Revenue Integrity and Chargemaster Boot Camp

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Revenue Integrity and Chargemaster Boot Camp

Product Code: CHBC


1st Attendee $1,499.00*
Additional Attendee(s)
Save $0.00$1,499.00 each

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

Revenue Integrity and Chargemaster Boot Camp

Course Overview

The Revenue Integrity and Chargemaster Boot Camp provides education on chargemaster and revenue integrity concepts in a classroom format. The program will relate the chargemaster function to cost reporting and key operational issues, such as clinical documentation, charge capture, and HIM coding. It will also provide context for chargemaster maintenance within revenue integrity processes, which can help avoid denials and improve clean claim rates for Medicare and other payers. 

You will leave this program knowing how to: 

  • Provide formal, organized education and training for revenue integrity and chargemaster staff 
  • Provide context for the intersection of the chargemaster with clinical/revenue departments, charge capture, finance, and patient access and billing 
  • Walk attendees through CMS regulatory requirements for pricing and charging patients, as well as key relationships between the chargemaster and provider cost reporting 
  • Give detailed instructions for the majority of revenue codes for optimal chargemaster setup, maintenance, charge capture, and documentation issues 
  • Review chargemaster issues for commercial/managed care versus CMS requirements 


Who should attend? 

  • CFOs 
  • Finance directors 
  • Reimbursement managers 
  • Chargemaster coordinators 
  • Patient financial services management and staff 
  • Managed care contracting management and staff 
  • Revenue integrity management and staff 
  • Payer relations staff 
  • HIM directors and managers 
  • Coding directors and managers 
  • Compliance officers, directors, and managers 


See the HCPro difference for yourself! 

Focus on the actual rules: Learn how to find and apply the HIPAA Transaction Sets rules and guidelines that apply to chargemaster and revenue integrity professionals to help ensure accurate and appropriate billing. 

Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research 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 HCPro's Boot Camps, contact customer service at 800-650-6787 or email customerservice@hcpro.com

Revenue Integrity and Chargemaster Boot Camp

Course Locations & Dates

Below is the current course schedule for upcoming classes of this 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, please call Customer Service at (800) 650-6787.

Locations marked as "Tentative" are subject to change.

To view our cancellation policy, click here

June 2017

Philadelphia, PA

 

June 12 - 15, 2017 
8:00 a.m. - 5:00 p.m.

NOTE: This course was designed to complement the June 16 Injections and Infusions Workshop in Philadelphia (East Norriton).

Hyatt House Philadelphia/Plymouth Meeting 
501 E. Germantown Pike
East Norriton, PA 19104
610-313-9990

Hotel Website

Hotel Rate: $149/night 
Hotel Cut-Off: May 22, 2017

 

August 2017

Portland, OR

 

August 21 - 24, 2017
8:00 a.m. - 5:00 p.m.

Hilton Garden Inn Portland Airport
12048 NE Airport Way
Portland, OR 97220
503-255-8600 
Hotel Website

Room Rate: $162/night
Hotel Cut-Off: August 7, 2017


 

December 2017

Dallas, TX

 

December 4 - 7, 2017
8:00 a.m. - 5:00 p.m.

Hyatt Place Dallas-North/by the Galleria
5229 Spring Valley Road
Dallas, TX 75254
972-716-2001 
Hotel Website

Room Rate: $135/night
Hotel Cut-Off: November 19, 2017


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Revenue Integrity and Chargemaster Boot Camp

