Medicare Boot Camp®—Physician Services Version

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Medicare Boot Camp®—Physician Services Version

Product Code: MBCP


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

Register for this Boot Camp and get a 30-day free trial to Revenue Cycle Advisor. See below for more details!

Medicare Boot Camp®—Physician Services Version

Course Overview

*This Boot Camp purchase entitles you to a 30-day trial membership to Revenue Cycle Advisor (Basic). See below for more details!

Physician practices are under increasing financial pressure, and Medicare accounts for a large portion of their revenue. The Medicare Boot Camp®—Physician Services Version teaches you the basics of navigating Medicare regulations and guidelines applicable to professional services.

Whether you’re in a physician practice or a hospital that is taking on a larger role in managing physician practices, the Medicare Boot Camp—Physician Services Version will help you avoid basic compliance pitfalls and costly mistakes. Apply concepts learned immediately with true-to-life case studies that accompany each module.

You’ll walk away from this three-day course with a complete understanding of the unique nuances of documentation and billing topics, including:

  • E/M services
  • "Incident to" billing and reimbursement for nonphysician practitioner services
  • How to research Medicare regulations and guidance
  • Participation in Medicare
  • Understanding the mechanics of the Medicare Physician Fee Schedule
  • Completion of the CMS-1500 claim form
  • Advance beneficiary notices (ABN)
  • National Correct Coding Initiative (NCCI)
  • Global surgery rules
  • Diagnostic testing rules
  • Teaching physician rules
  • Appeals process

 

Instructors teach directly from the Medicare regulations and provide full citations so that you can find the rules yourself after the Boot Camp is over. 

You will leave this program knowing how to:

  • Employ CMS guidelines to ensure proper reporting
  • Explain appropriate billing for professional services in many different scenarios
  • Identify compliance pitfalls and prepare for potential audits
  • Describe requirements for efficient processes that lead to increased productivity
  • Examine Medicare coverage guidelines, including the general types of physician services covered
  • Recognize specific Medicare coverage requirements for certain services
  • Interpret payment principles for physician services, allowing for a reasonably anticipated projected income stream

 

Who should attend?

  • Medical practice managers
  • Billers and coders
  • Medical records managers and staff
  • Health information managers and staff
  • Clinical managers and department heads
  • Finance and reimbursement managers and staff
  • Physicians
  • Nurse practitioners
  • Physician assistants
  • Compliance officers and auditors
  • Medicare carrier personnel
  • Healthcare consultants, CPAs, and lawyers
  • 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 professional 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 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.


*FREE TRIAL
By registering for this boot camp, you will receive a free 30-day trial to Revenue Cycle Advisor (Basic), a comprehensive website that combines all of HCPro's Medicare regulatory and reimbursement resources into one, giving you a single, trustworthy tool to help you navigate the ever-changing Medicare landscape. For more information regarding this association, click here: http://revenuecycleadvisor.com.

Medicare Boot Camp®—Physician Services 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, call Customer Service at (800) 650-6787.

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here.

 

November 2018


Las Vegas, NV

 

November 5 - 7, 2018
8:00AM – 4:00PM each day

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


Room Rate: $139/night
Room Rate Cut-Off: October 22, 2018

Medicare Boot Camp®—Physician Services Version

Course Outline/Agenda

Module 1: Medicare Overview and Resources

  • Overview of Medicare Part A, B, C, and D
  • Medicare Contractors, including MAC, RAC, and QIO
  • 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 2: Medicare Participation

  • Medicare physician/supplier enrollment process.
  • Medicare enrollment form to use – which form is appropriate?
  • Reporting NPIs on Medicare claims
  • Participation and non-participation in the Medicare program
  • “Opting out” of the Medicare program
  • Assigned versus non-assigned claims
  • “Limiting charge” rules and the implications assigned and non-assigned claims


Module 3: CMS Quality/Value Based Payment Incentives

  • Quality programs, Value Based Payment, and the CMS Quality Initiative
  • Current quality programs under Medicare for physician practices: PQRS, Meaningful Use, & Value-Based Payment Modifier
  • MACRA and the associated value based payment programs (MIPS, APM’s, PFPM’s)


Module 4: Medical Necessity and Non-Coverage

  • Social Security Act “Limitation on Liability” provisions and when it applies
  • Situations in which ABN is necessary to hold the patient responsible for non-covered services
  • Circumstances under which an ABN would be ineffective/invalid
  • When is it inappropriate to present an ABN to a patient
  • Circumstances where a routine ABN is permitted
  • Appropriate reporting of ABN modifiers


Quiz 1: Overview, Participation, VBP Incentives and Medical Necessity

Module 5: CMS 1500, ICD-10-CM, NPI and other must-know billing fundamentals

  • Role and functions of the Medicare Administrative Contractor (MAC)
  • MAC jurisdiction for services furnished to a Medicare beneficiary
  • CMS-1500 data set instructions and proper reporting of services provided
  • Proper reporting of site of service and the effect on payment
  • Overview of how SNF consolidated billing and how it effects billing for professional services furnished to SNF residents
  • Reassignment relationships and when they are permissible under the Medicare reassignment regulations/guidelines


