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      Medicare Boot Camp®—Hospital Version in Las Vegas

      • Medicare Boot Camp®—Hospital Version Photo #1
      1 of 1
      December 7, 2020

      Monday   8:00 AM - 1:00 PM (daily for 5 times)

      7830 South Las Vegas Boulevard
      Las Vegas, Nevada 89123

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      Medicare Boot Camp®—Hospital Version

      Medicare Boot Camp® - Hospital Version
      About this Event


      Course Overview

      Gain insight into the CMS initiatives affecting your revenue in 2020 by joining the nation’s leading Medicare experts for the Medicare Boot Camp®—Hospital Version.

      From changes to the inpatient-only list to new guidance on charity care and pressure on drug payments, it’s the finest details of recent CMS updates that may cause compliance traps in 2020. Delve into the details of regulatory changes to understand the revenue implications and implement the new guidance. Medicare Boot Camp—Hospital Version unlocks all of the answers to your Medicare questions by teaching you the latest rules and their application.

      Medicare Boot Camp—Hospital Version prepares you to better manage your revenue cycle and government audits by focusing on real guidance from CMS. You’ll leave class ready to make improvements that will strengthen reimbursement and compliance for your hospital or health system. And you’ll have the research tools and skills at your fingertips to answer your own Medicare questions long after the Boot Camp is over.

      Comprehensive sections explain the complexities of:

      The 2-midnight benchmark and presumption
      Coverage under NCDs, LCDs, and CED
      Inpatient order requirements
      Inpatient-only procedures, including changes for 2020
      Outpatient coverage and physician supervision
      Observation coverage, billing, and payment
      Correct use of condition codes 44 and W2
      NCCI edits, including PTP edits and MUEs
      Payment under the OPPS and IPPS
      Patient deductible and copayment amounts
      ABNs, HINNs and billing non-covered services
      Medicare websites and resources
      You will leave this program knowing how to:

      Prevent inpatient denials
      Conduct compliant "self-audits" for Part B inpatient payment
      Properly use and bill for observation services
      Research and resolve claim edits that delay revenue
      Prevent outpatient denials and missed revenue
      Implement best practices to get the revenue you deserve while staying in compliance

      Who should attend?

      Finance and reimbursement personnel
      Case Managers
      Chargemaster personnel
      Billers and coders
      Medical records/health information personnel
      Clinical department personnel
      Provider-based clinic personnel
      Revenue managers
      Compliance officers and auditors
      Registration personnel
      Medicare Advantage and MAC personnel
      Healthcare lawyers, consultants, and CPAs
      Legal department personnel
      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.

      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.

      Learning Objectives

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

      Locate key sources of Medicare authority on the Internet
      Interpret Medicare guidance and apply it to the services provided
      Describe how Medicare covers inpatient and outpatient services at hospitals
      Describe limitations on coverage under the Medicare program
      Recognize the effect of coding rules on the services the provider reports
      Explain how Medicare pays for inpatient and outpatient services
      Explain Medicare deductibles and copayments for hospital inpatient and outpatient services
      Employ inpatient and outpatient status rules and regulations


      Module 1: Medicare Overview and Contractors

      Overview of Medicare Part A, B, C, and D

      Medicare contractors, including the MAC, RAC and QIO

      Module 2: Medicare Research and Resources

      Finding Medicare source laws, including statutes, regulations and final rules

      Finding Medicare sub-regulatory guidance, including manuals and transmittals

      Medicare Coverage Center, including LCDs, NCDs, CED and Lab Coverage Manual

      Links to Medicare resources and resources for staying current

      Module 3: Coverage of Hospital Outpatient Services

      Incident-to coverage of outpatient therapeutic services

      Physician supervision requirements and definitions

      Coverage of observation services

      Coverage of drugs, including self-administered drugs

      Coverage requirements for outpatient diagnostic services

      Module 4: Coverage of Hospital Inpatient Services

      Inpatient order and certification requirements

      Inpatient criteria and the 2-Midnight Benchmark

      Admission on a case-by-case Basis

      Documentation and use of screening tools

      Utilization review determinations and short stay audits

      Inpatient Part B payment

      Module 5: Medicare Notices

      Delivery of the Medicare Outpatient Observation Notice (MOON)

