Medicare Boot Camp® - Physician Services Version

Bookmark and Share

Medicare Boot Camp® - Physician Services Version

Product Code: MBCP10272014


1st Attendee $1,199.00*
Additional Attendee(s)
Save $0.00.  $1,199.00 each

Total:
$1,199.00
Add Items to Cart
To register multiple attendees, please call Customer Service at (800) 650-6787.

Medicare Boot Camp® - Physician Services Version

Course Overview

Physician Practices are under increasing financial pressure, and Medicare accounts for a large portion of their revenue. With hospitals and healthcare organizations having a larger role in managing physician practices, they need to be sure that this less-familiar territory is well-charted to avoid money-costing mistakes.

Complete the Medicare Boot Camp® & Physician Services Version and gain the knowledge and confidence to:

  • Find the answers to your most troublesome Medicare questions
  • Contribute to the financial stability of your practice
  • Avoid compliance pitfalls
  • Serve as a resource to your team

The Medicare Boot Camp® - Physician Services Version focuses on the Medicare regulations and guidelines applicable to physician services. Understanding the unique nuances of documentation, billing, and other matters of business for these services is a necessity for the financial well-being of any organization, large or small. After you participate in the Medicare Boot Camp® - Physician Services Version, you'll be able to:

  • Recognize and apply CMS instructions to determine proper reporting
  • Determine the appropriate way to bill for Evaluation and Management services in many different scenarios including observation, emergency, and concurrent care
  • Identify and avoid compliance pitfalls and prepare for potential audits
  • Extend understanding of requirements and employ efficient processes that increase productivity
  • Understand Medicare coverage guidelines, including the general types of physician services covered as well as specific coverage requirements for certain services
  • Apply payment principles for physician services, allowing you to reasonably anticipate projected income stream

Need to train a group?
Bring the Medicare Boot Camp® - Physician Services Version to your organization. If you have a group to train, holding a Boot Camp at your organization is easy and cost-effective. Eliminate travel costs and enjoy a group discount while ensuring your staff is up to date on the latest Medicare regulations and guidelines applicable to physician services. Call 800-780-0584 to learn more.

Medicare Boot Camp® - Physician Services Version

Course Locations & Dates

Below is the current course schedule for upcoming courses of the Medicare Boot Camp - Physician Services Version.

To register for a class, click the "Register" button. If you would like to register multiple attendees, click the "Register Multiple Attendees" button.

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

Instructors for each class and locations marked as "Tentative" are subject to change. To view our cancellation policy, click here.

View Schedule For: Medicare Boot Camp - Physician Services Version
October 2014

 

 

 

October 2014

Location Class Dates

Schaumburg, (Chicago), IL

Price Per Person: $1,199

Hyatt Place Chicago/Schaumburg
1851 McConnor Parkway
Schaumburg, IL 60173

Room Rate: $118

Hotel cut-off date: 10/5/14

Oct-27-2014
thru
Oct-29-2014
 
 
 

Medicare Boot Camp® - Physician Services Version

Course Outline

Module 1: Medicare Research

  • End Your Confusion with the Medicare Web Site And Find What You Need


Module 2: Medical Necessity and Non-Coverage

  • What You Need to Know When Medicare is Not Paying the Bill


Module 3: NCCI, MUEs, Modifiers and Other Must-Know Coding Fundamentals


Module 4: Credentialing and Enrollment

  • First things first; How to be recognized by Medicare as an eligible physician


Module 5: Physicians Aren’t the Only Ones That Can Expect Compensation

  • Nonphysician practitioner


Module 6: Tools for Understanding and Predicting Medicare Reimbursement

  • Overview of the RBRVS


Module 7: CMS 1500, ICD-9-CM, NPI and Other Must-Know Billing Fundamentals


Module 8: Evaluation and Management Services

  • The Most Commonly Billed Physician Service And the Most Commonly Audited


Module 9: Surgical Services for Physician

  • Modifiers and More


Module 10: Let's Not Forget About Diagnostic Testing

  • Clinical Lab, Radiology, and Other Diagnostic Services


Module 11: Physicians at Teaching Hospitals

  • Teaching Physician Issues


Module 12: When the Medicare Payment is Not What You Expect

  • Audits and Appeal

Medicare Boot Camp® - Physician Services Version

Learning Objectives


Module 1: Introduction; Researching Medicare Issues

  • Be able to locate the key sources of Medicare authority on the Internet.
  • Be able to differentiate between statutes, regulations, transmittals and other interpretative guidance.
  • Be able to identify ways to efficiently keep up with operational changes in the Medicare program.