Course Outline/Full Agenda

  • Module 1:  Revenue Integrity Overview and Resources
    • Revenue integrity functions and key principles including how the chargemaster fits into over revenue integrity functions
    • Medicare and other revenue integrity and chargemaster resources
    • Understanding authoritative sources such as statutes, regulations, manuals, transmittals and other Medicare rules and guidelines
  • Module 2:  Eligibility Principles
    • Review major and different types of medical insurances
    • Principles of health insurance eligibility and verification of insurance
    • Coordination of Benefits & Subrogation
    • Medicare Secondary Payer (MSP) concepts
  • Module 3:  Benefits, Coverage and Medical Necessity
    • Review how insurance benefits are structured for hospital and other services
    • The importance of coverage, medical necessity and both implied and specifically excluded benefits
    • Medicare’s prohibition against unbundling for inpatient and outpatient hospital services
    • Pre-service coverage analysis and associated waiver/notice requirements
    • Serious preventable events and relationship to risk management
    • Investigational/experimental services and implications for coverage
  • Module 4: Provider Types, Licensure, Enrollment, & Privileges
    • Types of facilities, providers, physicians, practitioners and suppliers
    • Provider-based department requirements including implications of Section 603 of the Bipartisan Budget Act of 2015
    • Licensure, scope of practice, privileging and relationship to coverage
    • Conditions of participation, survey & certification and accreditation
    • Importance of medical staff bylaws & regulations and relationship to conditions of payment
  • Exercises:  Concepts of Revenue Integrity
  • Module 5: Charge Description Master Structure and Charge Capture Principles
    • Definition, purpose and key fields of a chargemaster
    • Concepts for code set up in CDMs and relationship to HIM coding
    • Principles of bundled services per CPT definition vs reporting packaged services and implications for separate charging of packaged services
    • Strategies to address payer differences in the chargemaster
    • The relationship of chargemaster to overall AR System
    • Concepts for pricing services and why APCs are not a good gauge for pricing hospital services
    • Chargemaster, general ledger and relationship to cost reporting
  • Module 6: Claims Submission Fundamentals and Code Edits
    • Key UB-04 fields applicable to hospital services
    • HIPAA transaction sets including ICD-10 and HCPCS codes
    • Common claim edits including NCCI and MUEs
    • Other transaction sets applicable to the revenue cycle such as eligibility, payment, claim status and denial transaction sets
  • Module 7:  Special Medicare Billing Issues
    • Billing requirements for outpatient repetitive versus non-repetitive recurring and non-recurring services
    • The three-day payment window and outpatient services billed on inpatient claims
    • Billing of non-covered inpatient and outpatient services
    • Patient status and billing inpatient non-medically necessary services
  • Exercises: CDM Structure, Claims and Billing Issues
  • Module 8: Strategies and Key Issues by Revenue Code: Routine Services and Observation
    • Key concepts for accommodation codes and routine services, including outpatients in beds, specialty care units and observation services
    • Coding and edit issues for revenue codes associated with routine services and observation
    • Major factors of coverage for these services
    • Applicable inpatient and outpatient payment concepts
    • General ledger and finance considerations including pricing and charge capture
  • Module 9:  Strategies and Key Issues by Revenue Code: Ancillary Services
    • Key concepts for major ancillary service departments, including peri-operative services, emergency, cardiology, diagnostic imaging, pharmacy and supplies
    • Coding and edit issues for revenue codes associated with ancillary services
    • Major factors of coverage for these services
    • Applicable inpatient and outpatient payment concepts
    • General ledger and finance considerations including pricing and charge capture
  • Module 10:  Strategies and Key Issues by Revenue Code:  Other Departments
    • Key concepts for other common ancillary service departments, including respiratory therapy, clinics, behavioral health, and preventive services
    • Coding and edit issues for revenue codes associated with other departments
    • Major factors of coverage for these services
    • Applicable inpatient and outpatient payment concepts
    • General ledger and finance considerations including pricing and charge capture
  • Exercises: Routine and Ancillary Services by Revenue Code
  • Module 11:  Introduction to Payment Systems
    • Review inpatient payment systems including DRGs, APR-DRGs, Case Rates and Per Diems
    • Discuss hospital outpatient hospital payment systems including OPPS & APCs, eAPGs, fee schedules and percent of charges
    • Review outpatient surgery payment methodologies such as ASC and ambulatory fee schedules
    • Review other ambulatory service payment systems such as the physician fee schedule (MPFS), DMEPOS, Clinical Lab Fee Schedule
    • Review emerging payment methodologies such as Bundled/Episode Payments (CJR) and Value-Based Purchasing
  • Module 12:  Outpatient Prospective Payment System (OPPS)
    • Understanding OPPS payable services and structure of APCs
    • Learn how to determine whether services are paid separately or packaged
    • Understand C-APCs and complexity adjustments
    • Understand impact of inpatient deductible cap on co-payments for beneficiaries
  • Module 13:  Medicare Physician Fee Schedule (MPFS)
    • The resource-based relative value system
    • Relative value unit (RVU) structure
    • Site of service adjustments for facility and non-facility services
    • Global versus technical and professional components
    • Payment policy indicators
  • Exercises: Payment Systems
  • Module 14: Charge Description Master Management and Maintenance Strategies
    • Issues surrounding the annual chargemaster updates including pricing, HCPCS codes, charge items with no volume
    • Strategies to work collaboratively with departments
    • Importance of patient account and charge reconciliation
    • Tracking CDM changes for compliance
    • Charge integrity monitoring and reducing unexplained variation in claims
  • Module 15:  Denial Management
    • Principles of denial management
    • Adjustment claims and automated provider reopening
    • Initial and revised determinations and appeal rights
    • Levels of appeal and timelines for filing
    • Types of auditors including external auditors from commercial plans
  • Module 16:  Payer Contracting Strategies
    • Concept and criteria for carve out options
    • Importance of tracking administrative cost by payer and developing and trending payer scorecards
    • Contract negotiations and annual price increase limits/caps applicable to chargemaster
  • Exercises: Strategies for CDM Management, Denials and Payer Contracting


