Medicare Boot Camp®-Utilization Review Version

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Medicare Boot Camp®—Utilization Review Version

Product Code: URBC


1st Attendee $1,099.00*
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Save $0.00$1,099.00 each

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$1,099.00
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To register multiple attendees, please call Customer Service at (800) 650-6787.

Medicare Boot Camp®—Utilization Review Version

Course Overview

Master Medicare rules for utilization review

Medicare Boot Camp®—Utilization Review Version is an intensive two-day course focusing on the Medicare regulatory requirements for patient status and the role of the utilization review (UR) committee.

Managing patient status plays a critical role in proper compliance, correct reimbursement, and stabilizing inpatient payments for the hospital. Don’t leave money on the table—ensure the UR committee is ready to implement and leverage the regulatory requirements.

Medicare Boot Camp—Utilization Review Version also answers all your questions about navigating the CMS website and finding Medicare requirements. You will be able to find answers to your questions long after the Boot Camp is over.

You will leave this program knowing:

  • How to apply the 2-midnight benchmark and 2-midnight presumptions
  • The differences between post-discharge versus concurrent patient status reviews
  • When self-denial is appropriate to take advantage of Part B payment for an inpatient case
  • How NCDs, LCDs, and coverage with evidence development (CED) affect coverage of cases that meet the 2-midnight benchmark
  • The observation coverage rules and how they interact with the 2-midnight benchmark
  • When ABNs and HINNs should be used for stays that don’t meet medical necessity requirements

 

Who should attend?

  • Utilization review coordinators
  • Utilization management managers and directors
  • Utilization review committee members
  • UR physician advisors
  • Case managers
  • Care coordinators
  • Revenue cycle staff
  • Nurse managers
  • Compliance officers and auditors
  • CFOs, CNOs, and VPs
  • Fiscal intermediary personnel
  • Healthcare lawyers and consultants

 

See the HCPro difference for yourself!

Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure 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 work a set of exercises/case studies 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.

Medicare Boot Camp®—Utilization Review Version

Course Locations & Dates

Below is the current course schedule for upcoming classes of Medicare Boot Camp®—Utilization Review 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, click the "Register Multiple Attendees" button.

To view our cancellation policy, click here.

 

March 2018

Las Vegas, NV

 

March 12 - 13, 2018

Hyatt Place Las Vegas
4520 Paradise Road 
Las Vegas, NV 89169
702-369-3366

Hotel website


Room Rate: $189
Room Rate Cut-Off: February 19, 2018

 

May 2018


Boston, MA

 

May 7 - 8, 2018
8:00AM – 5:00PM each day

HYATT house™ Boston/Burlington
2 Van De Graaff Drive
Burlington, MA 01803
781-270-0800
Hotel website


Room Rate: $195/night
Room Rate Cut-Off: April 22, 2018

 

July 2018


Orlando, FL

 

July 23 - 24, 2018
8:00AM – 5:00PM each day

Homewood Suites by Hilton International Drive
8745 International Drive
Orlando, FL 32819
407-248-2232
Hotel website


Room Rate: $159/night
Room Rate Cut-Off: July 2, 2018

 

December 2018


Orlando, FL

 

December 3 - 4, 2018
8:00AM – 5:00PM each day

HYATT house™ San Diego Sorrento Mesa r
10044 Pacific Mesa Blvd
San Diego, CA 92121
858-597-0500
Hotel website


Room Rate: $159/night
Room Rate Cut-Off: November 9, 2018

 

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Medicare Boot Camp®—Utilization Review Version

