Medicare Boot Camp®—Provider-Based Departments Version

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Medicare Boot Camp®—Provider-Based Departments Version

Product Code: PBBC

The Medicare Boot Camp®—Provider-Based Departments Version provides education on attestations, on- and off-campus determinations, enrollment, billing, and reimbursement. This Boot Camp will provide brand new insight for understanding hospital outpatient department billing and reimbursement in an ever-changing regulatory landscape.


Interested in this class? Contact us to be put on a notification list when a new date is added at
PD-IS@SimplifyCompliance.com

Medicare Boot Camp®—Provider-Based Departments Version

Course Overview

Reimbursement for provider-based departments (PBD) and clinics has been declining, with off-campus payment changes and significant encounter-based packaging initiatives by CMS. Hospitals need to understand both the outpatient prospective payment system as well as the new PBD site-specific physician fee schedule payment to effectively assess the impact of these initiatives on PBDs and patients. With more hospitals moving services off-campus due to the value of hospital space or for patient convenience, reimbursement and compliance now become even more complex.

The Medicare Boot Camp®—Provider-Based Departments Version provides education on attestations, on- and off-campus determinations, enrollment, billing, and reimbursement. This Boot Camp will provide brand new insight for understanding hospital outpatient department billing and reimbursement in an ever-changing regulatory landscape.

This boot camp will break down billing, coding, compliance, coverage, qualification, and other issues. It will help attendees gauge the financial impact of changes to off-campus PBDs, understand the effects of the recent increased packaging of services for all PBDs, and know how to handle other recent changes, such as modifiers -PO and -PN and modifier JG.

You will leave this program knowing how to:

  • Ensure PBDs meet regulatory requirements
  • Properly apply Modifiers -PO, -PN, -25, and -JG
  • Apply supervision requirements to ensure compliant, covered hospital outpatient services
  • Find and apply National and Local Coverage Determinations 
  • Research Medicare coverage, coding, and billing issues 
  • Accurately calculate reimbursement for on- and off-campus PBDs under both the OPPS and PBD site-specific MPFS rate
  • Determine when ancillary services such as drugs and testing are paid separately

Who should attend? 

  • Compliance directors, managers, and staff 
  • Finance staff 
  • Billers 
  • Auditors 
  • CFOs, finance directors 
  • Revenue cycle directors and professionals 
  • Revenue integrity professionals 
  • HIM directors and managers 
  • Coders 
  • Physician practice administrators 


See the HCPro difference for yourself! 

Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure provider-based department services furnished to Medicare beneficiaries are billed accurately and appropriately. 

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

Medicare Boot Camp®—Provider-Based Departments Version

Course Outline/Agenda

  • Module 1: Medicare Overview and Resources 
  • Module 2: On- and Off-Campus Provider-Based Department Requirements 
  • Module 3: Coverage of Hospital Outpatient Services 
  • Module 4: Medical Necessity, Coverage Determinations, and ABNs 
  • Module 5: Medicare Edit Systems and Claims Issues 
  • Module 6: Payment for Provider-Based Departments 
  • Module 7: Special Coding and Payment Issues: Part 1 – Procedures, Visits and Therapy 
  • Module 8: Special Coding and Payment Issues: Part 2 – Drugs and Diagnostics


Course Outline/Agenda subject to change.

Medicare Boot Camp®—Provider-Based Departments Version

Questions/Answers

What is the focus of the Medicare Boot Camp®—Provider-Based Departments Version? 
Medicare Boot Camp®—Provider Based Departments Version is an intensive, three-day course on Medicare coverage, billing, coding, and payment for provider-based department services. The course is technically oriented and focuses on the Medicare regulations and guidelines applicable to hospital services in provider-based departments. The objective of the course is to provide participants with a detailed understanding of the Medicare "rules," placing a particular emphasis on the operational application of those rules.

Where is the course offered? 
Open registration sessions of the Medicare Boot Camp®—Provider-Based Departments Version 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 Medicare Boot Camp®—Provider-Based Departments Version? 

  • Compliance directors, managers, and staff 
  • Finance staff 
  • Billers 
  • Auditors 
  • CFOs, finance directors 
  • Revenue cycle directors and professionals 
  • Revenue integrity professionals 
  • HIM directors and managers 
  • Coders 
  • Physician practice administrators 

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
  • 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 our sales team at 615-724-7200 or email PD-IS@SimplifyCompliance.com.