      Important Message from Medicare (IMM) and Detailed Notice of Discharge

      Limitations of liability statute and notice requirements

      The Advance Beneficiary Notice (ABN) form and instructions

      Hospital Issued Notices of Non-Coverage (HINN)

      Module 6: Medicare Claims Submission Fundamentals

      Claim fields with special instructions

      Medicare Secondary Payer principles, including liability claims

      Adjustment claims and automated reopenings

      Medicare claims flow

      Module 7: Medicare Edit Systems

      Outpatient Code Editor (OCE) and Medicare Code Editor (MCE)

      National Correct Coding Initiative (NCCI)

      Procedure to Procedure (PTP) edits and modifiers

      Medically Unlikely Edits (MUE) and Add-on code edits

      Module 8: Medicare Billing Issues

      Outpatient repetitive, non-repetitive, and recurring services

      Three-day payment window; outpatient services billed on inpatient claims

      Billing of non-covered outpatient services

      Treatment of conditions arising during or from a non-covered stay

      Module 9: Medicare Outpatient Payment Systems

      Outpatient Prospective Payment System (OPPS)

      Addendum B and D to determine the payment status of a HCPCS code

      Addendum A and Ambulatory Payment Classifications (APCs)

      Comprehensive APC (C-APC) basic rules

      Payment under the OPPS, including patient coinsurance and outlier

      Payment for therapy under the Physician Fee Schedule, including therapy caps

      “Sometimes” and “always” therapy codes

      Payment for labs under the Laboratory Fee Schedule, including reference lab

      Module 10: Outpatient Surgical Services, including Implantable Devices

      Inpatient-only procedures

      Surgical C-APCs, including complexity adjustment

      Multiple procedure discount for minor surgical services

      Terminated/discontinued and bilateral procedures

      Device intensive procedures and procedure-to-device edit

      Pass-through devices

      Value code FD for free and reduced-cost devices

      Module 11: Outpatient Visits and Observation Services

      Coding for clinics, emergency departments, critical care and trauma activation

      Proper use of modifier 25

      Payment for off-campus “non-excepted” department services

      Billing of observation services

      Observation Comprehensive APC Payment

      Module 12: Special Billing Issues for Outpatient Diagnostics, Drugs and Therapy

      Packaged, pass-through and non-pass-through drugs and biologicals

      Proper use of modifier JG and TB

      Discarded Drugs

      Biosimilar products

      Biological skin substitutes

      Radiation Therapy

      Imaging Family Composite APCs

      Special Radiology Modifiers

      Laboratory billing and coding issues, including date of service

      Blood and blood products

      Outpatient therapy functional status reporting

      Module 13: Inpatient Payment and Patient Responsibility

      Inpatient Part A payment and the Inpatient Prospective Payment System (IPPS)

      Medicare-severity diagnosis related groups (MS-DRG)

      Complications and co-morbidities and the effect of a hospital-acquired condition (HAC)

      Inpatient deductible, coinsurance, and lifetime reserve days

      Module 14: Inpatient Prospective Payment System (IPPS) Adjustment Factors

      Standardized amount adjustments: Hospital Quality Reporting Program and Electronic Health Record (EHR) Meaningful Use

      Quality adjustments: Value-Based Purchasing (VBP) Program, Hospital Readmissions Reduction Program (HRRP), and HAC Reduction Program

      Payment add-on for New Technology

      Medicare inpatient pricer

      Payment for transfers and post-acute care transfers

      Course Agenda/Outline is subject to change.


      Coming Soon!

      Cost: $1,689

      Categories: Conferences & Tradeshows

      This event repeats daily for 5 times: Dec 7, Dec 8, Dec 9

      Event details may change at any time, always check with the event organizer when planning to attend this event or purchase tickets.

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