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      Medicare Boot Camp®-Critical Access Hospital & Rural Health Version in Portland


      • Medicare Boot Camp®-Critical Access Hospital & Rural Health Version Photo #1
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      November 9, 2020

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

      12048 Northeast Airport Way
      Portland, Oregon 97220

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      EVENT DETAILS
      Medicare Boot Camp®-Critical Access Hospital & Rural Health Version

      Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic Version
      About this Event
      *** LIMITED TIME OFFER: FREE $100 AMAZON GIFT CARD! ***

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      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!

      Cost: $1,539

      Categories: Conferences & Tradeshows

      This event repeats daily for 4 times: Nov 9, Nov 10, Nov 11

      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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