Medicare Boot Camp®—Provider-Based Departments Version

Things to Know Before Attending Class

Directions and Hotel Information

The hotel address, phone number, URL, room rate and room rate cut-off date are posted on the Locations/Dates tab. The hotel websites give detailed directions to the hotel as well as information about the location.  Please call the hotel directly to make a room reservation.  Be sure to identify yourself as an HCPro Boot Camp participant.  Please be sure to make your reservation before the cut-off date.  After the cut-off date, contact the hotel to determine room availability and rates.

Course Materials

When you arrive at class, you will receive extensive workbooks containing the class materials utilized throughout the boot camp.  The workbooks will be yours to keep, so plan accordingly in allowing enough room in your luggage on the return trip home.  Workbooks may also be shipped from the hotel at your own expense.

Classroom Time

It is an understatement to say that this course is intense.  Other than breaks, we will be in class from 8:00am to 5:00pm. Monday-Thursday, and from 8:00am to 1:00pm on Friday.  There will be about a one hour lunch break each day. If the class gets behind, class may run later than 5:00pm.    

Lunch

We will take about a one hour break for lunch each day.  Although we typically provide coffee in the morning and drinks and snacks in the afternoon, everyone is on their own for lunch.  Note that many hotels do not have restaurants on-site.  If you are flying to the course, we generally recommend renting a car.

What to Bring to Class

We recommend you bring the following to all classes:

  • Highlighter and pen/pencil
  • A notebook for making your own notes
  • Sticky Notes/flags

Use of Laptop Computers or Electronic Devices

Our instructors demonstrate where to find many resources on the CMS website. If you have access to a laptop or tablet you may bring it to class to follow along, but you may wish to consider the power and wireless needs of your device. Many conference rooms do not have plugins situated conveniently to the tables so you may wish to ensure you have sufficient battery power. HCPro does not purchase group wireless access for the conference rooms, but many hotels provide free wireless access.  You may wish to confirm your connectivity options prior to arriving at the hotel.  Please be courteous in your use of electronic devices.  Use of electronic devices should not disrupt the class or disturb other participants.  HCPro is not responsible for lost, stolen or damaged devices.  Maintaining the security and safety of your device is your responsibility.  Cell phone use during class is strictly prohibited.

Dress

Business attire is not necessary.  Please dress comfortably.  Also, we find that the classrooms are sometimes on the cool side, even during the warmer months.  You may be more comfortable if you bring a sweater or sweatshirt in case you get cold.

Copyright Protection of Course Materials

You will receive a complete copy of our course materials at the beginning of class.  The materials used in connection with this course were custom designed by our company specifically for use in connection with this course.  We have invested a tremendous amount of time, money and effort in developing, refining and maintaining these materials and they are protected by copyright laws.  Course materials may not be duplicated.  You may use the materials (i) in direct connection with the course or (ii) as a personal reference in your day-to-day work.  No claim is asserted to any U.S. Government, American Medical Association or American Hospital Association works included in the course materials workbook. 

Cancellation and Transfer Policy

For our cancellation and transfer policy, visit our website:  http://hcmarketplace.com/cancellations

COVID Safety

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • If the region where our event is located is deemed by the CDC to be within the substantial or high-risk category, we will require all attendees, regardless of vaccination status, to wear masks when indoors except while actively eating or drinking. 
  • Meeting rooms will be set to support social distancing when necessary.
  • Food service will follow the safety guidelines implemented by the hotel.

 To view all the safety measures that a specific hotel has implemented, please see the information listed on their website. 

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines, and will communicate adjustments to the onsite policies and procedures as necessary.

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!

Medicare Boot Camp®—Provider-Based Departments Version

Learning Objectives

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

  • Ensure PBDs meet regulatory requirements
  • Properly apply Modifiers -PO, -PN, -25, and -JG
  • Apply supervision requirements to ensure compliant, covered hospital outpatient services
  • Find and apply National and Local Coverage Determinations 
  • Research Medicare coverage, coding, and billing issues 
  • Accurately calculate reimbursement for on- and off-campus PBDs under both the OPPS and PBD site-specific MPFS rate
  • Determine when ancillary services such as drugs and testing are paid separately


Continuing Education credits

AAPC
This program has been approved by the AAPC for 20.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

AHIMA
This program has been approved for 19 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

ANCC
HCPro is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

This activity is available for 22.5 nursing contact hours.

NAHRI
This program has been approved for 20.5 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).

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.

Medicare Boot Camp®—Provider-Based Departments Version

COVID

Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • Per current CDC guidelines, if the county where our event is located is deemed to be within the high level of COVID-19, it will be recommended that all attendees, regardless of vaccination status, wear masks when indoors except while actively eating or drinking.
  • Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.

Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines and will communicate adjustments to the onsite policies and procedures as necessary.