Medicare Boot Camp® - Critical Access Hospital Version

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Medicare Boot Camp®—Critical Access Hospital Version

Product Code: MBCC


1st Attendee $1,299.00*
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To register multiple attendees, please call our sales team at 615-724-7200.
CLICK HERE to learn about our optional combined Rural Health Clinic/Critical Access Hospital Version of this Boot Camp.

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, coding, billing, and payment for critical access hospitals. This course prepares you to better manage your revenue cycle in this unique setting by focusing on real guidance from CMS. You’ll leave class ready to make improvements that will strengthen reimbursement and compliance for your critical access hospital. And you’ll have the research tools and skills at your fingertips to answer your own Medicare questions long after the boot camp is over.

This one-of-a-kind, custom class will show you which rules apply to you so you can successfully process claims and get paid. Explore the details of regulatory changes to understand the revenue implications and implement the new guidance. Medicare Boot Camp—Critical Access Hospital Version unlocks all of the answers to your Medicare questions by teaching you the latest rules and their application in a CAH.

The Medicare Boot Camp—Critical Access Hospital Version will give you the knowledge to:

  • Find answers from CMS to your specific Medicare questions relating to CAHs
  • Understand outpatient observation, inpatient status, and UR requirements
  • Submit accurate claims to Medicare, including Part B inpatient
  • Ensure appropriate reimbursement for outpatient, inpatient, and swing bed services
  • Research and resolve claim edits that cause denials and delay revenue
  • Implement best practices to receive the revenue you deserve while staying in compliance with regulations


Who should attend?

  • Billing specialists
  • Coding specialists
  • Chargemaster coordinators and managers
  • HIM directors and staff
  • Clinical documentation improvement specialists
  • Clinical managers and department heads
  • Compliance officers and auditors
  • Finance and reimbursement personnel
  • Healthcare consultants, CPAs, and lawyers
  • Health plan financial analysts, claims processing, and provider relations professionals
  • HIM directors and staff
  • Medicare administrative contractors and Medicare Advantage personnel
  • Provider-based clinic personnel
  • Physician advisors
  • Patient access/registration staff


See the HCPro difference for yourself!

Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure critical access 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 participate in case studies during each module to ensure they understand the concepts and know how to apply them to actual situations that may occur in their CAH.

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. 

For more detailed information about the Medicare Boot Camp—Critical Access Hospital Version, contact customer service at 800-650-6787 or email customer@simplifycompliance.com.

Medicare Boot Camp®—Critical Access Hospital Version

Course Locations & Dates

Below is the current course schedule for upcoming classes of this Medicare Boot Camp. 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, fill in the "Additional Attendees" box or call our sales team at 615-724-7200 or email us at PD-IS@SimplifyCompliance.com.

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.

August 2020


Salt Lake City, UT

 

August 17 - 19, 2020
8:00AM – 5:00PM - each day

Hyatt House Salt Lake City/Downtown
140 South 300 West
Salt Lake City, UT 84101
801-359-4020
Hotel website


Room Rate: $159/night
Room Rate Cut-Off: August 3, 2020

 

November 2020


Portland, OR

 

November 9 - 11, 2020
8:00AM – 5:00PM - each day

Hilton Garden Inn Portland Airport
12048 NE Airport Way
Portland, OR 97220
503-255-8600
Hotel website


Room Rate: $152/night
Room Rate Cut-Off: October 26, 2020

 

December 2020


Dallas, TX

 

December 7 - 9, 2020
8:00AM – 5:00PM - each day

Hyatt Place Dallas North Galleria
5229 Spring Valley Road
Dallas, TX 75254
972-716-2001
Hotel website


Room Rate: $135/night
Room Rate Cut-Off: November 20, 2020

 

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Medicare Boot Camp®—Critical Access Hospital Version

Course Outline/Agenda

Module 1:  Overview of Critical Access Hospital (CAH) Designation

  • General requirements for CAH designation
  • Limitations on acute care beds and length of stay
  • Identification of and use of beds excluded from licensure limitations


Module 2:  Medicare Overview, Contractors, Research, and Resources

  • Overview of Medicare Parts 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
  • Links to Medicare information and resources for staying current


Module 3:  Medical Necessity and Limitation on Liability Notices

  • Medicare Coverage Center, including LCDs, NCDs, CED, and Lab Coverage Manual
  • Prior authorization for specified outpatient procedures and services
  • Limitations of liability statute and notice requirements
  • Advance Beneficiary Notice (ABN) form and instructions


Module 4:  Medicare Claims Submission Fundamentals and Billing Issues

  • UB-04 claim form and key fields applicable to a CAH
  • 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 inpatient stay


Module 5:  Medicare Edit Systems

  • Medicare Code Editor (MCE) and Outpatient Code Editor (OCE)
  • 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 6:  Outpatient Visits and Provider-Based Departments

  • Incident-to coverage of outpatient therapeutic services
  • Defining on- and off-campus departments
  • Coding for clinics, emergency departments, critical care, and trauma activation
  • Proper use of modifier -25


Module 7:  Observation Services

  • Coverage of observation services
  • Delivery of the Medicare Outpatient Observation Notice (MOON)
  • Billing and payment of observation services


Module 8:  Special Billing and Payment Topics for Outpatient Surgery and Therapy Services

