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Distance Learning<br>Mastering Medicare Billing, Coding & Compliance

Distance Learning
Mastering Medicare Billing, Coding & Compliance

Item ID: X1580A
Publisher: Contexo Media
Price: $469.00
Format: Distance Learning

Availability Date: May 31, 2008
 
 
You won't miss a step as you receive the same great information you've come to expect from our workshops streamed over the internet directly to your computer.

Register today and begin learning from your home or office and leave the worries of travel behind. No software to install or special equipment to purchase, all you need is a PC with an internet connection to receive this cutting edge course.

What you’ll learn:


• Medicare’s top claim denials and how to correct these in your practice
• The OIG Work Plan for 2008
• Resources for obtaining referring physician’s NPI numbers
• Reimbursement and coverage changes slated for 2008
• What to do when your practice receives a CERT or RAC audit letter
• How correct modifier usage can help decrease your claim denials
• How to help your physician decide whether to be a Participating Provider, Non Participating Provider or Opting Out of Medicare
• And much, much more!

Why Distance Learning?

• Audio, video and animated presentations – start and stop wherever you want
• No intense online reading
• Weekly teleconference Q&A with certified instructor You control the pace – course can be completed in as little as 1 day, or up to 3 months
• Approved by the AAPC and the ARHCP for up to 12 CEUs – certificate provided upon completion*
• Receive an electronic and printed course guide
• Course index for quick access to chapters

* Must score 70% or higher on chapter quizzes to receive CEU certificate. Retake the quiz as many times as needed.


COURSE OVERVIEW

Introduction to Medicare

• Medicare Part A vs. Medicare Part B
• Your choices as a par and non-par provider

• Non participating is not the same as opting out of Medicare
• How point-of-service collections can offset the risk of higher patient deductibles
• When can I bill my Medicare patient’s for services? The appropriate use of ABN’s. Modifiers GA, GZ, and GY
• Why everyone should have a Medigap cheat sheet
• Successful transitions to Medicare Administrative Contractor (MAC) and Durable Medical Equipment Suppliers

Medicare billing updates for 2008

• What you must know about the latest Medicare Physician Fee Schedule
• Learn what’s new about the revised CMS-1500 claim form
• How to locate NPI numbers for health care partners The NPI Registry
• Will I still need my UPIN or legacy number after May of 2008?
• Techniques for speeding up the revenue cycle
• Electronic Remittance Advice—why the good outweighs the bad
• Losing money on injected/infused drugs? Why the Competitive Acquisition Program may be the answer
• Tips on capturing and coding injections, infusions and drugs
• Updates to the PT cap and billing instructions for therapy
• Learn what commonly reported supplies may be considered “bundled” in 2008
• Why the updates to the RVUs are good for most specialties
• When to expect payment reductions for diagnostic tests performed in the office
• The opportunities of voluntary “pay-for-performance” programs

How to get paid for preventive services

• Learn when and how Medicare will pay for screening ultrasounds
• Learn the changes to the deductible for screening for colorectal cancer
• How to code and document problem-oriented evaluation on the same day as a “well” visit
• Don’t miss an opportunity—simple techniques to document and get paid for the IPPE (AKA “welcome to Medicare physical”)
• How to get paid for tobacco cessation counseling that lasts longer than 3 minutes
• Tips to decrease denials for screening lipid profiles and glucose tests
• Troubleshoot common problems related to Medicare-covered screening services

Decrease claim denials—for good

• How to use the Correct Coding Initiative edits to avoid denials for “unbundling”
• Get the first claim paid—how to avoid the most common reasons for claim denials
• Why remittance advice is like a treasure map
• No more guesswork—how to turn the RBRVS data into a lucrative billing tool

Opportunities to increase charges and revenue

• Tips and techniques for capturing services that are “outside” of the surgical package
• How to use the correct modifier to get your claim paid
• Learn how to communicate prolonged and/or unusual services
• Modifier 25—why you should be using it frequently and carefully
• Why the breakdown between the provider and the billing office may be costing you tens of thousands of dollars—and how to fix it
• Discover if your organization has an opportunity to increase collections
• Get answers to your questions regarding nursing home evaluations, home health certification, telephone calls, pre-op clearance and much, much more

Introduction to Medicare Part B compliance

• Not every “risk” is equal—learn what you should really be worried about in 2008
• Get a clear understanding of the roles different government offices and contractors play in monitoring compliance
• Learn who in the organization is liable for non-compliant billing

How to “bullet-proof” your E/M coding and documentation

• Simple steps to uncover “over-coding” and “under-coding”
• What does Medicare consider a “typical” coding pattern?
• The dos and don’ts of reporting CPT® code 99211
• Learn how documenting time can support higher-level office visits
• Satisfying the CMS documentation guidelines—how templates can help

Who can bill under the physician’s number?

• The elements of the “incident-to” rule—know them inside and out
• When non-physician practitioners can use their own, or the physician’s number
• The dangers of reporting services provided by locum tenens, covering physicians, residents, and “new” physicians in the group
• The rules surrounding NPI and the most up to date inforation on required use along with how to use and access the NPI registry
• Why it matters which physician in the group supervises the diagnostic test

Rules for patient collections

• How to identify if a service is payable by Medicare Part B or the patient
• When and how much you can charge a patient for non-covered services
• Learn why Medicare cares if you make a “reasonable effort to collect” coinsurance and deductible
• When professional courtesy is allowed—and when you should never extend it
• Why the excessive charge rule and multiple fee schedules is a volatile mixture
• The reasons why most practices under-charge—and how to avoid them

Laws and Sentencing Guidelines

• Understand and avoid the three ways of submitting False Claims
• Learn the III phases of the Stark Law and how violating any of them can affect you
• When professional courtesy is allowed--- and when you should never extend it
• How to identify and correct the potential areas of fraud and abuse within your practice

Best practices for managing an internal compliance plan

• The 7 elements of an effective compliance plan
• How to get the most out of initial and ongoing audits
• Roles and responsibilities of the compliance officer
• Learn what form every single employee involved in billing should understand and sign
• Improving coding and billing—how a compliance initiative can help
• Why not following a compliance plan is worse than not having one at all
• How to resolve compliance “issues” if you uncover them

How to avoid and respond to a Medicare audit

• The 3 signs that forecast a Medicare audit is around the corner
• What you must know about the 2008 OIG Work Plan
• Learn the difference between additional documentation, CERT, and RAC requests.
• Techniques for defusing a negative outcome from a Medicare audit
• Win appeals—how new time frames and physician rights make it easier for you
• The secrets of drafting letters to Medicare—avoid saying things you’ll regret

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