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      Critical Access Hospital and Rural Health Clinic Version in Chandler


      • Critical Access Hospital and Rural Health Clinic Version Photo #1
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      November 4, 2019

      Monday   8:00 AM - 5:00 PM (daily for 4 times)

      3535 West Chandler Boulevard Chandler, AZ
      Chandler, Arizona 85226

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      EVENT DETAILS
      Critical Access Hospital and Rural Health Clinic Version

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

      *** 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.

      Cost: $1,539

      Categories: Conferences & Tradeshows

      This event repeats daily for 4 times:

      Event details may change at any time, always check with the event organizer when planning to attend this event or purchase tickets.