Live Virtual Medicare Boot Camp®—Utilization Review Version

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Live Virtual Medicare Boot Camp®—Utilization Review Version

Product Code: URCV


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

Total:
$899.00
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* Next registration cut-off date: 9/14/2020

Live Virtual Medicare Boot Camp®—Utilization Review Version

Course Overview

The Live Virtual Medicare Boot Camp®—Utilization Review Version is an intensive course focusing on the Medicare regulatory requirements for patient status and the role of the utilization review (UR) committee. Master Medicare rules for UR in just five 3-hour live online sessions.

Managing patient status plays a critical role in proper compliance, correct reimbursement, and stabilizing inpatient payments for the hospital. In 2020, CMS made significant changes to the inpatient-only list and continues to change its strategies for auditing patient status. Don’t become a target or leave money on the table—ensure the UR committee is ready to implement and leverage the regulatory requirements.

Medicare Boot Camp®—Utilization Review Version also answers all your questions about navigating the CMS website and finding Medicare requirements. You will be able to find answers to your questions long after the Boot Camp is over.

You will leave this program knowing:

  • How to apply the 2-midnight benchmark and 2-midnight presumptions
  • Implement changes to the inpatient-only list for 2020
  • The differences between post-discharge versus concurrent patient status reviews
  • When self-denial is appropriate to take advantage of Part B payment for an inpatient case
  • How NCDs, LCDs, and coverage with evidence development (CED) affect coverage of cases that meet the 2-midnight benchmark
  • The observation coverage rules and how they interact with the 2-midnight benchmark
  • When ABNs and HINNs should be used for stays that don’t meet medical necessity requirements


Who should attend?

  • Utilization review coordinators
  • Utilization management managers and directors
  • Utilization review committee members
  • UR physician advisors
  • Case managers
  • Care coordinators
  • Revenue cycle staff
  • Nurse managers
  • Compliance officers and auditors
  • CFOs, CNOs, and VPs
  • Fiscal intermediary personnel
  • Healthcare lawyers and consultants


How does the Live Virtual Medicare Boot Camp®—Utilization Review Version work?

This class is five sessions. Classes are held Mondays, Wednesdays, and Fridays from 1:00 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 – Thursday from September 21 – September 30. Registration cut-off date: 9/14/2020

Class is held Monday – Thursday from November 9 – November 18. Registration cut-off date: 11/2/2020

Class is held Monday – Thursday from December 7 – December 16. Registration cut-off date: 11/30/2020

Live Virtual Medicare Boot Camp®—Utilization Review Version

Outline/Agenda

Week 1: Medicare Overview and Resources

  • Overview of Medicare Part A, B, C, and D
  • Medicare contractors, including the MAC, RAC and QIO
  • Links to Medicare resources and resources for staying current
  • Medicare Coverage Center, including LCDs, NCDs and CED
  • Prior authorization for specified outpatient procedures and services

Week 1: Medicare Observation:

  • Coverage of observation services
  • The Medicare Outpatient Observation Notice (MOON)
  • Advanced Beneficiary Notice (ABN) for non-covered observation
  • Coding and billing of observation
  • Payment for observation under the Observation Comprehensive APC (C-APC)
  • Payment for observation at a Critical Access Hospital (CAH)

Week 2: Coverage of Inpatient Admissions

  • Inpatient order requirements
  • Inpatient certification requirements, including 96-hour CAH certification
  • Inpatient criteria and the 2-Midnight Benchmark
  • Inpatient-only procedures
  • Admission on a case-by-case basis
  • Documentation and use of screening tools

Week 3: Inpatient Utilization Review and Notices

  • Utilization review requirements and self-denials
  • Concurrent review and billing with condition code 44
  • Inpatient Part B payment and billing with condition code W2
  • Important Message from Medicare (IM)
  • Detailed Notice of Discharge (DN)
  • Hospital Issued Notice of Non-Coverage (HINN) for non-covered inpatient services

Week 4: Medicare Payment Fundamentals and Patient Responsibility

  • Basics of the Outpatient Prospective Payment System (OPPS)
  • Patient coinsurance under Part B
  • Basics of the Inpatient Prospective Payment System (IPPS)
  • Three-day payment window and pre-admission services
  • Medicare-severity diagnosis related groups (MS-DRGs)
  • Payment for transfers and post-acute care transfers
  • Inpatient deductible, coinsurance, and lifetime reserve days (LRDs)


Course Agenda/Outline is subject to change.

Live Virtual Medicare Boot Camp®—Utilization Review Version

Schedule

Class Schedule (Eastern time)

July 21 1:00 p.m. – 3:00 p.m.  
July 23 1:00 p.m. – 3:00 p.m.  
July 24 11:30 a.m. – 12:30 p.m. Open Q&A
July 28 1:00 p.m. – 3:00 p.m.  
July 30 1:00 p.m. – 3:00 p.m.  
July 31 11:30 a.m. – 12:30 p.m.  Open Q&A
August 4 1:00 p.m. – 3:00 p.m.  
August 6 1:00 p.m. – 3:00 p.m.  
August 7 11:30 a.m. – 12:30 p.m.  Open Q&A
August 11 1:00 p.m. – 3:00 p.m.  
August 13 1:00 p.m. – 3:00 p.m.  
August 14 11:30 a.m. – 12:30 p.m.  Open Q&A

Live Virtual Medicare Boot Camp®—Utilization Review Version

Continuing Education

American Health Information Management Association (AHIMA)
This program has been approved for 15 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Association of Clinical Documentation Integrity Specialists (ACDIS)
This program has been approved for 15 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 Integrity 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 15 nursing contact hours is provided by HCPro.

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 18 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 15 continuing education credit to Certified Case Managers (CCMs).

ACCME
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 15 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

National Association of Healthcare Revenue Integrity (NAHRI)
This program has been approved for 15 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 18 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: 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.