Medicare Boot Camp® - Hospital Version

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Medicare Boot Camp®—Hospital Version

Product Code: MBCH

1st Attendee $1,699.00*
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To register multiple attendees, please call our sales team at 615-724-7200.

Medicare Boot Camp® - Hospital Version

Course Overview

Gain insight into the CMS initiatives affecting your revenue in 2019 by joining the nation’s leading Medicare experts for the Medicare Boot Camp®—Hospital Version.

From changes to the inpatient-only list to new guidance on charity care and pressure on drug payments, it’s the finest details of recent CMS updates that may cause compliance traps in 2019. Delve into the details of regulatory changes to understand the revenue implications and implement the new guidance. Medicare Boot Camp—Hospital Version unlocks all of the answers to your Medicare questions by teaching you the latest rules and their application.

Medicare Boot Camp—Hospital Version prepares you to better manage your revenue cycle and government audits by focusing on real guidance from CMS. You’ll leave class ready to make improvements that will strengthen reimbursement and compliance for your hospital or health system. And you’ll have the research tools and skills at your fingertips to answer your own Medicare questions long after the Boot Camp is over.

Comprehensive sections explain the complexities of:

  • The 2-midnight benchmark and presumption
  • Coverage under NCDs, LCDs, and CED
  • Inpatient order requirements
  • Inpatient-only procedures, including changes for 2019
  • Outpatient coverage and physician supervision
  • Observation coverage, billing, and payment
  • Correct use of condition codes 44 and W2
  • NCCI edits, including PTP edits and MUEs
  • Payment under the OPPS and IPPS
  • Patient deductible and copayment amounts
  • ABNs, HINNs and billing non-covered services
  • Medicare websites and resources

You will leave this program knowing how to:

  • Prevent inpatient denials
  • Conduct compliant "self-audits" for Part B inpatient payment
  • Properly use and bill for observation services
  • Research and resolve claim edits that delay revenue
  • Prevent outpatient denials and missed revenue
  • Implement best practices to get the revenue you deserve while staying in compliance

Who should attend?

  • 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


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.

Medicare Boot Camp—Hospital Version

Course Locations & Dates

Below is the current course schedule for upcoming classes of Medicare Boot Camp—Hospital 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, fill in the "Additional Attendees" box or call our sales team at 615-724-7200 or email us at

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.  

November 2019

Phoenix, AZ


November 11 - 15, 2019
8:00 a.m. - 5:00 p.m. (Days 1-4)
8:00 a.m. - 1:00 p.m. (Day 5)

Hyatt Place Phoenix/Chandler-Fashion Center
3535 W. Chandler Boulevard
Chandler, AZ 85226
480-812- 9600
Hotel website

Room Rate: $125/night
Room Rate Cut-Off: October 21, 2019


December 2019

Orlando, FL


December 2 - 6, 2019
8:00 a.m. - 5:00 p.m. (Days 1-4)
8:00 a.m. - 1:00 p.m. (Day 5)

Hilton Garden Inn Orlando International Drive North
5877 American Way
Orlando, FL 32819
Hotel website

