Medicare Boot Camp®—Denials and Appeals Version

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Medicare Boot Camp®—Denials and Appeals Version

Product Code: MBCD


1st Attendee $1,149.00*
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To register multiple attendees, or if you have any questions, please call Sales at 615-724-7200.

This live boot camp is best for those looking for an interactive learning experience. Classes are led by our expert instructors, take place over the course of a week, and allow instructor/student interaction and engagement.

Medicare Boot Camp®—Denials and Appeals Version

Course Overview

Reduce claim denials and win appeals

Get expert guidance on preventing denials and focusing appeals efforts for success. The evolution of reimbursement models and uncertainty regarding healthcare laws and CMS policy means that to keep the doors open and prevent insolvency, organizations cannot afford to write off appealable denials that are winnable. Organizations need sound, practical information on overturning denials. Medicare Boot Camp®—Denials and Appeals Version is your key to proven strategies for success and will answer your questions on denials management and appeals processes.

This Boot Camp teaches you about the latest claim audit and appeal issues based on official guidance and regulations. You’ll leave the class armed with a thorough understanding of the audit and appeal process and ready to put your new knowledge into action for tangible results.

You will leave this program knowing how to:

  • Prepare for CMS audits
  • Navigate the appeals process up through and beyond the Administrative Law Judge level
  • Research denials and upcoming audit focus areas
  • Implement policies to support efficient appeals and identify appropriate denials to appeal

Leave this boot camp with an understanding of:

  • Navigating regulations and CMS policies in order to comply and increase CMS reimbursement from the get-go
  • The different types of audits and how you can prepare your organization for them
  • The audit, denial, and appeals process and what to look out for
  • How you should respond to audits
  • How to increase your organizations favorable appeal decisions

Who should attend?
The course is fit for any member of your billing, revenue, or clinical team who is hoping to understand more about appeals and denials and how to prepare for and navigate them.

  • Revenue cycle directors and managers
  • Revenue integrity directors, managers, and staff
  • HIM directors, managers, and staff
  • CDI directors, managers, and specialists
  • Compliance directors, officers, and auditors
  • Business office managers
  • Case management directors and managers
  • Case managers
  • Utilizations review staff
  • Utilization management staff
  • Physician advisors
  • Audit directors and coordinators
  • Auditors
  • Appeals coordinators
  • Patient financial services directors

See the HCPro Difference for Yourself!

  • Focus on the actual rules: Learn how to prepare for CMS audits and navigate the appeals process and the rules and regulations up through (and beyond) the Administrative Law Judge and the Medicare Appeals Council levels. Also learn about the Medicare Appeals Council rules and regulations
  • Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research time-sensitive issues long after the Boot Camp ends. 
  • Highly rated, well-established program: Participants consistently give the course an overall rating of 4.75 or higher (on a 5.0 scale).

For more detailed information about HCPro's Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

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

Medicare Boot Camp®—Denials and Appeals Version

Course Locations & Dates

Below is the current course schedule for upcoming classes of Medicare Boot Camp®—Denials and Appeals Version. We update this schedule on a regular basis.

Registrations are processed in the order received. Class size is limited and classes often sell out. We recommend against making travel arrangements until after we have confirmed your course registration.

To register for a class, click the "Register" button. If you would like to register multiple attendees (large groups), contact us at 615-724-7200 or email PDIS@SimplifyCompliance.com.

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.  

September 2022


Phoenix, AZ

 

September 21 – 22, 2021
8:00AM – 5:00PM each day

Hilton Phoenix Resort at the Peak
7677 N. 16th Street
Phoenix, AZ 85020
407-586-0000
Hotel website
2022 Revenue Integrity Symposium Post-Conference: Booking Link


Room Rate: $179/night + taxes (currently at 12.57%)
Room Rate Cut-Off: August 28, 2022

 

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Medicare Boot Camp®—Denials and Appeals Version

Outline/Agenda

Module 1: Medicare Overview and Contractors

  • The Four Parts of Medicare
  • Medicare Contractors
  • Independent Government Agencies-Medicare Involvement


Module 2: Medicare Research and Resources

  • Web-Based Resources
  • Key Sources of Authority
  • Medicare Coverage Center, including LCDs NCDs, CED and Lab Coverage Manual
  • Ways to Stay Current 


Module 3: Medicare Program Safeguards and Medicare Notices

  • Medicare Policy Development, Financing, the Trust Funds, the need for Program Safeguards
  • Program Safeguards
  • Limitation on Liability provisions of the Social Security Act 
  • Notices of Non-Coverage 


