Boot Camps

Live Virtual Revenue Integrity and Chargemaster Boot Camp for Critical Access Hospitals

Course Overview

The Live Virtual Revenue Integrity and Chargemaster Boot Camp for Critical Access Hospitals looks at the chargemaster as it relates to revenue integrity functions, including cost reporting and key operational issues, such as coverage, clinical documentation, charge capture, and coding.

In a series of 3-hour virtual classes, our expert provides context for chargemaster set-up and maintenance within revenue integrity with an objective to help avoid pre- and post- billing edits and payer denials. Designed specifically to cover the unique challenges CAHs face, we discuss best practices for compliantly implementing or improving revenue cycle processes to ensure you capture all of the revenue you deserve. This Boot Camp is unique in that it provides formal, organized education and training for CAH staff integral in protecting revenue integrity and maintaining the chargemaster.

This class:

• Discusses strategies for how to improve processes and policies related to the chargemaster, including those that intersect with clinical/revenue departments, charge capture, coding, finance, and patient access and billing
• Walks attendees through CMS regulatory requirements for pricing and charging patients, as well as key relationships between the chargemaster and provider cost reporting
• Gives detailed instructions for the majority of revenue codes for optimal chargemaster setup, maintenance, charge capture, and documentation issues for critical access hospitals
• Reviews chargemaster issues for commercial/managed care versus CMS requirements for critical access hospitals

How does the Live Virtual Revenue Integrity and Chargemaster Boot Camp for Critical Access Hospitals work?

Class is held Monday – Friday from 1:00 p.m. – 4:00 p.m. Eastern Time for two consecutive weeks.

Looking to train your whole team? We can bring our expert instructors to you! Learn more here!

Live Virtual Revenue Integrity and Chargemaster Boot Camp for Critical Access Hospitals

Outline/Agenda

Module 1:  Revenue Integrity Overview and Resources

Module 2:  Eligibility Principles

Module 3:  Benefits, Coverage and Medical Necessity

Module 4: Provider Types, Licensure, Enrollment, Privileges, Credentialing and Scope of Practice

Module 5: Charge Description Master Structure and Relationship to Cost Reporting

Module 6: Principles of Charge Capture

Module 7: Claims Submission Fundamentals and Code Edits

Module 8: Strategies and Key Issues by Revenue Code: Routine Services and Observation

Module 9:  Strategies and Key Issues by Revenue Code: Ancillary Services

Module 10:  Strategies and Key Issues by Revenue Code:  Other Departments

Module 11:  Introduction to Payment Systems

Module 12:  Critical Access Hospital Reimbursement – Methods I & II

Module 13:  Medicare Physician Fee Schedule (MPFS)

Module 14: Charge Description Master Management and Maintenance Strategies

Module 15:  Denial Management

Module 16:  Payer Contracting Strategies

Course Outline/Agenda subject to change.

Live Virtual Revenue Integrity and Chargemaster Boot Camp for Critical Access Hospitals

Learning Objectives

At the conclusion of this educational activity, participants will be able to:

• Equip hospital, payer and other healthcare specialists with effective and efficient strategies to obtain and maintain overall revenue integrity for both governmental and non-governmental payers
• Gain a working understanding of revenue integrity principles associated with eligibility, coverage, coding, billing and payment using fee-for-service Medicare requirements as a framework
• Explain how the chargemaster fits into revenue integrity functions
• Review requirements and issues associated with provider-based status
• Explain standard charge description master (CDM) elements, design and relationship to the general ledger and revenue cycle processes of coding and billing
• Review claim requirements and specific issues of CDM set-up and maintenance by revenue code with associated cost reporting principles
• Review concepts of pricing different services
• Exemplify Critical Access Hospital cost-based reimbursement, including Method I and II, and as well as appeal strategies to protect revenue

Live Virtual Revenue Integrity and Chargemaster Boot Camp for Critical Access Hospitals

Continuing Education

Continuing Education credits for this course are pending approval.