Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version

Overview

Master the Complexities of FQHC Billing, Compliance, and Reimbursement

Federally Qualified Health Centers (FQHCs) face a unique set of challenges when billing Medicare, from navigating complex coding requirements to addressing eligibility and coordination of benefits. The high-risk nature of serving both insured and uninsured populations makes accurate billing crucial to avoid financial pitfalls and ensure proper reimbursement.

The Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version is an intensive two-day course that will provide comprehensive education on Medicare coverage, coding, billing, and payment regulations and guidelines for Federally Qualified Health Centers (FQHCs).

Our expert instructors provide in-depth education on common issues—eligibility problems, coding for non-qualifying visits, date of service errors, and incorrect coding, and more—that lead to rejected or denied claims, extend accounts receivable days, and impact your revenue cycle.

What You’ll Learn:

• Identify and manage non-qualifying visits: Learn how to recognize services that do not meet Medicare's criteria for qualifying visits and understand how to correctly document, code, and bill for these services to minimize rejections and ensure proper reporting.
• Master FQHC-specific coding requirements: Learn how to accurately use HCPCS codes for qualifying visits and properly pair them with CPT codes to meet Medicare’s unique billing requirements for FQHC and non-FQHC services, minimizing claim rejections and delays in reimbursement.
• Navigate claims for dually eligible beneficiaries: Learn how to coordinate benefits for patients with both Medicare and Medicaid, minimizing rejections due to eligibility or payer issues.
• Bill for telehealth and mental health services: Stay updated on recent regulatory changes and how to correctly bill for these high-demand services under Medicare’s evolving rules.
• Navigate "incident-to" billing complexities: Understand the specific requirements for billing "incident-to" services in FQHCs, including supervision rules, documentation standards, and the differentiation between bundled services and those eligible for separate billing, ensuring compliance and ensuring reimbursement.
• Gain comprehensive knowledge of the CMS-1450 (UB-04) claim form: Learn how to report multiple payment codes, navigate the Integrated Outpatient Code Editor (IOCE), and submit claims for dually eligible beneficiaries and Medicare Advantage plans, ensuring accurate billing and compliance.
• Differentiate between FQHCs and RHCs: Understand the differences in billing, coding, and reimbursement between Federally Qualified Health Centers and Rural Health Clinics (RHCs).

Take Action
Don’t let claim rejections and denials keep your FQHC from receiving the payments it deserves. HCPro’s Medicare Boot Camp provides in-depth, practical training on Medicare’s ever-evolving billing requirements and equips you to overcome the specific challenges faced by FQHCs.

Register today to secure your spot in this essential training program tailored specifically for Federally Qualified Health Centers!

How does the live virtual Medicare Boot Camp®—Federally Qualified Health Center Version work?

Class is held Monday – Wednesday for 1 week from 11:30 p.m. – 5:00 p.m. Eastern Time (3 classes).

Please Note: Four days before class starts, you will receive a welcome email that includes the dial-in information for the class.

Class is held Monday – Wednesday from November 11  – November 13. Registration cut-off date: 11/4/2024

Looking to train your whole team? Our experts can provide virtual training for your organization! Learn more here!

For more information about our Boot Camps, contact us at 800-650-6787 or email sales@hcpro.com.

Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version

Course Outline

Module 1: Review of Medicare Contractors, Research, and Resources

• Overview of Medicare Parts A, B, C, and D
• Role of Medicare contractors
• Medicare source laws, including statutes and regulations
• Medicare subregulatory guidance, including manuals and transmittals
• Links to Medicare information and resources for staying current

Module 2: Review of Medicare Coverage Guidance and the Advance Beneficiary Notice

• Medicare Coverage Center, including NCDs, LCDs, and Laboratory Manual
• Coverage of drugs, including self-administered drugs
• Limitations of liability statute and notice requirements
• Advance Beneficiary Notice and instructions

Module 3: Designation as an FQHC, Including Required Practitioners and Services

• Definition and purpose of an FQHC
• Differentiating between an FQHC and an FQHC look-alike
• Certification criteria, including location, staffing, and required services
• Requirements for services furnished by the FQHC or incident to an FQHC practitioner
• Services excluded from the FQHC benefit
• Distinguishing between an independent and a provider-based FQHC

Module 4: General Billing Requirements for FQHCs

• Overview of the CMS-1450 (UB-04)
• Claims processing requirements, including type of bill, revenue codes, HCPCS codes, modifiers, and charge reporting
• Global billing and the applicability to FQHCs
• Reporting multiple specific payment codes (G codes)
• Integrated Outpatient Code Editor and the applicability to FQHCs
• HCPCS coding specific to Medicaid
• Claim submission for dually eligible beneficiaries
• Billing for supplemental payments to FQHCs under contract with Medicare Advantage plans

Module 5: Coverage and Billing of FQHC Visits

• Medical and mental health visits
• Special services: diagnostic services, vaccines, injections, and other incident-to services
• Laboratory services
• Preventive health services
• Care management services
• Diabetes self-management training and medical nutrition services
• Hospice attending physician services
• Dental, podiatry, optometry, and chiropractic services
• FQHC practitioners and Appropriate Use Criteria

Module 6: Coverage and Billing of FQHC Services Provided Outside the FQHC

• Visiting nurse services
• Telehealth services
• Virtual communications

Module 7: Reimbursement Principles for FQHCs

• Identification of qualifying visits for payment purposes
• FQHC PPS payment rate and adjustments
• FQHC-specific payment codes
• Application of the Medicare Part B deductible and coinsurance
• Graduate medical education payments

Course agenda/outline is subject to change.

Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version

Schedule

November — Class Schedule (Eastern time)

Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version

Learning Outcomes

• At the conclusion of this educational activity, participants will be able to:
• Summarize the Medicare program, benefit categories, and the role of the Medicare functional contractors
• Locate and apply Medicare law, regulation, and subregulatory guidance for claim submission, appeal, and audit defense
• Locate and identify national and local coverage determinations and explain their role in medical necessity
• Understand the Advance Beneficiary Notice, its instructions, and appropriate use
• Explain and summarize the definition of an FQHC
• Analyze the FQHC requirements related to location, staffing, and required services
• Differentiate between FQHC and non-FQHC services
• Compare and contrast FQHCs and FQHC look-alikes
• Identify FQHC qualifying visits and summarize the importance of accurate reporting
• Examine Medicare “incident-to” and supervision requirements for services performed in an FQHC
• Understand Medicare’s FQHC billing and coding requirements, illustrating an understanding of bill type, revenue, HCPCS codes, and modifiers
• Identify and accurately bill for non-FQHC services, demonstrating an understanding of the appropriate Medicare benefit category and Medicare payment methodology
• Interpret integrated outpatient code edits applicable to FQHCs
• Examine and appropriately use FQHC-specific payment codes
• Analyze claim submission requirements for dually eligible beneficiaries
• Understand the FQHC prospective payment methodology (FQHC PPS), accurately determining Medicare reimbursement and patient cost sharing
• Summarize the billing process for supplemental payments to FQHCs under contract with Medicare Advantage plans
• Differentiate requirements, coding, billing, and reimbursement principles of clinics, RHCs, and FQHCs

Continuing Education

*Coming Soon! 

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.

Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version

Things to Know Before Attending Class

What Is Included With Your Purchase

When you purchase a seat for our live virtual Boot Camps, you get online access for one participant to the live sessions, a hard copy of our printed workbook materials, and access to the recordings of the sessions. HCPro reserves the right to revoke your access if we find that you are sharing your login or any of the class information.

Course Materials

You will receive a hard copy of the class materials. These will be shipped to you via UPS. If ordering on our website, please be sure to enter the physical address of where these materials should be shipped to. If you order over the phone or if you are unsure of what address we have on file, please ask the person you are speaking with to verify your address information and update accordingly or call our customer service department. Materials should arrive approximately two business days prior to the start of class.

Virtual Boot Camp Platform

We use GoToMeeting to present our virtual Boot Camps. To ensure your system supports GoToMeeting, use this link: https://support.goto.com/meeting/system-check. We will send out access information for the class four business days prior to the class start and again one business day prior.

Session Recordings

You will have access to the recordings of each class session via a password-protected page on our website. You will be given the page location in your welcome email. Recordings will be added to the page within one business day following the live session. You will have access to this page for 60 days after the final live session.

Continuing Education Credits

To receive continuing education credits, you will be required to successfully complete a 40-question quiz that is based off of the content covered throughout the course. Successful completion is achieved by getting at least 80% of the multiple-choice questions correct.

What to Bring to Class

We suggest that you have the following available during the class: 

• Highlighter
• Note paper
• Sticky notes/flags
• Pen/pencil

Contact Information

For more information about our Boot Camps, contact us at 800-650-6787 or email sales@hcpro.com.

We look forward to having you in class!

Live Virtual Medicare Boot Camp®—Federally Qualified Health Center Version

Questions and Answers

What is the focus of the live virtual Medicare Boot Camp®—Federally Qualified Health Center Version?
The Medicare Boot Camp—Federally Qualified Health Center Version is an intensive three-day course that will provide comprehensive education on Medicare hospital coverage, coding, billing, and payment regulations and guidelines for Federally Qualified Health Centers (FQHC).

What computer setup do I need to attend this class?
This class will be hosted on the GoToMeeting platform. Attendees should have access to a computer that has a microphone and speakers to participate; there is also an option to dial in over a phone line if you need to connect on your phone. You can read the full system requirements for GoToMeeting by visiting https://support.goto.com/meeting/help/system-requirements-for-attendees-g2m010003. You can also test your system by visiting https://support.logmeininc.com/gotomeeting/get-ready.

Does HCPro offer on-site sessions of the live virtual Medicare Boot Camp—Federally Qualified Health Center Version?
In addition to our live virtual courses, we also offer Medicare Boot Camp—Federally Qualified Health Center Version as an on-site program (with a substantial discount) for organizations with a number of employees who need training. For more information on hosting an on-site course, click on Train Groups On-Site.

What if I need to cancel or transfer my registration?
To view our cancellation policy, please click here.

Who typically attends Medicare Boot Camp—Federally Qualified Health Center Version?

• Auditors and analysts
• Billing specialists
• Chief financial officers
• Clinic managers
• Coding specialists
• Compliance officers
• Finance and reimbursement managers
• FQHC clinic revenue cycle, compliance, case management, and clinical personnel
• Healthcare consultants, CPAs, and lawyers
• Health plan financial analysts, claims processing, and provider relations professionals
• Medicare Administrative Contractors
• Patient access/front office staff
• Physician advisors
• Recovery audit coordinators

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.

How is the course taught?
The course is taught using a combination of lecture, class discussion, and case studies.

What should I have available for each session?
For each class, participants should have their packet of materials and may wish to also have available a highlighter, a notebook for taking notes, and sticky notes/flags.

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 us at 800-650-6787 or email sales@hcpro.com.