Medicare Boot Camp®—Physician Services Version

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Medicare Boot Camp®—Physician Services Version

Product Code: MBCP


1st Attendee $1,299.00*
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*To register multiple attendees, please call Customer Service at (800) 650-6787.

Register for this Boot Camp and get a 30-day free trial to Revenue Cycle Advisor. See below for more details!

Medicare Boot Camp®—Physician Services Version

Course Overview

*This Boot Camp purchase entitles you to a 30-day trial membership to Revenue Cycle Advisor (Basic). See below for more details!

Physician practices are under increasing financial pressure, and Medicare accounts for a large portion of their revenue. The Medicare Boot Camp®—Physician Services Version teaches you the basics of navigating Medicare regulations and guidelines applicable to professional services.

Whether you’re in a physician practice or a hospital that is taking on a larger role in managing physician practices, the Medicare Boot Camp—Physician Services Version will help you avoid basic compliance pitfalls and costly mistakes. Apply concepts learned immediately with true-to-life case studies that accompany each module.

You’ll walk away from this three-day course with a complete understanding of the unique nuances of documentation and billing topics, including:

  • E/M services
  • "Incident to" billing and reimbursement for nonphysician practitioner services
  • How to research Medicare regulations and guidance
  • Participation in Medicare
  • Understanding the mechanics of the Medicare Physician Fee Schedule
  • Completion of the CMS-1500 claim form
  • Advance beneficiary notices (ABN)
  • National Correct Coding Initiative (NCCI)
  • Global surgery rules
  • Diagnostic testing rules
  • Teaching physician rules
  • Appeals process

 

Instructors teach directly from the Medicare regulations and provide full citations so that you can find the rules yourself after the Boot Camp is over. 

You will leave this program knowing how to:

  • Employ CMS guidelines to ensure proper reporting
  • Explain appropriate billing for professional services in many different scenarios
  • Identify compliance pitfalls and prepare for potential audits
  • Describe requirements for efficient processes that lead to increased productivity
  • Examine Medicare coverage guidelines, including the general types of physician services covered
  • Recognize specific Medicare coverage requirements for certain services
  • Interpret payment principles for physician services, allowing for a reasonably anticipated projected income stream

 

Who should attend?

  • Medical practice managers
  • Billers and coders
  • Medical records managers and staff
  • Health information managers and staff
  • Clinical managers and department heads
  • Finance and reimbursement managers and staff
  • Physicians
  • Nurse practitioners
  • Physician assistants
  • Compliance officers and auditors
  • Medicare carrier personnel
  • Healthcare consultants, CPAs, and lawyers
  • Legal department personnel

 

See the HCPro difference for yourself!

Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure professional 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 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.

For more detailed information about Medicare Boot Camps, contact customer service at 800-650-6787 or email customerservice@hcpro.com.


*FREE TRIAL
By registering for this boot camp, you will receive a free 30-day trial to Revenue Cycle Advisor (Basic), a comprehensive website that combines all of HCPro's Medicare regulatory and reimbursement resources into one, giving you a single, trustworthy tool to help you navigate the ever-changing Medicare landscape. For more information regarding this association, click here: http://revenuecycleadvisor.com.

Medicare Boot Camp®—Physician Services 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, call Customer Service at (800) 650-6787.

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.

October 2017

Middleton, MA

 

October 16–18, 2017
8:00 a.m. - 4:00 p.m.

