On July 1, 2017, California’ out-of-network billing and payment law (AB 72) went into effect. This law changed the billing practices of non-participating physicians providing non-emergent care at in-network facilities by requiring payors to reimburse at an interim payment rate. This law also created a dispute resolution mechanism for physicians who believe the interim payment to be insufficient. This mechanism, the Independent Dispute Resolution Process (IDRP), uses a third-party arbiter to make a binding decision on the appeal for additional reimbursement and requires payors to participate once a physician initiates the IDRP.

www.cmaThis webinar will focus on how to utilize the IDRP to appeal for additional reimbursement and how to increase your chances of success, including how to craft an effective narrative justification, what to include in the supporting documentation, and how the California Medical Association (CMA) can help.