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      Medicare Boot Camp®—Critical Access Hospital Version in Chandler

      • Medicare Boot Camp®—Critical Access Hospital Version Photo #1
      1 of 1
      November 4, 2019

      Monday   8:00 AM - 5:00 PM (daily for 3 times)

      3535 W. Chandler Boulevard Chandler, AZ
      Chandler, Arizona 85226

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      Medicare Boot Camp®—Critical Access Hospital Version

      Medicare Boot Camp®—Critical Access Hospital Version


      Course Overview

      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

      Billing specialists

      Chargemaster coordinators and managers

      Clinical documentation improvement specialists

      Clinical 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

      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 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

      Course Outline-Agenda subject to change.

      Cost: $1,289

      Categories: Conferences & Tradeshows

      This event repeats daily for 3 times:

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

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