Medicare Boot Camp® - Hospital Version About this Event *** LIMITED
TIME OFFER: FREE $100 AMAZON GIFT CARD! *** REGISTER TODAY! Course
Overview Gain insight into the CMS initiatives affecting your revenue
in 2020 by joining the nation’s leading Medicare experts for the
Medicare Boot Camp®—Hospital Version. From changes to the
inpatient-only list to new guidance on charity care and pressure on
drug payments, it’s the finest details of recent CMS updates that
may cause compliance traps in 2020. Delve into the details of
regulatory changes to understand the revenue implications and
implement the new guidance. Medicare Boot Camp—Hospital Version
unlocks all of the answers to your Medicare questions by teaching you
the latest rules and their application. Medicare Boot Camp—Hospital
Version prepares you to better manage your revenue cycle and
government audits by focusing on real guidance from CMS. You’ll
leave class ready to make improvements that will strengthen
reimbursement and compliance for your hospital or health system. And
you’ll have the research tools and skills at your fingertips to
answer your own Medicare questions long after the Boot Camp is over.
Comprehensive sections explain the complexities of: The 2-midnight
benchmark and presumption Coverage under NCDs, LCDs, and CED Inpatient
order requirements Inpatient-only procedures, including changes for
2020 Outpatient coverage and physician supervision Observation
coverage, billing, and payment Correct use of condition codes 44 and
W2 NCCI edits, including PTP edits and MUEs Payment under the OPPS and
IPPS Patient deductible and copayment amounts ABNs, HINNs and billing
non-covered services Medicare websites and resources You will leave
this program knowing how to: Prevent inpatient denials Conduct
compliant "self-audits" for Part B inpatient payment Properly use and
bill for observation services Research and resolve claim edits that
delay revenue Prevent outpatient denials and missed revenue Implement
best practices to get the revenue you deserve while staying in
compliance Who should attend? Finance and reimbursement personnel Case
Managers Chargemaster personnel Billers and coders Medical
records/health information personnel Clinical department personnel
Provider-based clinic personnel Revenue managers Compliance officers
and auditors Registration personnel Medicare Advantage and MAC
personnel Healthcare lawyers, consultants, and CPAs Legal department
personnel 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.
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 hospitals Describe limitations on coverage
under the Medicare program Recognize the effect of coding rules on the
services the provider reports Explain how Medicare pays for inpatient
and outpatient services Explain Medicare deductibles and copayments
for hospital inpatient and outpatient services Employ inpatient and
outpatient status rules and regulations Outline/Agenda Module 1:
Medicare Overview and Contractors Overview of Medicare Part A, B, C,
and D Medicare contractors, including the MAC, RAC and QIO Module 2:
Medicare Research and Resources Finding Medicare source laws,
including statutes, regulations and final rules Finding Medicare
sub-regulatory guidance, including manuals and transmittals Medicare
Coverage Center, including LCDs, NCDs, CED and Lab Coverage Manual
Links to Medicare resources 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: Coverage of Hospital Inpatient Services
Inpatient order and certification requirements Inpatient criteria and
the 2-Midnight Benchmark Admission on a case-by-case Basis
Documentation and use of screening tools Utilization review
determinations and short stay audits Inpatient Part B payment Module
5: Medicare Notices Delivery of the Medicare Outpatient Observation
Notice (MOON) Important Message from Medicare (IMM) and Detailed
Notice of Discharge Limitations of liability statute and notice
requirements The Advance Beneficiary Notice (ABN) form and
instructions Hospital Issued Notices of Non-Coverage (HINN) Module 6:
Medicare Claims Submission Fundamentals Claim fields with special
instructions Medicare Secondary Payer principles, including liability
claims Adjustment claims and automated reopenings Medicare claims flow
Module 7: Medicare Edit Systems Outpatient Code Editor (OCE) and
Medicare Code Editor (MCE) National Correct Coding Initiative (NCCI)
Procedure to Procedure (PTP) edits and modifiers Medically Unlikely
Edits (MUE) and Add-on code edits Module 8: Medicare Billing Issues
Outpatient repetitive, non-repetitive, and recurring services
Three-day payment window; outpatient services billed on inpatient
claims Billing of non-covered outpatient services Treatment of
conditions arising during or from a non-covered stay Module 9:
Medicare Outpatient Payment Systems Outpatient Prospective Payment
System (OPPS) Addendum B and D to determine the payment status of a
HCPCS code Addendum A and Ambulatory Payment Classifications (APCs)
Comprehensive APC (C-APC) basic rules Payment under the OPPS,
including patient coinsurance and outlier Payment for therapy under
the Physician Fee Schedule, including therapy caps “Sometimes” and
“always” therapy codes Payment for labs under the Laboratory Fee
Schedule, including reference lab Module 10: Outpatient Surgical
Services, including Implantable Devices Inpatient-only procedures
Surgical C-APCs, including complexity adjustment Multiple procedure
discount for minor surgical services Terminated/discontinued and
bilateral procedures Device intensive procedures and
procedure-to-device edit Pass-through devices Value code FD for free
and reduced-cost devices Module 11: Outpatient Visits and Observation
Services Coding for clinics, emergency departments, critical care and
trauma activation Proper use of modifier 25 Payment for off-campus
“non-excepted” department services Billing of observation services
Observation Comprehensive APC Payment Module 12: Special Billing
Issues for Outpatient Diagnostics, Drugs and Therapy Packaged,
pass-through and non-pass-through drugs and biologicals Proper use of
modifier JG and TB Discarded Drugs Biosimilar products Biological skin
substitutes Radiation Therapy Imaging Family Composite APCs Special
Radiology Modifiers Laboratory billing and coding issues, including
date of service Blood and blood products Outpatient therapy functional
status reporting Module 13: Inpatient Payment and Patient
Responsibility Inpatient Part A payment and the Inpatient Prospective
Payment System (IPPS) Medicare-severity diagnosis related groups
(MS-DRG) Complications and co-morbidities and the effect of a
hospital-acquired condition (HAC) Inpatient deductible, coinsurance,
and lifetime reserve days Module 14: Inpatient Prospective Payment
System (IPPS) Adjustment Factors Standardized amount adjustments:
Hospital Quality Reporting Program and Electronic Health Record (EHR)
Meaningful Use Quality adjustments: Value-Based Purchasing (VBP)
Program, Hospital Readmissions Reduction Program (HRRP), and HAC
Reduction Program Payment add-on for New Technology Medicare inpatient
pricer Payment for transfers and post-acute care transfers Course
Agenda/Outline is subject to change. Speaker Coming Soon!
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25/02/2020 Last update