Module 4: Prepayment Claim Reviews/Audits

  • Prepayment Reviews Overview
  • Automated Prepayment Reviews
  • Prepayment Non-Medical Record Reviews
  • Prepayment Medical Record Reviews 


Module 5: Postpayment Claim Reviews/Audits

  • Establishment of Postpayment Claim Review/Audits Process
  • Postpayment Claim Reviews/Audits Overview
  • Postpayment Non-Medical Record Reviews
  • Statistical Sampling and Extrapolations
  • Postpayment Medical Record Reviews 


Module 6: Medicare FFS Claim Appeals Process (Part 1)

  • Initial Determinations
  • Reopenings and Overlap with Appeals Process
  • Level 1 Appeal Process: Redetermination
  • Level 2 Appeal Process: Reconsideration 


Module 7: Medicare Appeals Process Overview (Part 2)

  • Level 3 Appeal Process: Administrative Law Judge (ALJ) Hearing
  • Level 4 Appeal Process: Medicare Appeals Council
  • Level 5 Appeal Process: Judicial Review in U.S. District Court 


Module 8: Current Medicare Claim Audits and Appeals Issues Overview

  • COVID-19 Provider Burden Relief—Documentation
  • Two Midnight Rule Court Case Update—2nd Circuit Court of Appeals
  • QIC Telephone Discussion DEMO
  • Ways to Stay Current:  Audit Topics
  • Ways to Stay Current:  ALJ Decisions, Appeals Council Decisions and Federal Court Decisions


Course Agenda/Outline is subject to change.

Medicare Boot Camp®—Denials and Appeals Version

Questions/Answers

What is the focus of the Medicare Boot Camp®—Audits, Appeals, and Denials Version?
The Medicare Boot Camp®—Audits, Appeals, and Denials Version version is an intensive, two-day course on Medicare appeals and denials management, covering the Medicare claims review processes, types of audits and how providers should respond to them, and the different levels of the appeals process. The goal of the course is to provide participants with a sound understanding of the audit, denial, and appeal processes, including the payer perspective, based directly upon current regulations.

Where is the course offered?
Open registration sessions are offered at various locations around the country, typically at mid-priced business hotels such as HYATT Place or Hilton Garden Inn. For a current schedule of upcoming open registration courses, click on "Locations/Dates" above.

Does HCPro offer an "on-site" version of this Boot Camp?
In addition to our open registration courses, we also offer this boot camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site boot camp, click on Host an On-Site Course.

What if I need to cancel or transfer my registration?
To view our cancellation policy, click here.

Who typically attends the Medicare Boot Camp®—Audits, Appeals, and Denials Version?

  • Revenue cycle directors and managers
  • Revenue integrity directors, managers, and staff
  • HIM directors, managers, and staff
  • CDI directors, managers, and specialists
  • Compliance directors, officers, and auditors
  • Business office managers
  • Case management directors and managers
  • Case managers
  • Utilizations review staff
  • Utilization management staff
  • Physician advisors
  • Audit directors and coordinators
  • Auditors
  • Appeals coordinators
  • Patient financial services directors


What material does the course cover?
To view the course outline, click on "Course Outline" above.

Does the course require any previous experience or training?
No. The course starts with Medicare fundamentals and does not assume that participants have any particular background or experience. However, because of the fast-paced nature of the course, it is recommended (but not required) that participants have at least one year of experience working in a hospital.

How is the course taught?
The course is taught using a combination of lecture, class discussion, and hands-on exercise/case studies.

What do I need to bring to class?
When you arrive at class, you will receive an extensive notebook of course materials. In addition, please bring the following to all classes:

  • A highlighter
  • A notebook for taking notes
  • Sticky notes/flags
  • A pen/pencil


Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?
Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information? 
Contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Medicare Boot Camp®—Denials and Appeals Version

Things to Know Before Attending Class

Directions and Hotel Information

The hotel address, phone number, URL, room rate and room rate cut-off date are posted on the Locations/Dates tab. The hotel websites give detailed directions to the hotel as well as information about the location.  Please call the hotel directly to make a room reservation.  Be sure to identify yourself as an HCPro Boot Camp participant.  Please be sure to make your reservation before the cut-off date.  After the cut-off date, contact the hotel to determine room availability and rates.

Course Materials

When you arrive at class, you will receive extensive workbooks containing the class materials utilized throughout the boot camp.  The workbooks will be yours to keep, so plan accordingly in allowing enough room in your luggage on the return trip home.  Workbooks may also be shipped from the hotel at your own expense.

Classroom Time

It is an understatement to say that this course is intense.  Other than breaks, we will be in class from 8:00am to 5:00pm. Monday-Thursday, and from 8:00am to 1:00pm on Friday.  There will be about a one hour lunch break each day. If the class gets behind, class may run later than 5:00pm.    

