Payer enrollment with Megan Struxness

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.Watch on YouTube: Click here to watch a video of this episode. (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? ---Learn more about Bridge: https://www.usebridge.com/Connect with Megan on LinkedIn: https://www.linkedin.com/in/megan-struxness-79962866/Referenced in the episode: - "Reality has a surprising amount of detail" by John Salvatier: http://johnsalvatier.org/blog/2017/reality-has-a-surprising-amount-of-detail---Listen and subscribe to the Understanding Healthcare with Zack Kanter podcast:YouTube: https://www.youtube.com/playlist?list=PLZ4o7H5Som0Zlo2dGH4jMJy0nlL1oqxDoSpotify: https://open.spotify.com/show/6cyz5JaAoG3R995QokLR2dApple Podcasts: https://podcasts.apple.com/podcast/understanding-healthcare-with-zack-kanter/id1860618431RSS feed: https://feeds.transistor.fm/understanding-healthcare-with-zack-kanter