Igniting Opportunity: Navigating the Medicare Advantage Landscape Webinar Series – Part 3 Dec 16
11:00 am - 12:30 pm CST Hosted by
PHA

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About the Event

Igniting Opportunity: Navigating the Medicare Advantage Landscape Webinar Series

Part 1: October 15, 2026
Part 2: November 11, 2026
Part 3: December 16, 2026
All sessions are 11:00am – 12:30pm EST

Series Description
Medicare Advantage continues to reshape the home health marketplace, creating opportunities for growth while introducing new financial, contractual, and administrative challenges. This three-part webinar series will help home health leaders make informed decisions about payer participation, evaluate and negotiate managed care contracts, and strengthen the processes that support authorization, documentation, billing, and denial prevention.

Participants will learn how to assess Medicare Advantage plans using market data and agency performance measures, identify contract provisions that affect reimbursement and operations, and demonstrate their organization’s value to health plans. The series will also address the practical challenges that arise after a contract is signed, including prior authorization requirements, utilization management, documentation expectations, and payer-specific workflows.

Part 3: Managing Authorizations, Documentation, Denials, and Administrative Burden

December 16, 2026
11:00am – 12:30pm EST
Speakers: Melinda A. Gaboury, CEO & Regina Wild, Director of Managed Care Consulting

Description
Signing a managed care contract represents only the beginning of the payer relationship. Agencies must establish reliable processes for verifying benefits, obtaining authorizations, documenting skilled care, submitting claims, and responding to denials. Weaknesses in any of these areas can delay care, increase staff workload, and reduce the value of the contract.

This session focuses on the operational practices needed to manage Medicare Advantage patients effectively. Participants will examine common authorization and denial risks, payer documentation expectations, discipline-specific documentation concerns, and frequent administrative missteps. The session will also present strategies for monitoring payer performance, preventing avoidable denials, and improving coordination among intake, clinical, authorization, billing, and leadership teams.

Learning Objectives

By the end of this session, participants will be able to:

• Identify common authorization, documentation, billing, and eligibility errors that contribute to claim denials and payment delays.
• Establish workflows for benefit verification, authorization tracking, clinical-document submission, pre-bill review, and denial follow-up.
• Use payer-specific performance data to identify operational problems and support corrective action or contract renegotiation.