Medicare Boot Camp®—Critical Access Hospital Version
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Master Medicare rules for critical access hospitals
Medicare Boot Camp—Critical Access Hospital Version is a three-day intensive course on Medicare coverage, billing, coding, and payment for critical access hospitals. It gives you the knowledge and tools to find the answers to your most pressing Medicare coding, billing, and reimbursement questions pertaining to this unique setting.
Find the answers to all of your coding, billing, and reimbursement questions pertaining to your unique position in the healthcare industry—the CAH.
This one-of-a-kind, custom class will show you which rules apply to you so you can successfully process claims and get paid. It will also teach you how to prepare and respond to recovery audits by mastering the key concepts behind what the Recovery Auditors have audited so far.
The Medicare Boot Camp—Critical Access Hospital Version will give you the knowledge and confidence to:
Find the answers to your specific Medicare questions relating to CAHs Understand outpatient observation and inpatient status rules and UR requirements Submit accurate claims to Medicare, including Part A to B rebilling Ensure appropriate reimbursement Avoid compliance pitfalls Identify risks for recovery audits and other government audits
Who should attend?
Auditors and analysts
Chargemaster coordinators and managers
Clinical documentation improvement specialists
Clinical managers and department heads
Finance and reimbursement managers
Healthcare consultants, CPAs, and lawyers
Health plan financial analysts, claims processing, and provider relations professionals
HIM directors and managers
Medicare administrative contractors
Patient access/admitting staff
Provider-based clinical personnel
Recovery audit coordinators
See the HCPro difference for yourself!
Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure hospital services furnished to Medicare beneficiaries are billed accurately and appropriately.
Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research Medicare questions long after the Boot Camp ends.
Hands-on learning: Attendees work a set of exercises/case studies after each module to ensure they understand the concepts and know how to apply them to real-world situations.
Small class size: A low participant-to-teacher ratio is guaranteed.
Highly rated, well-established program: Participants consistently give the course an overall rating of 4.75 or higher (on a 5.0 scale). We currently conduct more than 30 Medicare Boot Camp courses each year.
At the conclusion of this educational activity, participants will be able to:
Locate key sources of Medicare authority on the Internet
Interpret Medicare guidance and apply it to the services provided
Describe how Medicare covers inpatient and outpatient services at CAHs
Describe limitations on coverage under the Medicare program
Explain when the beneficiary is financially responsible for services provided
Discuss how documentation of patient care affects billing of the services the provider renders
Explain how Medicare pays for inpatient and outpatient services
Employ outpatient and inpatient status rules and regulations
Module 1: Overview of Critical Access Hospital (CAH) Designation
Requirements for CAH designation Limitations on acute care beds and length of stay Inpatient Rehabilitation and Psychiatric Distinct Part Units (DPU)
Module 2: Medicare Overview, Contractors, Research and Resources
Overview of Medicare Part A, B, C, and D Medicare Contractors, including the MAC, RAC and QIO Medicare source laws, including statutes, regulations and final rules Medicare sub-regulatory guidance, including manuals and transmittals Medicare Coverage Center, including LCDs, NCDs, CED, and Laboratory Manual Links to Medicare information and resources for staying current
Module 3: Coverage of Hospital Outpatient Services
Incident-to coverage of outpatient therapeutic services Physician supervision requirements and definitions Coverage of observation services Coverage of drugs, including self-administered drugs Coverage requirements for outpatient diagnostic services
Module 4: Medicare Notices
Delivery of the Medicare Outpatient Observation Notice (MOON) Limitations of liability statute and notice requirements The Advance Beneficiary Notice (ABN) form and instructions Important Message from Medicare (IMM) Hospital Issued Notices of Non-Coverage (HINN)
Module 5: Medicare Claims Submission Fundamentals and Billing Issues
UB-04 claim form and key fields applicable to a CAH Medicare claims flow, including timely filing Outpatient repetitive, non-repetitive and recurring services Outpatient services billed separately from inpatient claims Billing of non-covered outpatient services Treatment of conditions arising during or from a non-covered stay
Module 6: Medicare Edit Systems
Outpatient Code Editor (OCE) and Medicare Code Editor (MCE) National Correct Coding Initiative (NCCI); including Procedure to Procedure (PTP) Edits, Medically Unlikely Edits (MUE), and Add-on code edits Modifiers used with NCCI edits
Module 7: Outpatient Visits and Observation Services
Coding for clinics, emergency departments, critical care and trauma activation Proper use of modifier -25 Billing and payment for observation services
Module 8: Outpatient Surgery and Radiology Services
Multiple procedure discounting for surgical and radiology services for Method II billing Terminated/discontinued and bilateral procedures Special considerations for inpatient-only procedures and reduced cost devices and items
Module 9: Special Billing and Payment Issues for Drugs, Outpatient Diagnostics, and Therapy
Discarded Drugs Laboratory billing and coding issues Blood and blood products Payment for lab services, including reference lab Outpatient therapy functional status reporting Payment for therapy, including therapy caps “Sometimes” and “always” therapy
Module 10: Overview of the Cost-Based Reimbursement System
Components of the cost-based system Method I and Method II billing CRNA pass-through exemption Patient responsibility, including outpatient and inpatient deductible and coinsurance
Module 11: Coverage, Notice Requirements and Billing for Inpatient Services
Inpatient criteria and the 2-Midnight Benchmark Inpatient order and certification requirements Utilization review determinations for non-covered inpatient cases Inpatient Part B billing requirements
Module 12: Coverage and Billing for Swing Bed Admissions
Coverage for CAH swing beds Level of care and documentation requirements Reimbursement methodology and patient coinsurance Exclusion from SNF consolidated billing rules
Course Outline-Agenda subject to change.
Please contact the event manager Marilyn (bWFyaWx5biAhIGIgISB0dXJuZXIgfCBueWV2ZW50c2xpc3QgISBjb20=
) below for:- Multiple participant discounts- Price quotations or visa invitation letters- Payment by alternate channels (PayPal, check, Western Union, wire transfers etc)- Event sponsorshipsNO REFUNDS ALLOWED ON REGISTRATIONSService fees included in this listing.-----------------------------------------------------------------BUSINESS & LEGAL RESOURCES-BLR - New York Events List http://www.NyEventsList.com http://www.BostonEventsList.com http://www.SFBayEventsList.com-----------------------------------------------------------------MYL190123CEV