Course Outline/Agenda subject to change.

Revenue Integrity and Chargemaster Boot Camp

Learning Objectives

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

  • Equip hospital, payer and other healthcare specialists with effective and efficient strategies to obtain and maintain overall revenue integrity for both governmental and non-governmental payers
  • Gain a working understanding of revenue integrity principles associated with eligibility, coverage, coding, billing and payment using fee-for-service Medicare requirements as a framework
  • Explain standard charge description master (CDM) elements, design and relationship to the general ledger and revenue cycle processes of coding and billing
  • Review claim requirements and specific issues of CDM set-up and maintenance by revenue code with associated cost reporting principles
  • Exemplify outpatient and inpatient hospital prospective payment systems reimbursement and rate setting methodologies as well as appeal strategies to protect revenue

Revenue Integrity and Chargemaster Boot Camp

Continuing Education

AAPC
This program has the prior approval of AAPC for 30 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 30 continuing education units 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 36 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 36 nursing contact hours is provided by HCPro. 

California Board of Registered Nursing 
HCPro is approved by the California Board of Registered Nursing to provide 36 nursing contact hours. California BRN Provider #CEP 14494. 

Commission for Case Manager Certification (CCMC) 
This program has been submitted to The Commission for Case Manager Certification for approval to provide board certified case managers with 30 clock hours. 

Compliance Certification Board (CCB)
The Compliance Certification Board (CCB) has approved this event for up to 38.4 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 State Boards of Accountancy (NASBA) 
Earn up to 36 CPE Credits! 
Program Level: Basic 
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. 

Revenue Integrity and Chargemaster Boot Camp

Questions/Answers

What is the focus of the Revenue Integrity and Chargemaster Boot Camp? 
The boot camp focuses on finding and applying the HIPAA Transaction Sets rules and guidelines that apply to chargemaster and revenue integrity professionals to help ensure accurate and appropriate billing. 

Where is the course offered? 
Open registration sessions of the Revenue Integrity and Chargemaster Boot Camp 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 courses, click on "Locations/Dates" above. 

Does HCPro offer an "on-site" version of this Boot Camp? 
In addition to our open registration courses, we also offer this 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 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 Revenue Integrity and Chargemaster Boot Camp? 

  • CFOs 
  • Finance directors 
  • Reimbursement managers 
  • Chargemaster coordinators 
  • Patient financial services management and staff 
  • Managed care contracting management and staff 
  • Revenue integrity management and staff 
  • Payer relations staff 
  • HIM directors and managers 
  • Coding directors and managers 
  • Compliance officers, directors, and managers 


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. 

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