Module 2: Credentialing and Enrollment

  • Be able to explain the Medicare physician/supplier enrollment process.
  • Be able to determine the appropriate Medicare enrollment form to use.
  • Be able to determine the differences between NPIs and UPINs.
  • Be able to explain how NPIs and UPINs are reported on Medicare claims.
  • Be able to explain how NPIs will be assigned and used.
  • Be able to identify the differences between participation and non-participation in the Medicare program.
  • Be able to explain the ramifications and process for "opting out" of the Medicare program.


Module 3: Non-Physician Practitioner Services

  • Be able to distinguish between "incident to" and "separate enrollment" coverage of non-physician practitioner services.
  • Be able to determine whether a particular non-physician practitioner service qualifies for "incident to" coverage.
  • Be able to explain when the services of nurse practitioners and physician assistants may be appropriately billed under the "separate enrollment" coverage rules.


Module 4: RBRVS Mechanics

  • Be able to explain how Medicare payment is determined under the physician fee schedule.
  • Be able to use the data in the Medicare relative value file/physician fee schedule database to make operational billing decisions.
  • Be able to explain how Medicare's annual deductible and coinsurance affect beneficiary liability and payment to practitioners.
  • Be able to identify situations where the -22 and -52 modifiers should be used.
  • Be able to explain the affect of the -22 and -52 modifiers on payment.

Module 5: Claims for Physician/Practitioner Services

  • Be able to explain the role and functions of the Medicare carrier.
  • Be able to determine Carrier jurisdiction for services furnished to a Medicare beneficiary.
  • Be able to use the CMS-1500 08-05 data set instructions to determine proper reporting of services provided.
  • Be able to explain how to properly report site of service and the effect of site of service on payment.
  • Be able to explain the differences and implications of assigned versus non-assigned claims.
  • Be able to determine when and how the "limiting charge" rules apply to both assigned and non-assigned claims.
  • Be able to determine when a practitioner may/may not bill for services furnished to a relative.
  • Be able to provide an overview of how SNF consolidated billing affects billing for professional services furnished to SNF residents.
  • Be able to determine whether a particular reassignment relationship is permissible under the Medicare reassignment regulations/guidelines


Module 6: Advanced Beneficiary Notices and Non-Covered Services

  • Be able to determine when the Medicare "financial liability protections" provisions apply to professional services.
  • Be able to determine when it would be appropriate/inappropriate to present an ABN to a patient.
  • Be able to identify those circumstances under which an ABN would be ineffective or invalid.
  • Be able to determine when it would be appropriate to use an NEMB.
  • Be able to identify those circumstances where a single ABN will cover an extended course of treatment.
  • Be able to identify those circumstances where a routine ABN is permitted.
  • Be able to determine how to properly report non-covered services on a professional services claim, including the appropriate use of modifiers.


Module 7: The National Correct Coding Initiative

  • Be able to use the CMS web site to locate the NCCI policies and edits applicable to professional services.
  • Be able to determine when an NCCI edit applies to an outpatient claim.
  • Be able to differentiate between the "column 1/column 2" edits and the "mutually exclusive" NCCI edits.
  • Be able to determine the correct way to bill for a code pair that is subject to an NCCI edit, including appropriate use of the "correct coding modifiers."
  • Be able to detect automatic denial for Medically Unlikely Edits.


