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This course may be used to fulfill a voluntary compliance program’s training component, as recommended by the Office of the Inspector General.
- This important primer course takes participants through the statutory obligations, rights, roles and responsibilities of the Medicare provider.
- Receive tips on how to work with the CMS and Medicaid regional offices.
- More than 25,000 medical office staff across the country have benefited from this class.
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Course Agenda:
- Understanding Medicare’s Correct Coding Initiative
- RBRVS and your Medicare fee schedule
- How to get a list of all non-covered services
- Advance Beneficiary Notice guidelines
- Proper use of the GA modifier for successful payment
- What “assignment” means under Medicare law
- Determining whether Medicare is primary or secondary payer
- Improve understanding of audit triggers
- The dangers of fragmenting, bundling, unbundling
- Correct use of comprehensive and mutually exclusive codes
- Preventive vs. problem-oriented services
- Differences between PAR, non-PAR and opting out of Medicare
- Caring for the indigent Medicare patient
- Stark laws and the dangers of courtesy discounts and kickbacks
- Your rights during a carrier audit
- Billing for services that are not medically necessary
- Proper documentation for medical necessity
- Uncovering the Medicare appeals process and review
- Your rights in making sure you receive a fair hearing
- Interacting with an administrative law judge
Classroom Presentation:
Physicians and coding staff will get answers to their most pressing Medicare questions. Get tips such as: why you should never appeal a Medicare claim before reviewing Medicare’s National Correct Coding Policy. Plus, receive the latest information on documentation guidelines for E&M services, and CMS’s Correct Coding Policy.
Who Should Attend:
Designed for physicians, coding and billing staff, and compliance officers seeking a detailed overview of the Medicare reimbursement system.
Course Materials:
A course manual will be provided to each participant. No additional materials are required for this course.
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Schedule as of 7/4/2008
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Audio CD Training
Reference