$1,539

Medicare Boot Camp®-Critical Access Hospital & Rural Health Version (ahm) S

Event Information

Share this event

Date and Time

Location

Location

Hilton Garden Inn Portland Airport

12048 NE Airport Way

Portland, OR 97220

View Map

Refund Policy

Refund Policy

No Refunds

Event description
Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic Version

About this Event

*** LIMITED TIME OFFER: FREE $100 AMAZON GIFT CARD! ***

REGISTER TODAY!

Course Overview

Master Medicare rules for critical access hospitals and rural health clinics

Medicare Boot Camp—Critical Access Hospital and Rural Health Clinic Version is a four-day intensive course on Medicare coverage, billing, coding, and payment for critical access hospitals (three days) and rural health clinics (1 day). It gives you the knowledge and tools to find the answers to your most pressing Medicare coding, billing, and reimbursement questions pertaining to these unique settings.

Find the answers to all of your coding, billing, and reimbursement questions pertaining to your unique position in the healthcare industry.

This one-of-a-kind, custom class will show you which rules apply to you so you can successfully process claims and get paid without disruption to your revenue stream. It will also teach you how to research Medicare regulations to resolve billing issues and respond to denials and audits.

The Medicare Boot Camp—Critical Access Hospital and Rural Health Clinic Version will give you the knowledge and confidence to:

  • Find the answers to your specific Medicare questions relating to CAHs and RHCs
  • Understand outpatient observation and inpatient status rules and UR requirements at CAHs
  • Submit accurate claims to Medicare, including CAH Part A to B rebilling, and from both independent and provider-based RHCs
  • Ensure appropriate reimbursement from Medicare and application of the patient’s financial responsibility
  • Avoid compliance pitfalls
  • Identify risks for recovery audits and other government audits
  • Understand RHC reporting of revenue codes, HCPCS codes, and related charges for all services provided

Who should attend?

  • Auditors and analysts
  • Billing specialists
  • Chargemaster coordinators and managers
  • Clinical documentation improvement specialists
  • Clinic managers and department heads
  • Compliance officers
  • 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
  • Physician advisors
  • Recovery audit coordinators
  • Coding specialists
  • Rural Health Clinic revenue cycle, compliance, case management, and clinical personnel
  • Critical Access Hospital revenue cycle, compliance, case management, and clinical personnel

Learning Objectives

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

Course Outline/Agenda

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

(Optional 4th Day) Medicare Boot Camp®—Rural Health Clinic Version

Module 1: Medicare Overview, Contractors, Research, and Resources

Overview of Medicare Part A, B, C, and D

Role of Medicare contractors

Medicare source laws, including statutes and regulations

Medicare sub-regulatory guidance, including manuals and transmittals

Links to Medicare information and resources for staying current

Module 2: Designation as a Rural Health Clinic (RHC) and Required Practitioners and Services

Definition and purpose of an RHC

Certification criteria, including location, staffing, and required services

Basic requirements for services furnished by RHC practitioners or incident to an RHC practitioner, including requirements for direct supervision

Services that are excluded from the RHC benefit

Distinguish between an independent and provider-based RHC

Module 3: Application of Medicare Coverage and the Advance Beneficiary Notice

Medicare Coverage Center, including LCDs and NCDs, and Laboratory Manual

Coverage of drugs, including self-administered drugs

Coverage requirements for outpatient diagnostic services, including laboratory services

Limitations of liability statute and notice requirements

Advance Beneficiary Notice (ABN) form and instructions

Module 4: General Billing Requirements for Rural Health Clinic (RHC) Services

Claims processing requirements, including type of bill, revenue codes, HCPCS codes, modifiers, and charge reporting

Coverage and billing for a medical visit and mental health visit

Coverage and billing for preventive services

Coverage and billing for special services, including diagnostic services, vaccines, injections, and other incident-to services

Coverage and billing for laboratory services

Special circumstances for billing transitional care management (TCM), chronic care management (CCM), and telehealth

Module 5: Basic Reimbursement Principles for Rural Health Clinic (RHC) Services

Identification of an "encounter" for payment purposes

Basic all-inclusive rate (AIR) reimbursement methodology for provider-based and independent RHCs

Application of upper payment limit for freestanding and provider-based RHCs

Application of Part B deductible and coinsurance

Module 6: Appendixes of Source Authority

Key government documents to support appropriate billing

Course Outline-Agenda subject to change.

Speaker

Coming Soon!

"Please contact the community manager Marilyn (marilyn.b.turner@nyeventslist.com ) below for:

- Multiple participant discounts

- Price quotations or visa invitation letters

- Payment by alternate channels (PayPal, check, Western Union, wire transfers etc)

- Event sponsorships

NO REFUNDS ALLOWED ON REGISTRATIONS

Service 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

-----------------------------------------------------------------

MYL191213CEV"

Share with friends

Date and Time

Location

Hilton Garden Inn Portland Airport

12048 NE Airport Way

Portland, OR 97220

View Map

Refund Policy

No Refunds

Save This Event

Event Saved