Room Rate: $105/night
Room Rate Cut-Off: November 8, 2019



Medicare Boot Camp® - Hospital Version


  • 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
    • Links to Medicare resources and resources for staying current
  • Module 3: Coverage of Hospital Outpatient Services 
    • Incident-to coverage of outpatient therapeutic services
    • Physician supervision requirements and definitions
    • Coverage of observation services 
    • Coverage of drugs, including self-administered drugs
    • Coverage requirements for outpatient diagnostic services
  • Module 4: Coverage of Hospital Inpatient Services
    • Inpatient order and certification requirements
    • Inpatient criteria and the 2-Midnight Benchmark 
    • Admission on a case-by-case Basis
    • Documentation and use of screening tools
    • Utilization review determinations and short stay audits 
    • Inpatient Part B payment
  • Module 5: Medicare Notices
    • Delivery of the Medicare Outpatient Observation Notice (MOON)
    • Important Message from Medicare (IMM) and Detailed Notice of Discharge
    • Limitations of liability statute and notice requirements
    • The Advance Beneficiary Notice (ABN) form and instructions
    • Hospital Issued Notices of Non-Coverage (HINN)
  • Module 6: Medicare Claims Submission Fundamentals 
    • Claim fields with special instructions
    • Medicare Secondary Payer principles, including liability claims
    • Adjustment claims and automated reopenings
    • Medicare claims flow
  • Module 7: Medicare Edit Systems
    • Outpatient Code Editor (OCE) and Medicare Code Editor (MCE) 
    • National Correct Coding Initiative (NCCI)
    • Procedure to Procedure (PTP) edits and modifiers
    • Medically Unlikely Edits (MUE) and Add-on code edits
  • Module 8: Medicare Billing Issues
    • Outpatient repetitive, non-repetitive, and recurring services
    • Three-day payment window; outpatient services billed on inpatient claims
    • Billing of non-covered outpatient services
    • Treatment of conditions arising during or from a non-covered stay
  • Module 9: Medicare Outpatient Payment Systems 
    • Outpatient Prospective Payment System (OPPS)
    • Addendum B and D to determine the payment status of a HCPCS code 
    • Addendum A and Ambulatory Payment Classifications (APCs)
    • Comprehensive APC (C-APC) basic rules
    • Payment under the OPPS, including patient coinsurance and outlier
    • Payment for therapy under the Physician Fee Schedule, including therapy caps
    • “Sometimes” and “always” therapy codes
    • Payment for labs under the Laboratory Fee Schedule, including reference lab
  • Module 10: Outpatient Surgical Services, including Implantable Devices
    • Inpatient-only procedures
    • Surgical C-APCs, including complexity adjustment
    • Multiple procedure discount for minor surgical services
    • Terminated/discontinued and bilateral procedures
    • Device intensive procedures and procedure-to-device edit
    • Pass-through devices
    • Value code FD for free and reduced-cost devices
  • Module 11: Outpatient Visits and Observation Services
    • Coding for clinics, emergency departments, critical care and trauma activation
    • Proper use of modifier 25
    • Payment for off-campus “non-excepted” department services
    • Billing of observation services
    • Observation Comprehensive APC Payment
  • Module 12: Special Billing Issues for Outpatient Diagnostics, Drugs and Therapy
    • Packaged, pass-through and non-pass-through drugs and biologicals
    • Proper use of modifier JG and TB
    • Discarded Drugs
    • Biosimilar products
    • Biological skin substitutes
    • Radiation Therapy 
    • Imaging Family Composite APCs
    • Special Radiology Modifiers
    • Laboratory billing and coding issues, including date of service
    • Blood and blood products
    • Outpatient therapy functional status reporting
  • Module 13: Inpatient Payment and Patient Responsibility
    • Inpatient Part A payment and the Inpatient Prospective Payment System (IPPS)
    • Medicare-severity diagnosis related groups (MS-DRG)
    • Complications and co-morbidities and the effect of a hospital-acquired condition (HAC)
    • Inpatient deductible, coinsurance, and lifetime reserve days
  • Module 14: Inpatient Prospective Payment System (IPPS) Adjustment Factors
    • Standardized amount adjustments: Hospital Quality Reporting Program and Electronic Health Record (EHR) Meaningful Use
    • Quality adjustments: Value-Based Purchasing (VBP) Program, Hospital Readmissions Reduction Program (HRRP), and HAC Reduction Program
    • Payment add-on for New Technology 
    • Medicare inpatient pricer
    • Payment for transfers and post-acute care transfers

Course Agenda/Outline is subject to change.

Medicare Boot Camp® - Hospital 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 hospitals
  • Describe limitations on coverage under the Medicare program
  • Recognize the effect of coding rules on the services the provider reports
  • Explain how Medicare pays for inpatient and outpatient services
  • Explain Medicare deductibles and copayments for hospital inpatient and outpatient services
  • Employ inpatient and outpatient status rules and regulations

Medicare Boot Camp® - Hospital Version

Continuing Education

This program has been approved by the AAPC for 34.5 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 34 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’s Commission on Accreditation.

This educational activity for 34.5 nursing contact hours is provided by HCPro.

Association of Clinical Documentation Improvement Specialists (ACDIS)
This program has been approved for 34.5 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).

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 41.4 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 34.5 hours of continuing education credit to CCM board certified case managers.

Compliance Certification Board (CCB)
The Compliance Certification Board (CCB) has approved this event for up to 41.4 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this program content or of the program sponsor.

National Association of Healthcare Revenue Integrity (NAHRI)
This program has been approved for 34.5 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).

National Association of State Boards of Accountancy (NASBA)
Earn up to 41 CPE Credits!
Program Level: Basic
Delivery Method: Group-Live
Field of Study: Specialized Knowledge

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:

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® - Hospital Version


What is the focus of the Medicare Boot Camp?
Medicare Boot Camp—Hospital Version is an intensive, five-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," placing a particular emphasis on the operational 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 this course prepare participants for coding certification?
Medicare Boot Camp—Hospital 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, while 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 information, please review the information for these courses using the links above, or contact customer service at 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—Hospital Version 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

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-10-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 our sales team at 615-724-7200 or email

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.