BEGIN:VCALENDAR VERSION:2.0 PRODID:icalendar-ruby CALSCALE:GREGORIAN BEGIN:VEVENT DTSTAMP:20240328T221846Z UID:56383e65-c5d6-43ad-a6e6-4f6ec39af184 DTSTART:20201203T080000 DTEND:20201204T080000 CLASS:PRIVATE DESCRIPTION:
\nMaster Medicare rules for utilization review
Managing patient status plays a critical role in proper compliance\, co rrect reimbursement\, and stabilizing inpatient payments for the hospital. In 2020\, CMS made significant changes to the inpatient-only list and con tinues to change its strategies for auditing patient status. Don&rsquo\;t become a target or leave money on the table&mdash\;ensure the UR committee is ready to implement and leverage the regulatory requirements.
\n\nMedicare Boot Camp&mdash\;Utilization Review Version also answers all you r questions about navigating the CMS website and finding Medicare requirem ents. You will be able to find answers to your questions long after the Bo ot Camp is over.
\n\n
\nYou will leave this program kno
wing:
\nHow to apply the 2-midnight benchmark and
2-midnight presumptions
\nImplement changes to the inpatient-only li
st for 2020 \;
\nThe differences between post-discharge versus co
ncurrent patient status reviews
\nWhen self-denial is appropriate to
take advantage of Part B payment for an inpatient case
\nHow NCDs\, L
CDs\, and coverage with evidence development (CED) affect coverage of case
s that meet the 2-midnight benchmark
\nThe observation coverage rules
and how they interact with the 2-midnight benchmark
\nWhen ABNs and
HINNs should be used for stays that don&rsquo\;t meet medical necessity re
quirements
\nUtilization review coordinators
\nUtilization management m
anagers and directors
\nUtilization review committee members
\nU
R physician advisors
\nCase managers
\nCare coordinators
\n
Revenue cycle staff
\nNurse managers
\nCompliance officers and a
uditors
\nCFOs\, CNOs\, and VPs
\nFiscal intermediary personnel<
br />\nHealthcare lawyers and consultants
 \;
\n\n
\nModule
1: Medicare Overview and Contractors
\n
\nOverview
of Medicare Part A\, B\, C\, and D
\nMedicare contractors\, includin
g the MAC\, RAC and QIO
Module 2: Medicare Research
and Resources \;
\n
\nFinding Medicare source
laws\, including statutes\, regulations and final rules
\nFinding Med
icare sub-regulatory guidance\, including manuals and transmittals \;<
br />\nMedicare Coverage Center\, including LCDs\, NCDs\, CED and Lab Cove
rage Manual
\nLimitations of Liability and notice requirements for no
n-covered services
\nLinks to Medicare resources and resources for st
aying current
\nModule 3: Outpatient Observati
on
\nCoverage of observation services
\nThe Medica
re Outpatient Observation Notice (MOON)
\nAdvanced Beneficiary Notice
(ABN) for non-covered observation
\nCoding and billing of observatio
n
\nPayment for observation under the Observation Comprehensive APC (
C-APC)
\nModule 4: Coverage of Inpatient Admis
sions
\nInpatient order and certification requirements<
br />\nInpatient criteria and the 2-Midnight Benchmark
\nInpatient-on
ly procedures
\nAdmission on a case-by-case basis
\nDocumentatio
n and use of screening tools
\nQIO short stay audits
\nModule 5: Inpatient Utilization Review and Notices<
/em>
\nUtilization review requirements and self-denials
\nConcur
rent review and billing with condition code 44 \;
\nInpatient Par
t B payment and billing with condition code W2
\nImportant Message fr
om Medicare (IM)
\nDetailed Notice of Discharge (DN)
\nHospital
Issued Notice of Non-Coverage (HINN) for non-covered inpatient services
\nModule 6: Medicare Payment Fundamentals and Pa
tient Responsibility
\nBasics of the Outpatient Prospec
tive Payment System (OPPS)
\nPatient coinsurance under Part B
\n
Basics of the Inpatient Prospective Payment System (IPPS)
\nThree-day
payment window and pre-admission services
\nMedicare-severity diagno
