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      Medicare Boot Camp®—Critical Access Hospital Version in Portland

      • Medicare Boot Camp®—Critical Access Hospital Version Photo #1
      1 of 1
      November 9, 2020

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

      12048 Northeast Airport Way
      Portland, Oregon 97220

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      Medicare Boot Camp®—Critical Access Hospital Version

      Medicare Boot Camp®—Critical Access Hospital Version
      About this Event


      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.


      Coming Soon!

      Cost: $1,289

      Categories: Conferences & Tradeshows

      This event repeats daily for 3 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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