  • Multiple procedure discounting for surgical services for Method II billing
  • Global surgery concepts for Method II billing
  • Reporting modifiers for terminated/discontinued and bilateral procedures
  • Special consideration for inpatient-only procedures
  • Payment for therapy, including therapy thresholds
  • “Sometimes” and “always” therapy


Module 9:  Special Billing and Payment Topics for Outpatient Diagnostic Services and Drugs

  • Coverage requirements for outpatient diagnostic services
  • Appropriate Use Criteria for Advanced Imaging Services
  • Multiple procedure discounting for radiology services for Method II billing
  • Exclusion from reporting certain imaging modifiers
  • Laboratory coding, billing, and payment, including reference lab
  • Blood and blood products
  • Coverage, billing, and payment for drugs, including self-administered drugs and discarded drugs


Module 10:  Overview of the Cost-Based Reimbursement System

  • Components of the cost-based system
  • Method I and Method II billing
  • Quality Payment Program under Method II billing
  • CRNA pass-through exemption
  • Price transparency
  • Patient responsibility, including outpatient and inpatient deductible and coinsurance


Module 11:  Coverage, Notices, and Billing for Inpatient Services

  • Inpatient order and certification requirements
  • Inpatient criteria and the 2-Midnight Benchmark
  • Important Message from Medicare (IMM) and Detailed Notice of Discharge
  • Hospital Issued Notices of Non-Coverage (HINN)
  • Utilization review determinations for non-covered inpatient cases
  • Inpatient Part B billing and payment


Module 12:  Coverage, Notices, and Billing for Swing Bed Admissions in a CAH

  • Coverage for swing beds
  • Level of care and documentation requirements
  • SNFABN notice requirements
  • Reimbursement methodology and patient coinsurance
  • Exclusion from SNF PPS consolidated billing rules


Course outline/agenda subject to change.

Medicare Boot Camp®—Critical Access Hospital Version

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
  • Explain how Medicare pays for outpatient, inpatient, and swing bed services
  • Apply outpatient and inpatient status rules and regulations

Medicare Boot Camp®—Critical Access Hospital Version

Continuing Education

AAPC
This program has prior approval of the AAPC for 22.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the AAPC of the program, content or the program sponsor. 

American Health Information Management Association (AHIMA)
This program has been approved for 22.5 Continuing Education credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Commission for Case Manager Certification (CCMC)
This program is approved by the Commission for Case Manager Certification for 22.5 Continuing Education Units.

Association of Clinical Documentation Integrity Specialists (ACDIS)
This program has been approved for 22.5 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).

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 22.5 nursing contact hours is provided by HCPro.

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 27 nursing contact hours. California BRN Provider #CEP 14494.

National Association of Healthcare Revenue Integrity (NAHRI)
This program has been approved for 22.5 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).

National Association of State Boards of Accountancy (NASBA)
Earn up to 27 CPE Credits!
Program Level: Basic
Delivery Method: Group-Live
Field of Study: Specialized Knowledge

HCPro is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.learningmarket.org.

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®—Critical Access Hospital Version

Questions/Answers

What is the focus of the Medicare Boot Camp®—Critical Access Hospital Version?
The Medicare Boot Camp—Critical Access Hospital Version is a three-day intensive course on Medicare coverage, billing, coding, and payment for CAHs. 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. This one-of-a-kind class will show you which rules apply to your setting so you can successfully submit claims and get paid appropriately. It will also teach you how to prepare for and respond to MAC and other government audits.

Does this course prepare participants for coding certification?
The Medicare Boot Camp—Critical Access Hospital Version contains a review of pertinent coding issues as they relate to Medicare coverage, billing, and payment; however, the course is not designed as a coding course. HCPro does offer two courses focused on coding fundamentals. The Certified Coder Boot Camp®—Original Version focuses on coding for physician and hospital outpatient services. The Certified Coder Boot Camp®—Inpatient Version focuses on hospital inpatient facility services. These courses may assist participants in preparation for national coding certification. For more details, please review the information for these courses using the links above or contact customer service at email customer@simplifycompliance.com or 800-650-6787. 

Does HCPro offer on-site Medicare Boot Camps?
In addition to our open registration courses, we also offer the Medicare 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 Medicare Boot Camp—Critical Access Hospital Version, call 800-780-0584 or click on "Train Groups On-Site". We offer a Rural Health Clinic add-on that covers general billing requirements and reimbursement for this unique setting.

What if I need to cancel or transfer my registration?
Cancellation Policy

Please click here to view our cancellation policy. 

Who typically attends the Medicare Boot Camp?

• Finance and reimbursement personnel
• Billers and coders
• Medical records/health information personnel
• Clinical department personnel
• Case managers
• CDI professionals
• Provider-based clinic personnel
• RAC coordinators
• Compliance officers and auditors
• Revenue managers
• Chargemaster personnel
• Fiscal intermediary personnel
• Registration personnel
• Legal department personnel

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 with coding, billing, and reimbursement. 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
• A handheld calculator

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 our sales team at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Need to train a group?

Bring our industry-leading instructors to your facility! Hosting a Boot Camp is a cost-effective and convenient solution for training your staff on the latest regulations. For more information, call 877-233-8734 or contact one of our account managers.