2017 Course Outline/Agenda -  2018 Agenda coming soon!

  • Module 1:  Medicare Overview and Contractors
    • Overview of Medicare Part A, B, C, and D
    • Medicare contractors, including the MAC, RAC and QIO
  • Module 2:  Medicare Research and Resources
    • Finding Medicare source laws, including statutes, regulations and final rules
    • Finding Medicare sub-regulatory guidance, including manuals and transmittals
    • Medicare Coverage Center, including LCDs, NCDs, CED and Lab Coverage Manual
    • Limitations of Liability and notice requirements for non-covered services
    • Links to Medicare resources and resources for staying current
  • Module 3: Outpatient Observation
    • Coverage of observation services
    • The Medicare Outpatient Observation Notice (MOON)
    • Advanced Beneficiary Notice (ABN) for non-covered observation
    • Coding and billing of observation
    • Payment for observation under the Observation Comprehensive APC (C-APC)
  • Quiz 1: Medicare Overview, Resources, and Observation
  • Module 4: Coverage of Inpatient Admissions
    • Inpatient order and certification requirements
    • Inpatient criteria and the 2-Midnight Benchmark
    • Inpatient-only procedures
    • Admission on a case-by-case basis
    • Documentation and use of screening tools
    • QIO short stay audits
  • Module 5: Inpatient Utilization Review and Notices
    • Utilization review requirements and self-denials
    • Concurrent review and billing with condition code 44
    • Important Message from Medicare (IM)
    • Detailed Notice of Discharge (DN)
    • Hospital Issued Notice of Non-Coverage (HINN) for non-covered inpatient services
  • Module 6: Part B Payment for Inpatient and Outpatient Services
    • Basics of the Outpatient Prospective Payment System (OPPS), including
    • Comprehensive APCs (i.e., outpatient surgical encounter based payments)
    • Inpatient Part B payment and billing with condition code W2
    • Patient coinsurance under Part B
  • Module 7: Part A Payment for Inpatient Services
    • Inpatient Prospective Payment System (IPPS)
    • Three-day payment window and pre-admission services
    • Medicare-severity diagnosis related groups (MS-DRGs)
    • Payment for transfers and post-acute care transfers
    • Inpatient deductible, coinsurance, and lifetime reserve days (LRDs)
  • Quiz 2: Inpatient Coverage, Utilization Review, and Payment


Course Outline/Agenda subject to change

Medicare Boot Camp®—Utilization Review Version

Learning Objectives

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

  • Define observation coverage, billing, coding, and payment rules
  • Discuss the appropriate application of ABNs for observation patients
  • State the inpatient order and certification requirements
  • Explain CMS’ 2-midnight rule benchmark 
  • Recognize exceptions to the 2-midnight benchmark
  • Discuss how QIOs will conduct short stay audits
  • Describe the impact of LCD/NCD/CED criteria on inpatient coverage
  • State the rules for "inpatient-only" procedure billing and reimbursement
  • Describe the differences between condition codes 44 and W2
  • Use appropriate billing codes for full Part B payment for inpatient cases, including for "self-denials"
  • Differentiate inpatient and outpatient deductibles and copayments

Medicare Boot Camp®—Utilization Review Version

2017 Continuing Education - 2018 CE Credit coming soon!

AAPC
This program has been approved by the AAPC for 15 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 15 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Association of Clinical Documentation Improvement Specialists (ACDIS)
This program has been approved for 15 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 Improvement 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 15 nursing contact hours is provided by HCPro.

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 18 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 continuing education credit to Certified Case Managers (CCMs).

ACCME
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 15 AMA PRA Category 1 Credits™. 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 18 CPE Credits!
Program Level: Basic
Delivery Method: Group-Live
Field of Study: Specialized Knowledge and Applications

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®—Utilization Review Version

2017 Questions/Answers - 2018 FAQs coming soon!

What is the focus of Medicare Boot Camp®—Utilization Review Version?

Medicare Boot Camp—Utilization Review Version is an intensive two-day course on Medicare coverage, billing, coding, and payment for hospital outpatient and inpatient services. The course is technically oriented and focuses on the Medicare regulations and guidelines applicable to hospital services. The objective of the course is to provide participants with a detailed understanding of the Medicare "rules," with a particular emphasis on the operational application of those rules.

Where is the course offered?

Open registration sessions of Medicare Boot Camp—Utilization Review Version 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."

Does this course prepare participants for coding certification?

Medicare Boot Camp—Utilization Review Version contains a review of pertinent coding issues as they relate to Medicare coverage, billing, and payment; however, it is not primarily 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 help participants prepare for national coding certification. For more details, please review the information for these courses using the links above, or contact customer service at customerservice@hcpro.com or 800-650-6787.

Does HCPro offer on-site sessions of Medicare Boot Camp—Utilization Review Version?

In addition to our open registration courses, we also offer Medicare Boot Camp—Utilization Review Version as an on-site program (with a substantial discount) for organizations with a number of employees who need training. For more information on hosting an on-site Medicare Boot Camp—Utilization Review Version, click on Train Groups On-sites.

What if I need to cancel or transfer my registration?

Cancellation Policy
Please click here to view our cancellation policy.

Who typically attends Medicare Boot Camp—Utilization Review Version?

  • Utilization review coordinators
  • Utilization management managers and directors
  • Utilization review committee members
  • UR physician advisors
  • Case managers
  • Care coordinators
  • Revenue cycle staff
  • Nurse managers
  • Compliance officers and auditors
  • CFOs, CNOs, and VPs
  • Fiscal intermediary personnel
  • Healthcare lawyers and consultants

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. Familiarity with the ICD-9-CM and CPT coding systems is helpful, but not required.

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 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.