Hotel Information coming soon!
Address
City, State, Zip
Phone
Hotel website

Room Rate: $/night
Room Rate Cut-Off: TBA

Medicare Boot Camp®—Physician Services Version

Course Agenda/Outline

  • Module 1:  Medicare Overview and Resources
    • Overview of Medicare Part A, B, C and D
    • Overview of the UB-04 and CMS 1500 forms.
    • Medicare Contractors, including the MAC, RAC and QIO
    • Key sources of Medicare authority and their location
    • Understanding statutes, regulations, CMS Manuals, CMS Transmittals and other interpretive guidance
    • Links to Medicare resources and resources for staying current
  • Module 2: To Be or Not to Be Participating with Medicare; Pros and Cons of Medicare Participation
    • Medicare physician/supplier enrollment process.
    • Determine the appropriate Medicare enrollment form to use.
    • NPIs and appropriate use on Medicare claims
    • Medicare participation vs. non-participation
    • “Opting out” of the Medicare program
  • Module 3: CMS’s Quality/Value Based Payment Incentives – Affordable Care Act, MACRA and Beyond
    • Overview of Quality programs, Value Based Payment, and the CMS Quality Initiative
    • Provide details on the current quality programs under Medicare for physician practices: PQRS, Meaningful Use, & Value-Based Payment Modifier
    • MACRA rule and the new value based payment programs that will be available under that program (MIPS, APM’s, PFPM’s)
  • Quiz 1:  Medicare Overview, Participation and CMS Value Based Payment Incentives
  • Module 4: Medical Necessity and Non-Coverage: What you need to know when Medicare is not paying the bill
    • Social Security Act “Limitation on Liability” provisions apply
    • When is an ABN is necessary to hold the patient responsible for non-covered services
    • Circumstances under which an ABN would be ineffective/invalid
    • Scenarios in which ABNs are inappropriate
    • Identify those circumstances where a routine ABN is permitted
    • Report ABN modifiers appropriately on claims.
  • Module 5: CMS 1500, ICD-10-CM, NPI and other must-know billing fundamentals
    • Role and functions of the Medicare Administrative Contractor (MAC)
    • MAC jurisdiction for services furnished to a Medicare beneficiary
    • CMS-1500 data set instructions to determine proper reporting of services provided
    • Site of service and the effect of site of service on payment
    • Determine when a practitioner may/may not bill for services furnished to a relative
    • Overview of how SNF consolidated billing affects billing for professional services furnished to SNF residents
    • Determine whether a particular reassignment relationship is permissible under the Medicare reassignment regulations/guidelines
  • Module 6: Tools for understanding and predicting Medicare reimbursement; Overview of the RBRVS
    • Explain how Medicare payment is determined under the physician fee schedule.
    • Utilize the relative value file/physician fee schedule database to make operational decisions.
    • The effect of Medicare’s annual deductible and coinsurance on beneficiary liability and practitioner payment
    • Identify situations where the -22 and -52 modifiers should be used and their effect on claim submission, documentation and reimbursement
  • Module 7: NCCI, MUEs, Modifiers and Other Must Know Coding Fundamentals
    • Composition and application of NCCI edits.
    • Overview of the Column 1/Column 2 and the Mutually Exclusive code edits.
    • Practical issues for practitioners related to NCCI edits.
    • Understanding when an NCCI edit will apply to a claim
    • Correct reporting of a code pair subject to an NCCI edit including appropriate use of modifiers
  • Quiz 2:  Medicare Coverage, Coding, Billing and Payment
  • Module 8: Evaluation and Management Services: The most commonly billed physician service and the most commonly audited
    • Appropriate billing for E/M services furnished to a hospital inpatients and observation patients
    • “Welcome to Medicare” visit.
    • Annual Wellness visit.
    • E/M services furnished in an emergency department
    • E/M services furnished to a nursing facility patient.
    • Consultation services and Medicare
    • Covered critical care services.
    • Concurrent care services.
    • Appropriate billing for care plan oversight services
    • Appropriate billing for chronic care management services
  • Module 9: Surgical services for physicians: Modifiers and more
    • Understanding the global surgical package and Medicare’s definition
    • Determine the applicable postoperative period of a procedure.
    • Appropriate billing for services furnished during the postoperative period that are not included in the surgical package, including the use of appropriate modifiers
    • Apply the multiple procedure reduction to Medicare claims
    • Appropriate billing for bilateral surgeries, assistant surgeons, co-surgeons and team surgeons.
  • Module 10: Let’s not forget about diagnostic testing: clinical lab, radiology and other diagnostic services
    • Professional and technical component services for a diagnostic test – understanding when they are separately billable
    • Appropriate use of modifiers for professional and technical component services
    • Diagnostic testing and appropriate physician supervision
    • Bill appropriately for diagnostic radiology services in a professional practice setting
    • Identify when the multiple procedure payment reduction applies and be able to calculate its effect on reimbursement
    • CLIA requirements applicable for laboratory services furnished in a professional practice setting
    • Locate and effectively use the clinical diagnostic laboratory services fee schedule
    • Locate and effectively use the national coverage determinations (NCDs) applicable to clinical laboratory services
  • Quiz 3:  Medicare Physician Services – Appropriate Coding and Billing
  • Module 11:  Physicians aren’t the only ones that can expect compensation; Non-Physician Practitioner Services
    • “Incident to” and “split/shared” coverage of NPP services
    • “Incident to” coverage requirements
    • Explain when NPP services may be appropriately billed under the split/shared coverage rules
  • Module 12: Physicians at teaching hospitals: Teaching physician issues
    • Medicare coverage of services provided by interns and residents
    • Situations in which a teaching/attending physician’s presence is required when residents are involved in patient care
    • Appropriate billing for resident involvement of patient care (including the appropriate use of modifiers)
    • Documentation requirements applicable to teaching/attending physician services when residents are involved in patient care
    • Intern or resident functioning as an assistant surgeon
    • Determine if Medicare payment is available for services furnished by a particular moonlighting resident
  • Module 13: When the Medicare payment is not what you expect: audits and appeals
    • Provide an overview of the Medicare program integrity function applicable to services furnished in a professional practice setting.
    • Recovery audit Contractors
    • Comprehensive Error Rate Testing program and its purpose
    • Respond to a notice of audit
    • Provide an overview of the Medicare Part B appeals process
  • Quiz 4: Teaching Physicians, Non-Physician Practitioners and Appeals


