior and abuse, and misuse, of their managed care contracted rates. Participants will be shown how to recognize language loopholes and where to strengthen contract language to prevent future abuse.

Speaker: Sherry Gunderman

Director, Silent PPO Services

MedAssets, Inc.

Payer Update – United Healthcare – ICD-10 Readiness

Speaker: Aaron Sapp

Sr. Network Program

In the interest of having speakers prepare to answer questions more specifically, we are asking providers to e-mail questions to by 09/12/2013

Please list the payer to whom you are addressing the question.

Registration Fee $95.00 Dress: Business Casual AAHAM CEU’s = 10.0

To register: Mail: NJAAHAM, PO Box 938, Pt. Pleasant Boro, N.J. 08742

Or online @ NJAAHAM.COM

Any Registration Questions: Email:

Check our website for any meeting changes: NJAAHAM.COM (meeting times subject to change)

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