Live Virtual Medicare Boot Camp®—Denials and Appeals Version

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Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Product Code: MBDV


1st Attendee $899.00*
Additional Attendee(s)
Save $0.00$899.00 each

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$899.00
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* Registration cut-off date: 08/16/2021

To register multiple attendees, please call our sales team at 615-724-7200.

Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Course Overview

Get expert guidance on preventing denials and focusing appeals efforts for success. The evolution of reimbursement models and uncertainty regarding healthcare laws mean that to keep the doors open, organizations can’t afford write off appealable denials. Organizations need sound, practical information on overturning denials. Live Virtual Medicare Boot Camp®—Denials and Appeals Version is your key to proven strategies for success and will answer all of your questions on denials management and appeals processes.

This Boot Camp teaches you about the latest claim audit and appeal issues based on official guidance. You’ll leave the class armed with a thorough understanding of the audit and appeal process and ready to put your new knowledge into action.

You will leave this program knowing how to:

  • Prepare for CMS audits
  • Navigate the appeals process up to the Administrative Law Judge level
  • Research denials and upcoming audit focus areas
  • Implement policies to support efficient appeals and identify appropriate denials to appeal


Who should attend?

  • Revenue cycle directors and managers
  • Revenue integrity directors, managers, and staff
  • HIM directors, managers, and staff
  • CDI directors, managers, and specialists
  • Compliance directors, officers, and auditors
  • Business office managers
  • Case management directors and managers
  • Case managers
  • Utilizations review staff
  • Utilization management staff
  • Physician advisors
  • Audit directors and coordinators
  • Auditors
  • Appeals coordinators
  • Patient financial services directors


How does the Live Virtual Medicare Boot Camp®—Denials and Appeals Version work?

This class is five sessions. Class is held Monday – Friday from 12:30 p.m. – 4:00 p.m. Eastern Time.

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 – Friday from August 23 – August 27. Registration cut-off date: 8/16/2021

Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Outline/Agenda

Module 1: Medicare Overview and Resources

  • The Four Parts of Medicare
  • Medicare Contractors
  • Independent Government Agencies-Medicare Involvement


Module 2: Medicare Research and Resources

  • Web-Based Resources
  • Key Sources of Authority
  • Medicare Coverage Center, including LCDs NCDs, CED and Lab Coverage Manual
  • Ways to Stay Current 


Module 3: Medicare Program Safeguards and Medicare Notices

  • Medicare Policy Development, Financing, the Trust Funds, the need for Program Safeguards
  • Improper Payments
  • Program Safeguards
  • Limitation on Liability provisions of the Social Security Act  
  • Notices of Non-Coverage


Module 4: Prepayment Claim Reviews/Audits

  • Prepayment Reviews Overview
  • Automated Prepayment Reviews
  • Prepayment Non-Medical Record Reviews
  • Prepayment Medical Record Reviews 


Module 5: Postpayment Claim Reviews/Audits

  • Establishment of Postpayment Claim Review/Audits Process
  • Postpayment Claim Reviews/Audits Overview
  • Postpayment Non-Medical Record Reviews
  • Statistical Sampling and Extrapolations
  • Postpayment Medical Record Reviews 


Module 6: Medicare FFS Claim Appeals Process (Part 1)

  • Initial Determinations
  • Reopenings and Overlap with Appeals Process
  • Level 1 Appeal Process: Redetermination
  • Level 2 Appeal Process: Reconsideration


Module 7: Medicare Appeals Process Overview (Part 2)

  • Level 3 Appeal Process: Administrative Law Judge (ALJ) Hearing
  • Level 4 Appeal Process: Medicare Appeals Council
  • Level 5 Appeal Process: Judicial Review in U.S. District Court 


Module 8: Current Medicare Claim Audits and Appeals Issues Overview

  • Two Midnight Expectation and QIO Review
  • Expedited Judicial Review
  • Medicare Overpayments
  • Appeals Backlog
  • Ways to Stay Current: Audit Topics
  • Ways to Stay Current: ALJ Decisions, Appeals Council Decisions and Federal Court Decisions


Course Agenda/Outline is subject to change.

Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Schedule

Class Schedule (Eastern time)

August 23 12:30 p.m. – 4:00 p.m.
August 24 12:30 p.m. – 4:00 p.m.
August 25 12:30 p.m. – 4:00 p.m.
August 26 12:30 p.m. – 4:00 p.m.
August 27 12:30 p.m. – 4:00 p.m.

Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Learning Objectives

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

  • Research the appeals process and related regulations
  • Identify key steps in the appeals process up to the Administrative Law Judge level
  • Explain common causes of Medicare denials
  • Develop policies and practices to support compliance, reduce denials, and expedite appeals
  • Analyze denied claims to select appropriate appeals

Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Continuing Education Credit

*Coming Soon! 

Live Virtual Medicare Boot Camp®—Denials and Appeals Version

Questions/Answers

What is the focus of the Live Virtual Medicare Boot Camp®—Denials and Appeals Version?
Live Virtual Medicare Boot Camp®—Denials and Appeals Version version is an intensive, two-day course on Medicare appeals and denials management, covering the Medicare claims review processes, types of audits and how providers should respond to them, and the different levels of the appeals process. The goal of the course is to provide participants with a sound understanding of the audit, denial, and appeal process, including the payer perspective, that is based directly on current regulations.

What computer set-up do I need to attend this class?
This 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 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?
To view our cancellation policy, click here.

Who typically attends the Medicare Boot Camp®—Denials and Appeals Version?

  • Revenue cycle directors and managers
  • Revenue integrity directors, managers, and staff
  • HIM directors, managers, and staff
  • CDI directors, managers, and specialists
  • Compliance directors, officers, and auditors
  • Business office managers
  • Case management directors and managers
  • Case managers
  • Utilizations review staff
  • Utilization management staff
  • Physician advisors
  • Audit directors and coordinators
  • Auditors
  • Appeals coordinators
  • Patient financial services directors


What do I need to know prior to attending?
Please read further with our Get Ready for Class outline.

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


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 customer@simplifycompliance.com.