Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp

Course Overview

Charge capture’s importance is at an all-time high.  Let our expert instructors peel back the layers of chargemaster and revenue integrity.

The Revenue Integrity and Chargemaster Boot Camp – Critical Access Hospital Version provides education on chargemaster and revenue integrity concepts in a classroom format. The program will relate the chargemaster function to revenue cycle and revenue integrity functions, including cost reporting and key operational issues, such as coverage, clinical documentation, charge capture, and coding.

It will also provide context for chargemaster set-up and maintenance within revenue integrity with an objective to help avoid pre- and post- billing edits and payer denials. This Boot Camp reviews chargemaster coding requirements for Critical Access Hospitals and excludes discussion of topics that are specific to coding for the outpatient prospective payment system.

You will leave this program knowing how to:

• Provide formal, organized education and training for revenue integrity and chargemaster staff
• Provide context for the intersection of the chargemaster with clinical/revenue departments, charge capture, coding, finance, and patient access and billing
• Walk attendees through CMS regulatory requirements for pricing and charging patients, as well as key relationships between the chargemaster and provider cost reporting
• Give detailed instructions for the majority of revenue codes for optimal chargemaster setup, maintenance, charge capture, and documentation issues for critical access hospitals
• Review chargemaster issues for commercial/managed care versus CMS requirements for critical access hospitals**

See the HCPro difference for yourself!

Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure hospital 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 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). We currently conduct more than 30 Medicare Boot Camp courses each year.

Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp

Outline/Agenda

Module 1: Revenue Integrity Overview and Resources

Module 2: Eligibility Principles

Module 3: Benefits, Coverage and Medical Necessity

Module 4: Provider Types, Licensure, Enrollment, Privileges, Credentialing and Scope of Practice

Module 5: Charge Description Master Structure and Relationship to Cost Reporting

Module 6: Principles of Charge Capture

Module 7: Claims Submission Fundamentals and Code Edits

Module 8: Strategies and Key Issues by Revenue Code: Routine Services and Observation

Module 9: Strategies and Key Issues by Revenue Code: Ancillary Services

Module 10: Strategies and Key Issues by Revenue Code:  Other Departments

Module 11: Introduction to Payment Systems

Module 12: Critical Access Hospital Reimbursement – Methods I & II

Module 13: Medicare Physician Fee Schedule (MPFS)

Module 14:Charge Description Master Management and Maintenance Strategies

Module 15: Denial Management

Module 16: Payer Contracting Strategies

Course Outline/Agenda subject to change.

Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp

Learning Objectives

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

• Equip hospital, payer and other healthcare specialists with effective and efficient strategies to obtain and maintain overall revenue integrity for both governmental and non-governmental payers
• Gain a working understanding of revenue integrity principles associated with eligibility, coverage, coding, billing and payment using fee-for-service Medicare requirements as a framework
• Explain how the chargemaster fits into revenue integrity functions
• Review requirements and issues associated with provider-based status
• Explain standard charge description master (CDM) elements, design and relationship to the general ledger and revenue cycle processes of coding and billing
• Review claim requirements and specific issues of CDM set-up and maintenance by revenue code with associated cost reporting principles
• Review concepts of pricing different services
• Exemplify Critical Access Hospital cost-based reimbursement, including Method I and II, and as well as appeal strategies to protect revenue

Continuing Education

Continuing Education credits for this course are pending approval.

Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp

Questions/Answers

What is the focus of the Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp?
This Boot Camp educates those who work within the critical access hospital setting about chargemaster and revenue integrity concepts. Some of these concepts include revenue cycle and revenue integrity functions as well as cost reporting and key operations issues like coverage, clinical documentation, charge capture, and coding. 

It also gives attendees context about chargemaster set-up and maintenance within revenue integrity and will help educate you about pre- and post- billing edits and payer denials.

Where is the course offered?
Open registration sessions of the Revenue Integrity and Chargemaster Boot Camp 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 Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp?

• Reimbursement managers
• Revenue managers
• Chargemaster staff
• Chargemaster managers
• Finance and reimbursement staff
• Finance and reimbursement managers & directors
• CFOs
• Payer relations staff
• HIM directors and managers
• Compliance officers, directors, and managers
• Coding directors and managers
• RAC coordinators**

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.

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

Revenue Integrity and Chargemaster for Critical Access Hospitals Boot Camp

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.