Medicare Boot Camp®—Utilization Review Version Online

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Medicare Boot Camp®—Utilization Review Version Online

Product Code: URBO


1st Attendee $899.00*
Additional Attendee(s)
Save $0.00$899.00 each

Total:
$899.00
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Register up until the day before the class
to attend this course.

To register multiple attendees, please call our sales team at 615-724-7200.

Want to book training for a few weeks or months down the line? We can do that! Give us a call (800) 650-6787 and we will get you signed up for the start date of your choice!

Medicare Boot Camp®—Utilization Review Version Online

Course Overview

Master Medicare rules for utilization review

The Medicare Boot Camp®—Utilization Review Version Online is an intensive eLearning 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. In 2021, CMS made significant changes to the inpatient-only list and continues to change its strategies for auditing patient status. Don’t become a target or leave money on the table—ensure the UR committee is ready to implement and leverage the regulatory requirements.

You will leave this program knowing:

  • How to apply the 2-midnight benchmark
  • The observation coverage rules and how they interact with the 2-midnight benchmark
  • How the inpatient only list is changing starting in CY2021
  • 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
  • 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
  • Fiscal intermediary personnel
  • Healthcare lawyers and consultants


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

Medicare Boot Camp®—Utilization Review Version Online

Dates

Below is the current course schedule for upcoming Medicare Boot Camp®—Utilization Review Version Online classes.

To view our cancellation policy, click here.

 

Course

Class Dates

Registration Deadline

December 2021 - February 2022

12/7/2021 - 2/5/2022 12/6/2021

December 2021 - February 2022

12/21/2021 - 2/19/2022 12/20/2021

January 2022 - March 2022

1/12/2022 - 3/13/2022 1/11/2022

February 2022 - April 2022

2/9/2022 - 4/10/2022 2/8/2022

March 2022 - May 2022

3/9/2022 - 5/8/2022 3/82022

April 2022 - June 2022

4/13/2022 - 6/12/2022 4/12/2022

Medicare Boot Camp®—Utilization Review Version Online

Outline/Agenda

Medicare Overview

  • Overview of Medicare Part A, B, C, and D
  • Medicare contractors, including the MAC, RAC and QIO

Medicare Coverage

  • Medicare Coverage Center, including LCDs, NCDs and CED
  • Prior authorization for specified outpatient procedures and services

Coverage of Observation

  • Coverage of observation services

Observation Coding, Billing, and Payment

  • Coding and billing of observation
  • Payment for observation under the Observation Comprehensive APC (C-APC)
  • Payment for observation at a Critical Access Hospital (CAH)

The Medicare Outpatient Observation Notice (MOON)

  • The Medicare Outpatient Observation Notice (MOON)

Notice for Non-Covered Observation

  • Advanced Beneficiary Notice (ABN) for non-covered observation

Inpatient Orders

  • Inpatient order requirements

Inpatient Certifications

  • Inpatient certification requirements, including 96-hour CAH certification
  • Certification for continued hospitalization when no SNF bed is available

Inpatient Coverage: Inpatient-Only Procedures

  • Inpatient-only rule
  • Auditing of formerly inpatient only procedures

Inpatient Coverage: Two-Midnight Rule

  • Two-midnight rule, including outpatient care and transfers

Inpatient Coverage: Admission on a Case-by-Case Basis

  • Admission on case-by-case basis
  • Documentation and use of screening tools

UR Committee and Determination Requirements

  • Composition of the UR committee
  • Timing of UR Determinations, including self-denial and condition code 44

Inpatient Part B billing

  • Inpatient Part B billing with condition code W2 and payment under OPPS

Inpatient Notices

  • Important Message from Medicare (IM)
  • Detailed Notice of Discharge (DN)
  • Hospital Issued Notice of Non-Coverage (HINN) for non-covered inpatient services

Patient Responsibility

  • Basics of OPPS
  • Outpatient Coinsurance under Part B
  • Basics of IPPS
  • Inpatient Coinsurance, including lifetime reserve days


Course Agenda/Outline is subject to change.

Medicare Boot Camp®—Utilization Review Version Online

Continuing Education

AAPC
This program has the prior approval of AAPC for 8.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

AHIMA
This program has been approved for 8.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

ACDIS
This program has been approved for 8.5 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 Improvement Specialists (ACDIS).

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 8.5 nursing contact hours is provided by HCPro.

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 8.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

NAHRI
This program has been approved for 8.5 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).

Medicare Boot Camp®—Utilization Review Version Online

Questions/Answers

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

How does it work?
You’ll receive the same content and instruction that you would experience at our classroom-based, nationally recognized Boot Camps. Here’s how it works:

  • 60-day access to video instruction after purchase date: View video sessions and complete all assignments, including review of all answer keys.
  • 24-hour access: Video instruction is available at any time of day—you choose the time that works for you. You can also email questions to our instructors. We try to answer all questions either via email or phone within two business days.


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 long will I have access to the content? 
The online portal location for your class sessions and materials will be available for 60 days from the class start date.

Does this course prepare participants for coding certification?
The Medicare Boot Camp®—Utilization Review Version Online 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 Medicare Boot Camps 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?
Cancellation Policy
Please click here to view our cancellation policy.

Who typically attends the Medicare Boot Camp?

  • Finance and reimbursement personnel
  • Case Managers
  • Chargemaster personnel
  • Billers and coders
  • Medical records/health information personnel
  • Clinical department personnel
  • Provider-based clinic personnel
  • Revenue managers
  • Compliance officers and auditors
  • Registration personnel
  • Medicare Advantage and MAC personnel
  • Healthcare lawyers, consultants, and CPAs
  • Legal department personnel


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.