Course Agenda/Outline subject to change

Medicare Boot Camp®—Physician Services Version

Learning Objectives

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

  • Employ CMS guidelines to ensure proper reporting
  • Explain appropriate billing for professional services in many different scenarios
  • Identify compliance pitfalls and prepare for potential audits
  • Describe requirements for efficient processes that lead to increased productivity
  • Examine Medicare coverage guidelines, including the general types of physician services covered
  • Recognize specific Medicare coverage requirements for certain services
  • Interpret payment principles for physician services, allowing for a reasonably anticipated projected income stream

 

Medicare Boot Camp®—Physician Services Version

Continuing Education

AAPC

This program has been approved by the AAPC for 21 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 19 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 Commission on Accreditation.

This educational activity for 21 nursing contact hours is provided by HCPro.

California Board of Registered Nursing

HCPro is approved by the California Board of Registered Nursing to provide 25.2 nursing contact hours. California BRN Provider #CEP 14494.

National Association of State Boards of Accountancy (NASBA)

Earn up to 25 CPE Credits!

Program Level: Intermediate

Delivery Method: Group-Live

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®—Physician Services Version

Questions/Answers

What is the focus of the Medicare Boot Camp®—Physician Services Version?

Medicare Boot Camp—Physician Services Version is technically oriented and focuses on the Medicare regulations and guidelines applicable to professional services. The course is taught using a combination of lecture, class discussion, and hands-on exercises. The objective of the course is to provide course participants with a detailed understanding of the Medicare "rules," with a particular emphasis on the real-world application of those rules.

Where is the course offered?

Open registration Medicare Boot Camps 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 Medicare Boot Camps, click on "Locations/Dates" above.

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, click on Host an On-Site Course.

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—Physician Services Version?

  • Medical practice managers
  • Billers and coders
  • Medical records/health information managers/staff
  • Clinical managers and department heads
  • Finance and reimbursement managers/staff
  • Physicians, nurse practitioners, and physician assistants
  • Compliance officers and auditors
  • Medicare carrier personnel
  • Healthcare consultants, CPAs, and lawyers
  • 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?

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 professional practice setting. Familiarity with the CPT® coding system will be particularly helpful.

How is the course taught?

The course is taught using a combination of lecture, class discussion, and hands-on exercises.

What do I need to bring to class?

When you arrive at class, you will receive an extensive binder of course materials. However, in order to get the most out of the course, you should bring a current CPT manual to class. Any current version of the CPT manual will be fine so long as it is published by the American Medical Association (AMA). (Our instructors use and recommend the AMA's CPT Professional Edition.)

HCPro offers the 2016 edition of the CPT manual (published by the AMA) on HCMarketplace.

Optum publishes a manual called CPT Expert. We recommend against using it for this course because CPT Expert does not contain all of the official CPT guidelines.

Please bring the following to all classes:

  • Your CPT manual
  • A handheld calculator
  • Note paper

 

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 customer service at 800-650-6787 or email customerservice@hcpro.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.