Medicare Boot Camp—Critical Access Hospital and Rural Health Clinic Version

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Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic Version

Product Code: MBRH


1st Attendee $1,499.00*
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To register multiple attendees or large groups, please call Customer Service at (800) 650-6787.

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 and Rural Health Clinic Version

Course Overview

Master Medicare rules for critical access hospitals

Medicare Boot Camp—Critical Access Hospital and Rural Health Clinic Version is a four-day intensive course on Medicare coverage, billing, coding, and payment for critical access hospitals. 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.

Find the answers to all of your coding, billing, and reimbursement questions pertaining to your unique position in the healthcare industry—the CAH.

This one-of-a-kind, custom class will show you which rules apply to you so you can successfully process claims and get paid. It will also teach you how to prepare and respond to recovery audits by mastering the key concepts behind what the Recovery Auditors have audited so far.

The Medicare Boot Camp—Critical Access Hospital and Rural Health Clinic Version will give you the knowledge and confidence to:

  • Find the answers to your specific Medicare questions relating to CAHs
  • Understand outpatient observation and inpatient status rules and UR requirements
  • Submit accurate claims to Medicare, including Part A to B rebilling
  • Ensure appropriate reimbursement
  • Avoid compliance pitfalls
  • Identify risks for recovery audits and other government audits


Who should attend?

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


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 the Medicare Boot Camp—Critical Access Hospital and Rural Health Care Version, contact customer service at 800-650-6787 or email customerservice@hcpro.com.

Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic 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.
For larger groups, contact Customer Service at (800) 650-6787 to inquire about group rates. 

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.


July 2017September 2017November 2017

 

July 2017

Nashville, TN

 

July 17-20, 2017
8:00 a.m. - 5:00 p.m.


HYATT PLACE Nashville/ Brentwood
202 Summit View Drive
Brentwood, TN 37027
615-661- 9477
Hotel website

Room Rate: $139/night
Room Rate Cutoff: June 16, 2017

 

September 2017

Minneapolis, MN

 

September 25-28, 2017
8:00 a.m. - 5:00 p.m.


SpringHill Suites Minneapolis-Saint Paul Airport/Mall of America
2870 Metro Drive
Bloomington, MN 55425
952-854-0300
Hotel Website

Room Rate: $134/night
Room Rate Cutoff: August 24, 2017

 

November 2017

Chicago, IL

 

November 13-16, 2017
8:00 a.m. - 5:00 p.m.


Four Points by Sheraton Buffalo Grove
900 W. Lake Cook Road
Buffalo Grove IL  60089
847-215-8883
Hotel Website

Room Rate: $109/night
Room Rate Cutoff: October 23, 2017

 

 

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Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic Version

Course Outline-Agenda (Days 1-3)

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

  • Requirements for CAH designation
  • Limitations on acute care beds and length of stay
  • Inpatient rehabilitation and psychiatric distinct part units (DPU)

 

Module 2: Medicare Overview and Resources

  • Overview of Medicare Parts A, B, C, and D
  • Medicare source laws, including statutes and regulations
  • Medicare sub-regulatory guidance, including manuals and transmittals
  • Links to Medicare information and resources for staying current
  • Medicare Administrative Contractors (MAC), Recovery Auditors (RA), and other audit contractors

 

Module 3: Coverage of Hospital Outpatient Services

  • Incident-to coverage of outpatient therapeutic services, including provider-based departments
  • Physician supervision requirements and definitions
  • Coverage requirements for outpatient diagnostic services
  • Coverage of observation services

 

Module 4: Medical Necessity, Coverage Determinations, and Notice Requirements

  • Medicare Coverage Center, including local coverage determinations (LCD), national coverage determinations (NCD), and coverage with evidence development (CED)
  • Limitations of liability statute and notice requirements
  • Advance beneficiary notice (ABN) for outpatient services
  • Billing non-covered outpatient services

 

Module 5: Medicare Claims Submission Fundamentals

  • UB-04 claim form and key fields applicable to a CAH
  • Medicare claims flow, including timely filing
  • Outpatient repetitive, non-repetitive, and recurring services
  • Outpatient services billed separately from inpatient claims

