Online Training Course

Prod ID: 101
Understanding Payer Reimbursement Guidelines

The key to winning anything is understanding the rules of the game and it’s no different in healthcare. There are hundreds if not thousands of federal, state and commercial guidelines to abide by in order to achieve and maintain payer reimbursement and compliance.




54 min



This program addresses oversight bodies, relevant legislation, and policies that govern medical office reimbursement. Key points include:

  • Reimbursement guidelines (federal, state, and commercial)
  • Regulations that all medical billing entities must follow
  • Federal agencies that monitor healthcare standard practices
  • Policies that your practice must abide by for accurate payer reimbursement

Taya Gordon


Shawntea "Taya" Gordon is a subject matter expert in healthcare compliance, organizational governance, process optimization, and revenue cycle management. Having held senior-level executive management positions in private practices, collaborative institutes, and national care coordination organizations, Taya now educates and consults on all areas of healthcare operations. Teaching and consulting topics include performance improvement, quality improvement, risk reduction, and the shift to value-based payment methodologies. Taya also functions as Chief Revenue Cycle Officer for H4 Technology, LLC, a Data Management Software as a Service (DMSaaS) organization providing services to hundreds of providers across the nation.

A proud member of the Medical Group Management Association's (MGMA’s) Government Affairs Council and E/M Workgroup, Taya co-authored the publication: Revenue Cycle Management: Don’t Get Lost in the Financial Maze. Her thoughts on the innovative use of people and IT was included in the HIMSS Voices of Innovation Publication in 2019, coordinated by the Cleveland Clinic. She is also a noted speaker and author for organizations such as HealthLeaders Media, the Practice Management Institute (PMI), MGMA, and Medical Economics.

Taya is the Past President of the HIMSS Nebraska Chapter, former Chair of the Membership and Corporate Development Maryland MGMA Chapter, and was recognized in 2019 by Midland’s Business Journal as a ‘40 Under 40’ Executives & Entrepreneurs Award Recipient.

Passionate about physician advocacy, community outreach, and healthcare improvement processes, she has volunteered in several terms on government affairs and legislative committees lobbying for healthcare improvement and various committees with Habitat for Humanity Omaha.

The healthcare team must have a clear understanding of state and federal regulations and the ramifications that may arise when these guidelines are not followed.

Instructor Taya Gordon is a healthcare management consultant well-versed in practice management and healthcare quality improvement. She will cover several key points that will help participants improve their understanding of healthcare billing standards and the regulatory agencies that govern and monitor billing practices.

Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.

Past participant comments:

"Excellent content!"

"Highly recommend. Presenter offers great information."

"It was insightful and informative."


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