Module 6: Overview of the Resource Based Relative Value Scale (RBRVS)

  • Medicare payment and the physician fee schedule
  • Using relative value file/physician fee schedule database to make operational decisions
  • Medicare’s annual deductible and coinsurance and the effect on beneficiary liability and payment to practitioners-22
  • Proper use of modifier -22 and -52 and the effect on reimbursement


Module 7: NCCI, MUEs, Modifiers and Other Must-Know Billing Fundamentals

  • NCCI edits, composition and application
  • Differentiate between the Column 1/Column 2 and the Mutually Exclusive code edits.
  • Determine special considerations and practical issues for practitioners related to NCCI edits.
  • Determine when an NCCI edit will apply to a claim.
  • Determine the correct way to bill for a code pair that is subject to an NCCI edit including appropriate use of modifiers.


Quiz 2: CMS 1500, RBRVS and NCCI

Module 8: Evaluation and Management Services: The Most Commonly Billed Physician Service

  • Appropriate billing for E/M services furnished to a hospital inpatient
  • Determine the appropriate way to bill for E/M services furnished to a hospital observation patient.
  • Appropriate reporting of E/M services furnished in an emergency department
  • Appropriate reporting of E/M services furnished to a nursing facility patient
  • Medicare’s approach to consultations
  • Appropriate billing for critical care, concurrent care, care management, behavioral integration and care plan oversight services


Module 9: Surgical services for physicians: Modifiers and More

  • Global surgical package –inclusion and exclusion of services
  • Determine the applicable postoperative period of a procedure
  • Appropriate billing for services furnished during the postoperative period that are not included in the surgical package, including the use of appropriate modifiers
  • Multiple procedure reduction and its application to a particular Medicare claim
  • Appropriate billing for bilateral surgeries, assistant surgeons, co-surgeons and team surgeons
  • Determine the appropriate way to bill for assistant surgeons, co-surgeons and team surgeons


Module 10: Clinical Lab, Radiology and Other Diagnostic Services

  • Determine when the professional and technical component services for a diagnostic test are separately billable
  • Determine when and how to use modifiers to appropriately bill for professional and technical component services
  • Physician supervision required for a particular diagnostic test
  • Bill appropriately for diagnostic radiology services in a professional practice setting
  • Application of multiple procedure payment reduction and calculation of its effect on reimbursement
  • CLIA requirements applicable for laboratory services furnished in a professional practice setting
  • Locate and effectively use the clinical diagnostic laboratory services fee schedule and the national coverage determinations (NCDs) applicable to clinical laboratory services


Quiz 3: E/M, Surgical and Diagnostic Services

Module 11: Non-Physician Practitioner and Therapist Services

  • Medicare’s recognition of Non-physician practitioners
  • “Incident to” and “split/shared” coverage of NPPs services
  • NPP services that qualify for “incident to” coverage
  • Circumstances when NPP services may appropriately billed under “split/shared” coverage rules


Module 12: Physicians at teaching hospitals: Teaching physician issues

  • Overview of Medicare coverage of services provided by interns and residents.
  • Situations in which a teaching/attending physician’s presence is required when residents are involved in patient care.
  • Appropriate billing for resident involvement of patient care (including the appropriate use of modifiers).
  • Documentation requirements applicable to teaching/attending physician services when residents are involved in patient care.
  • Appropriately bill for services furnished by an intern or resident functioning as an assistant surgeon.
  • Determine if Medicare payment is available for services furnished by a particular moonlighting resident


Module 13: When the Medicare payment is not what you expect: audits and appeals

  • Overview of the Medicare program integrity function applicable to services furnished in a professional practice setting.
  • Comprehensive Error Rate Testing program.
  • Proper Response for Audit and Record Request
  • Overview of the Medicare Part B appeals process


Module 14: Medicare coverage of preventive health services

  • Initial Preventive Physical Exam
  • Annual Wellness Visits
  • Medicare Coverage of Screening Services
  • Medicare Diabetes Prevention Program


Quiz 4: Non-Physician Practitioner services; audit and appeals, teaching physicians and preventive services

Medicare Boot Camp®—Physician Services Version

Learning Objectives

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

  • Employ CMS guidelines to ensure proper reporting
  • Explain appropriate billing for professional services in many different scenarios
  • Identify compliance pitfalls and prepare for potential audits
  • Describe requirements for efficient processes that lead to increased productivity
  • Examine Medicare coverage guidelines, including the general types of physician services covered
  • Recognize specific Medicare coverage requirements for certain services
  • Interpret payment principles for physician services, allowing for a reasonably anticipated projected income stream

Medicare Boot Camp®—Physician Services Version

AAPC
This program has been approved by the AAPC for 20.5 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 19 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 Commission on Accreditation.

This educational activity for 21 nursing contact hours is provided by HCPro.

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

National Association of State Boards of Accountancy (NASBA)
Earn up to 25 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®—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. 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?

Cancellation Policy
Please click here to view our cancellation policy.

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?

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 professional practice setting. 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.

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

HCPro offers the 2016 edition of the CPT manual (published by the AMA) on HCMarketplace.

Optum publishes a manual called CPT Expert. We recommend against using it 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

 

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.