$179
Fighting Back Against Recoupment, Special Investigation and Insurance Payor Audit
Presenter: Thomas J. Force, ESQ. Date: Wednesday, August 26, 2026 Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT Duration: 60 minutes
Course Description Healthcare providers must know what recoupment and audits are; and what steps should be taken to defend against the insurance company’s overpayment demands. This webinar will address the ERISA obligations and protections and the importance of a provider obtaining a valid Assignment of Benefits. It will also set forth the notifications which must be sent out by the insurance company when it conducts an audit and seeks recoupment. Attendees will learn how to properly and effectively defend itself from insurer audits, special investigations and refund demands. Mr. Force will unravel the complexities of healthcare audits and recoupment demands. Attendees will learn about provider rights under state and federal law and how to draft on effective response and appeal to such audits. The Webinar will discuss the concept of full and fair review and that recoupment demands are considered “adverse benefit determinations”. It will advise the attendees of what information they are entitled to so that they can respond to and defend the audit findings and recoupment demands. The presenter will discuss various court cases on these issues and the most common basis for recoupments, such as services not covered under the plan or non-compliant. Learning Outcomes
Areas Covered in the Session
Recommended Participants
About the Presenter
Thomas J. Force, ESQ is a state and federally licensed attorney with over 34 years of experience in the healthcare and insurance industries. As a former U.S. Marine and a successful Wall Street insurance litigator, Mr. Force served as General Counsel for a New York-based Accident and Health Insurance Company, where he also served as Chief Compliance Officer. These experiences led to the founding of The Patriot Group. Mr. Force is a nationally recognized expert in revenue collection techniques, appeal strategies, and healthcare compliance. He is on the Advisory Board at Hunter Business School, a New York-based school for medical billing and coding students. Mr. Force is an active member and frequent speaker on managed care and collection techniques for the Health Finance Management Association, several state medical associations, and other healthcare organizations. On March 29th, 2022, Thomas J. Force, J.D, Esq, President of The Patriot Group, served as moderator for the forum on Clinical Denial Management at Hofstra University, organized by the Health Finance Management Association – Metropolitan Section. Additional Information
After Registration:
You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.
System Requirement:
Can't Listen Live?
No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience.
For more information,
you can reach out to the below contact:
Toll-Free No: 1-302-444-0162 Email: care@skillacquire.com Address: 651 N. Broad Street, Suite 206, Middletown, DE 19709 Snippets From Our Previous Session |