sis related groups (MS-DRGs)
\nPayment for transfers and post-acute c
are transfers
\nInpatient deductible\, coinsurance\, and lifetime res
erve days (LRDs)
\nAt the conclusion of this educational activity\, partici
pants will be able to:
Define observation coverage\, billing\, c
oding\, and payment rules
\nDiscuss the appropriate application of AB
Ns for observation patients
\nState the new/revised inpatient order a
nd certification requirements
\nExplain CMS&rsquo\; 2-midnight rule b
enchmark \;
\nDescribe the effect of hospital practice patterns o
n the 2-midnight presumption \;
\nRecognize exceptions to the 2-m
idnight benchmark
\nDescribe the impact of LCD/NCD/CED criteria on in
patient coverage
\nState the rules for "\;inpatient-only"\; p
rocedure billing and reimbursement
\nDescribe the differences between
condition codes 44 and W2
\nUse appropriate billing codes for full P
art B payment for inpatient cases\, including for "\;self-denials"
\;
\nDifferentiate inpatient and outpatient deductibles and co-paymen
ts
\nAAPC
\nThis program has been approved by the AA
PC for 15 continuing education hours. Granting of prior approval in no way
constitutes endorsement by AAPC of the program content or the program spo
nsor.
\nAmerican Health Information Management Ass
ociation (AHIMA)
\nThis program has been approved for 15 CE
credits for use in fulfilling the continuing education requirements of the
American Health Information Management Association (AHIMA).
\nAssociation of Clinical Documentation Improvement Specialists
(ACDIS)
\nThis program has been approved for 15 continuing
education units towards fulfilling the requirements of the Certified Clini
cal Documentation Specialist (CCDS) certification\, offered as a service o
f the Association of Clinical Documentation Improvement Specialists (ACDIS
).
\nAmerican Nurses Credentialing Center (ANCC)
strong>
\nHCPro is accredited as a provider of continuing nursing edu
cation by the American Nurses Credentialing Center'\;s Commission on Ac
creditation.
This educational activity for 15 nursing contact ho urs is provided by HCPro.
\n\n
\nCalifornia Board of Re
gistered Nursing
\nHCPro is approved by the California Board
of Registered Nursing to provide 18 nursing contact hours. California BRN
Provider #CEP 14494.
\nCommission for Case Manage
r Certification (CCMC)
\nThis program has been pre-approved
by the Commission for Case Manager Certification to provide 15 continuing
education credit to Certified Case Managers (CCMs).
\n
\nHCPro is accredited by the Accreditation Council
for Continuing Medical Education (ACCME) to provide continuing medical ed
ucation for physicians.
HCPro designates this educational activi ty for a maximum of 15 AMA PRA Category 1 Credits&trade\;. Physicians shou ld only claim credit commensurate with the extent of their participation i n the activity.
\n\n
\nNational Association of State Bo
ards of Accountancy (NASBA)
\nEarn up to 18 CPE Credits!
\nProgram Level: Basic
\nDelivery Method: Group-Live
\nField o
f Study: Specialized Knowledge and Applications
HCPro is registe red with the National Association of State Boards of Accountancy (NASBA) a s a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the a cceptance of individual courses for CPE credit.
\n\n
\nPlease c
ontact the event manager Marilyn (marilyn.b.turner(at)nyeventslist.com ) b
elow for:
\n- Multiple participant discounts
\n- Price quotation
s or visa invitation letters
\n- Payment by alternate channels (PayPa
l\, check\, Western Union\, wire transfers etc)
\n- Event sponsorship
s
\nNO REFUNDS ALLOWED ON REGISTRATIONS
\nService fee
s included in this listing.
\n---------------------------------------
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\n
Business &\; Legal Resources - NewYorkEventsList
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\nROC171018CEL