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: 7/4/2022

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

This live virtual Boot Camp is perfect for those looking to expand their Medicare knowledge with instructor-led education that can be accessed from the comfort of your own home. Classes are led by our expert instructors, typically take place over the course of a week or two, and allow instructor/student interaction and engagement.

Live Virtual Medicare Boot Camp®—Utilization Review Version

Course Overview

Master Medicare rules for utilization review

Live Virtual Medicare Boot Camp®—Utilization Review Version is an intensive two-day course focusing on the Medicare regulatory requirements for patient status and the role of the utilization review (UR) committee.

Managing patient status plays a critical role in proper compliance, correct reimbursement, and stabilizing inpatient payments for the hospital. In 2022, CMS reversed course on the inpatient only list elimination and adopted a new strategy for auditing services removed from the inpatient only list. The OIG has also announced they will start patient status directed audits after a 7-year hiatus.  Don’t become a target or leave money on the table—have confidence in the UR determinations you and your facility are making.

Live Virtual 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, including cases with observation
  • CMS’ current strategy related to the inpatient only list and services not returned to the list for 2022
  • CMS guidance on case-by-case admissions
  • 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

This Boot Camp will help you to:

  • Determine the correct inpatient or outpatient status of a patient under Medicare FFS guidelines
  • Conduct compliant utilization review of Medicare patients
  • Implement condition code 44 or self-denial processes correctly and compliantly
  • Understand the role of a utilization review team in your organization and how they contribute to compliance and accurate reimbursement

Who should attend?
With a more clinical focus than other Boot Camp courses, this class is designed for the physicians and nurses involved in the Medicare utilization review process, as well as the revenue cycle people who support them. The course is also helpful for staff dealing with inpatient and outpatient denials and appeals.

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

See the HCPro difference for yourself!

Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure Medicare beneficiaries are placed in the correct status and billed correctly for the services they receive.

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.

Case studies: Case studies ensure attendees 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).


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

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 July 11 – July 14. Registration cut-off date: 7/4/2022

Class is held Monday – Friday from December 5 – December 8. Registration cut-off date: 11/28/2022


For more information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

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

July — Class Schedule (Eastern time)

July 11 12:30 p.m. – 4:30 p.m.
July 12 12:30 p.m. – 4:30 p.m.
July 13 12:30 p.m. – 4:30 p.m.
July 14 12:30 p.m. – 4:30 p.m.

December — Class Schedule (Eastern time)

December 5 12:30 p.m. – 4:30 p.m.
December 6 12:30 p.m. – 4:30 p.m.
December 7 12:30 p.m. – 4:30 p.m.
December 8 12:30 p.m. – 4:30 p.m.

Live Virtual Medicare Boot Camp®—Utilization Review Version

Questions/Answers

What is the focus of Live Virtual Medicare Boot Camp®—Utilization Review Version?
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.

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 on-site sessions of Live Virtual Medicare Boot Camp—Utilization Review Version?
In addition to our open registration courses, we also offer Medicare Boot Camp—Utilization Review 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 Medicare Boot Camp—Utilization Review Version, click on Train Groups On-sites.

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

Who typically attends Medicare Boot Camp—Utilization Review Version?

  • 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

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, notebook for taking notes, and sticky notes/flags.

What if I have a question that didn’t get addressed in class?
The course offers open office hours each week to address topics related to the course materials and class discussion. Questions should be related to the course and topics discussed throughout the course. Instructors are not able to address questions outside the scope of the course.

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 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Live Virtual Medicare Boot Camp®—Utilization Review 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 4 business days prior to the class start and again 1 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 two business days following the first session. 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
  • Notepaper
  • Sticky Notes/flags
  • Pen/Pencil

Contact Information

For more information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

We Look Forward to Having You In Class!

Live Virtual Medicare Boot Camp®—Utilization Review Version

Learning Objectives

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.