 

Module 6: Medicare Edit Systems

  • Outpatient Code Editor (OCE) and Medicare Code Editor (MCE)
  • 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 7: Observation, Outpatient Visits, and Therapy Services

  • Billing observation services
  • E/M coding for clinics, emergency departments, critical care, and trauma activation
  • Proper use of modifier -25
  • Outpatient therapy services, including therapy caps and functional status reporting

 

Module 8: Outpatient Surgical and Radiology Services

  • Multiple procedure discounting for surgical and radiology services for Method II billing
  • Terminated/discontinued and bilateral procedures
  • Special considerations for inpatient-only procedures and reduced cost devices
  • Never-event procedures

 

Module 9: Outpatient Drugs and Laboratory Services

  • Coverage of drugs, including self-administered drugs and discarded drugs
  • NCD manual for laboratory services
  • Reference laboratory services
  • Blood and blood products
  • Payment and patient responsibility for laboratory services

 

Module 10: Overview of the Cost-Based Reimbursement System

  • Components of the cost-based system
  • Method I and Method II billing
  • CRNA pass-through exemption
  • Patient responsibility, including outpatient deductible and coinsurance

 

Module 11: Coverage and Billing for Hospital Inpatient Services

  • Inpatient criteria and the 2-midnight benchmark
  • Inpatient order and certification requirements
  • Utilization review determinations and condition codes 44 and W2
  • Inpatient Part B billing requirements
  • Inpatient coverage, including Hospital Issued Notices of Non-Coverage (HINN)
  • Patient responsibility, including inpatient deductible, coinsurance, and lifetime reserve days

 

Module 12: Coverage and Billing for Swing Bed Admissions

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


Rural Health Clinic Version Add-On - Optional Day 4

Module 1: Medicare Overview and Resources

  • Overview of Medicare Part A, B, C, and D
  • Medicare source laws, including statutes and regulations
  • Medicare sub-regulatory guidance, including manuals and transmittals
  • Links to Medicare information and resources for staying current

 

Module 2: Rural Health Clinics - Background and General Information

  • Definition of a rural health clinic (RHC)
  • Certification criteria, including location, staffing, and required services
  • Definition of a provider-based RHC

 

Module 3: Qualified Healthcare Professionals and Related Services

  • Covered RHC services
  • Commonly furnished services by physicians, including "incident to" and requirements for direct supervision
  • Basic requirements for services furnished by or “incident to” a physician assistant, nurse practitioner, and certified nurse midwife
  • General requirements for coverage of a visiting nurse service
  • Basic requirements for services provided by a clinical psychologist and clinical social worker
  • Services that are excluded from the RHC benefit

 

Module 4: General Billing Requirements for RHC Services

  • Type of Bill (TOB), revenue codes, and HCPCS codes
  • Billing for preventive services
  • Correct billing for special services offered by an RHC
  • Billing for laboratory services
  • Special circumstances for split-billing claims

 

Module 5: Reimbursement for RHC Services

  • Identification of an "encounter" for payment purposes
  • Basic all-inclusive rate (AIR) reimbursement methodology for provider-based RHCs and independent RHCs
  • Application of Part B deductible and coinsurance

 

Course Outline-Agenda subject to change.

Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic 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
  • Discuss how documentation of patient care affects billing of the services the provider renders
  • Explain how Medicare pays for inpatient and outpatient services
  • Employ outpatient and inpatient status rules and regulations

Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic 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 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 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 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 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 State Boards of Accountancy (NASBA)

Earn up to 27 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®—Critical Access Hospital and Rural Health Clinic Version

Questions/Answers

What is the focus of the Medicare Boot Camp®—Critical Access Hospital and Rural Health Clinic Version?
The Medicare Boot Camp—Critical Access Hospital and Rural Health Clinic Version is a four-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 and Rural Health Clinic 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 customerservice@hcpro.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 customer service at 800-650-6787 or email customerservice@hcpro.com.