Module 8: Evaluation and Management Services

  • Be able to determine the appropriate way to bill for E/M services furnished to a hospital inpatient.
  • Be able to determine the appropriate way to bill for E/M services furnished to a hospital observation patient.
  • Be able to bill appropriately for a "Welcome to Medicare" visit
  • Be able to determine the appropriate way to bill for E/M services furnished to an emergency department.
  • Be able to determine the appropriate way to bill for E/M services furnished to a nursing facility patient.
  • Be able to determine whether a particular encounter qualifies to be billed as a consultation.
  • Be able to identify the circumstances under which Medicare does and does not cover critical care.
  • Be able to determine the appropriate way to bill for covered critical care services.
  • Be able to determine the appropriate way to bill for concurrent care services.
  • Be able to determine the appropriate way to bill for care plan oversight services.


Module 9: Surgical Services

  • Be able to determine when a service is and is not included in the global surgical package.
  • Be able to determine the applicable postoperative period of a procedure.
  • Be able to determine the appropriate way to bill for services furnished during the postoperative period that are not included in the surgical package, including the use of appropriate modifiers.
  • Be able to determine how the multiple procedure reduction applies to a particular Medicare claim.
  • Be able to determine the appropriate way to bill for bilateral surgeries.
  • Be able to determine the appropriate way to bill for assistant surgeons, co-surgeons and team surgeons.


Module 10: Diagnostic Testing

  • Be able to determine when the professional and technical component services for a diagnostic test are separately billable.
  • Be able to determine when and how to use modifiers to appropriately bill for professional and technical component services.
  • Be able to determine the level of physician supervision required for a particular diagnostic test.
  • Be able to appropriately bill diagnostic radiology services in a professional practice setting.
  • Be able to explain the CLIA requirements applicable for laboratory services furnished in a professional practice setting.
  • Be able to locate and effectively use the clinical diagnostic laboratory services fee schedule.
  • Be able to locate and effectively use the national coverage determinations (NCDs) applicable to clinical laboratory services.


Module 11: Teaching Physician Issues

  • Be able to provide an overview of Medicare coverage of services provided by interns and residents.
  • Be able to identify situations in which a teaching/attending physician's presence is required when residents are involved in patient care.
  • Be able to determine the proper way to bill for resident involvement of patient care (including the appropriate use of modifiers).
  • Be able to explain the documentation requirements applicable to teaching/attending physician services when residents are involved in patient care.
  • Be able to determine how to bill appropriately for services furnished an intern or resident functioning as an assistant surgeon.
  • Be able to determine if Medicare payment is available for services furnished by a particular moonlighting resident.


Module 12: Audits and Appeals

  • Be able to provide an overview of the Medicare program integrity function applicable to services furnished in a professional practice setting.
  • Be able to differentiate between "medical review" and "benefit integrity" and their respective purposes.
  • Be able to respond to a notice of audit.
  • Be able to provide an overview of the Medicare Part B appeals process.

Medicare Boot Camp® - Physician Services Version

Continuing Education


American Academy of Professional Coders (AAPC)

This program has been approved by the American Academy of Professional Coders 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 Nurses Credentialing Center (ANCC)     

HCPro, Inc. 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, Inc.

Nurses should only claim credit commensurate with the extent of their participation in the activity.


California Board of Registered Nursing

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

American College of Medical Practice Executives (ACMPE)     This program may qualify for continuing education credit in the American College of Medical Practice Executives. To apply for ACMPE credit, submit the ACMPE generic credit hour form with a copy of the certificate of completion.


Continuing Medical Education (CME)     

HCPro, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

HCPro, Inc. designates this educational activity for a maximum of 21 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

National Association of State Boards of Accountancy (NASBA)     

Earn up to 25 CPE Credits!
Program Level: Intermediate
Delivery Method: Group-Live

HCPro, Inc. 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 addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN, 37219-2417. Web site: www.nasba.org.

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/case studies. 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?

To view our Cancellation Policy, click here.


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?

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. However, the course starts with Medicare fundamentals and does not assume that participants have any particular background or experience. 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/case studies.

 

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. (Our instructors use and recommend the AMA's CPT Professional Edition.)

HCPro offers the 2009 edition of the CPT Manual (published by AMA) on HCMarketplace.

Ingenix publishes a manual called "CPT Expert." We recommend against using CPT Expert 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 (we recommend "3 hole" paper so that you can insert your notes in the course workbook)


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) 780-0584 or bootcamps@hcpro.com.