In-Network and Out of Network Billing: Successful Claim Appeal Process

Starting from:

$179

Presenter: Kate Gilman, CPC, CPCO
Date: Thursday, May 7, 2026
Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT

Duration: 60 minutes

Course Description

The goal this presentation is to understand the meaning of being in network and out of network with payers; review the life of the claim; review what the appeal process means, review claim appeal guidelines and requirements, review what attachments are needed for appeal, and how to set protocols for successful follow-up of denied claims for in and out of network providers

Learning Outcomes

To review what is in and out of network billing.
To review In and out of network requirements.
To review federal plan requirements for out of network providers.
To review the life of the claim.
To review what the appeal process means.
To review appeal process for in and out of network providers.
To understand the timing when appeal is appropriate.
To understand what attachments are needed for appeal.
To discuss ways how to set protocols for successful follow-up of denied claims for in and out of network providers.

Areas Covered in the Session

In and out of network billing
In and out of network billing rules and requirements
Federal plan requirements for out of network providers.
Life of the claim
Appeal process for in and out of network providers.
When and how to Appeal
Documents required for appeal.
Setting protocols for successful follow-up of denied clams for in and out of network providers.
Live Q&A Session

Recommended Participants

Medical providers
Practice Managers
Medical practice owners
C-level executives
Medical billing staff
Prior authorization department staff

About the Presenter

Kate Gilman, CPC, CPCO,

Kate has almost two decades of experience in the healthcare industry. She is an expert coder, compliance officer, and trains healthcare providers all over the country. Kate utilizes her expertise to uncover ways to improve billing and coding inefficiencies, training staff, and ensuring compliance, while achieving maximum results and revenues for her clients.

Kate’s successes include small and large practices, ranging from primary care to specialists and surgeons. She is known for helping providers feel confident in their coding and peace of mind with their compliance practices.

Kate’s acute attention to detail, deep understanding of coding and billing, and proactive approach, make her an indispensable asset with all her clients.

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:

Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

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

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In-Network and Out of Network Billing: Successful Claim Appeal Process