Session Connections (Immersive Education)

The Contract Does Not Guarantee Payment

In this interactive crossover session, Paula Roth and Brian O’Sullivan bring their expertise together to explore the real-world intersections between front-end operations and payor contracting. Through a live “spin the wheel” format, each turn lands on a different stage of the revenue cycle, from referral and intake to collections and denials. At each stop, Paula and Brian will unpack how payor contract terms, carve-outs and reimbursement methodologies influence workflows, compliance requirements and financial outcomes. They’ll also examine where misalignment creates friction, denial risk and payment leakage and how tighter coordination between intake, revenue cycle management and payor relations can drive stronger performance and faster payments.
In this interactive crossover session, Paula Roth and Brian O’Sullivan bring their expertise together to explore the real-world intersections between front-end operations and payor contracting. Through a live “spin the wheel” format, each turn lands on a different stage of the revenue cycle, from referral and intake to collections and denials. At each stop, Paula and Brian will unpack how payor contract terms, carve-outs and reimbursement methodologies influence workflows, compliance requirements and financial outcomes. They’ll also examine where misalignment creates friction, denial risk and payment leakage and how tighter coordination between intake, revenue cycle management and payor relations can drive stronger performance and faster payments.

Learning Objectives

  • Describe how contract language shapes processes at every stage of the revenue cycle.
  • Identify where carve-outs surface operationally and how to manage them proactively.
  • Explain the connection between front-end accuracy and back-end reimbursement.
  • Analyze how negotiation strategy impacts denial trends and payment integrity.
  • Develop tactics to identify and reduce payment leakage across the continuum.
  • Speaker(s)

    Paula Roth  VP, Pharmacy Operations
    Prochant

    Brian O'Sullivan MBA President
    The O'Sullivan Group

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