Lunch

We will take about a one hour break for lunch each day.  Although we typically provide coffee in the morning and drinks and snacks in the afternoon, everyone is on their own for lunch.  Note that many hotels do not have restaurants on-site.  If you are flying to the course, we generally recommend renting a car.

What to Bring to Class

We recommend you bring the following to all classes:

  • Highlighter and pen/pencil
  • A notebook for making your own notes
  • Sticky Notes/flags

Use of Laptop Computers or Electronic Devices

Our instructors demonstrate where to find many resources on the CMS website. If you have access to a laptop or tablet you may bring it to class to follow along, but you may wish to consider the power and wireless needs of your device. Many conference rooms do not have plugins situated conveniently to the tables so you may wish to ensure you have sufficient battery power. HCPro does not purchase group wireless access for the conference rooms, but many hotels provide free wireless access.  You may wish to confirm your connectivity options prior to arriving at the hotel.  Please be courteous in your use of electronic devices.  Use of electronic devices should not disrupt the class or disturb other participants.  HCPro is not responsible for lost, stolen or damaged devices.  Maintaining the security and safety of your device is your responsibility.  Cell phone use during class is strictly prohibited.

Dress

Business attire is not necessary.  Please dress comfortably.  Also, we find that the classrooms are sometimes on the cool side, even during the warmer months.  You may be more comfortable if you bring a sweater or sweatshirt in case you get cold.

Copyright Protection of Course Materials

You will receive a complete copy of our course materials at the beginning of class.  The materials used in connection with this course were custom designed by our company specifically for use in connection with this course.  We have invested a tremendous amount of time, money and effort in developing, refining and maintaining these materials and they are protected by copyright laws.  Course materials may not be duplicated.  You may use the materials (i) in direct connection with the course or (ii) as a personal reference in your day-to-day work.  No claim is asserted to any U.S. Government, American Medical Association or American Hospital Association works included in the course materials workbook. 

Cancellation and Transfer Policy

For our cancellation and transfer policy, visit our website:  http://hcmarketplace.com/cancellations

COVID Safety

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • If the region where our event is located is deemed by the CDC to be within the substantial or high-risk category, we will require all attendees, regardless of vaccination status, to wear masks when indoors except while actively eating or drinking. 
  • Meeting rooms will be set to support social distancing when necessary.
  • Food service will follow the safety guidelines implemented by the hotel.

 To view all the safety measures that a specific hotel has implemented, please see the information listed on their website. 

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines, and will communicate adjustments to the onsite policies and procedures as necessary.

Contact Information

For more information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

We Look Forward to Having You In Class!

Medicare Boot Camp®—Denials and Appeals Version

Learning Objectives

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

  • Research the appeals process and related regulations
  • Identify key steps in the appeals process up to the Administrative Law Judge level
  • Explain common causes of Medicare denials
  • Develop policies and practices to support compliance, reduce denials, and expedite appeals
  • Analyze denied claims to select appropriate appeals

Continuing Education Credit

AAPC
This program has been approved by the AAPC for 16 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

American Health Information Management Association (AHIMA)
This program has been approved for 16 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

American Nurses Credentialing Center (ANCC)
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 16 nursing contact hours is provided by HCPro.

Association of Clinical Documentation Integrity Specialists (ACDIS)
This program has been approved for 16 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 19.2 nursing contact hours. California BRN Provider #CEP 14494.

Commission for Case Manager Certification (CCMC)
This program has been pre-approved by The Commission for Case Manager Certification to provide 16 hours of continuing education credit to CCM board certified case managers.

Compliance Certification Board (CCB)
The Compliance Certification Board (CCB) has approved this event for up to 19.2 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this program content or of the program sponsor.

National Association of Healthcare Revenue Integrity (NAHRI)
This program has been approved for 16 continuing education units towards fulfilling the requirements of the Certification in Healthcare Revenue Integrity (CHRI), offered as a service of the National Association of Healthcare Revenue Integrity (NAHRI).

Disclosure Statement:
HCPro has confirmed that none of the faculty/presenters, planners, or contributors have any relevant financial relationships to disclose related to the content of this educational activity.

Medicare Boot Camp®—Denials and Appeals Version

COVID

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • Per current CDC guidelines, if the county where our event is located is deemed to be within the high level of COVID-19, it will be recommended that all attendees, regardless of vaccination status, wear masks when indoors except while actively eating or drinking.
  • Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines and will communicate adjustments to the onsite policies and procedures as necessary.