AHCA is hosting a two-part webinar series designed to help nursing facilities tackle the challenges of working with Medicare Advantage plans by offering strategies and solutions to help mitigate their impact. Whether you’re a facility administrator, billing specialist, or care coordinator, this series will equip you with the tools and knowledge to navigate managed care more effectively.
Both webinars are free for AHCA members and $65 each for non-members. Register now even if you can’t attend when the webinars are scheduled. All registrants will be notified as soon as the recordings are available.
Part 1: Tuesday, July 29, 3:00 – 4:00 p.m. EDT
Recent Medicare Advantage (MA) rule changes have introduced critical tools to help skilled nursing facilities (SNFs) better manage claims denials and early termination of services. The Calendar Year (CY) 2024 Final Rule brought long-overdue improvements to transparency and accountability in the appeals process, helping reduce improper denials and clarify reimbursement pathways.
Building on this, the CY 2025 Final Rule—effective January 1, 2025—empowers SNFs with access to independent reviews and the ability to escalate cases to an Administrative Law Judge (ALJ). These changes are an important step in breaking the cycle of insurer-dominated appeals and ensuring fairer outcomes.
This session will focus on best practices to:
- Utilize independent review processes effectively.
- Escalate denials strategically to maximize reimbursement.
- Strengthen internal workflows to ensure compliance and timely responses.
- Proactively manage early terminations of services with documentation and appeal readiness.
Attendees will leave with actionable strategies to improve outcomes, reduce administrative burden, and deliver better care under evolving managed care rules. Register for this webinar here.
Part 2: Monday, August 11, 3:00 – 4:00 p.m. EDT
As managed care continues to expand, providers in skilled nursing and post-acute settings face growing pressure to deliver high-quality care within increasingly compressed timeframes. Shortened lengths of stay, early discharges, and tighter reimbursement structures can compromise resident outcomes and operational stability.
This session brings together a panel of seasoned providers to share real-world challenges and, more importantly, the strategies they have developed to mitigate these risks. From clinical decision-making to financial navigation, attendees will gain practical insights into managing the realities of care under managed care. Register for this webinar here.