Payer enrollment with Megan Struxness

Описание: Megan Struxness is Head of Payer Operations and Revenue Cycle Management at Bridge, a healthcare platform that helps telehealth providers accept insurance nationwide.

In this episode, Megan and Zack discuss payer enrollment – the industry term for what healthcare providers need to do to accept insurance.

They cover payer contracting, credentialing, what superbills are, how out-of-network claims work, and how small operational details – like enrollment and eligibility checks – determine what providers actually get paid.

00:00 Intro
00:27 What is Bridge?
02:20 How Bridge helps providers accept insurance
04:36 Can a brand new practice work with Bridge?
07:31 What is an EMR?
10:27 What it takes for a provider to accept insurance
13:15 What are super bills?
15:41 How out-of-network payments work
18:35 What is payer enrollment?
22:41 The alternative to self-managing revenue cycle management (RCM)
28:50 How does Bridge onboard providers in 45 days?
32:44 What are MSOs?
37:05 Why eligibility checks can’t guarantee payment
41:42 What is guaranteed payment?
44:48 The source of truth for provider contracts
51:36 What would Megan change about RCM?
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Learn more about Bridge: https://www.usebridge.com/
Connect with Megan on LinkedIn:   / megan-struxness-79962866  

Referenced in the episode:
"Reality has a surprising amount of detail" by John Salvatier: http://johnsalvatier.org/blog/2017/re...

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