San Francisco Professional Events List

Medicare Boot Camp®—Long-Term Care Version San Francisco (BLR )

Oct 28, 2018 - 07:00 PM
NY Events List
AMA San Francisco Executive Conference Center
55, Fourth Street 2nd

Level San Francisco,
ZIP: 94103

Medicare Boot Camp®—Long-Term Care Version San Francisco (BLR )

Course Overview

HCPro's Medicare Boot Camp®—Long-Term Care Version covers the latest Medicare rules and regulations so that you can help your facility provide quality resident care, document successfully, bill appropriately for services, and prevent payment denials.

Medicare Boot Camp—Long-Term Care Version follows a Medicare patient from preadmission through discharge, addressing the function of each department, and uncovering the pitfalls along the way.

The Medicare Boot Camp—Long-Term Care Version offers the help you need to:

Locate key Medicare sources of authority so that you can find answers to your Medicare questions
Identify facility challenges involving all parts of Medicare (A, B, C, D)
Enhance skilled documentation to meet medical necessity and level of care requirements
Determine the correct RUG-IV payment category driven by the MDS
Seamlessly manage blending scheduled and unscheduled MDS assessments
Evaluate and improve your ICD-10 coding practices and processes
Implement processes to achieve accurate documentation
Address Medicare Advantage plan hurdles and methods to overcome payment obstacles

Benefits of HCPro's Medicare Boot Camp—Long-Term Care Version include:

A focus on the actual rules—Learn how to find and apply CMS rules and guidelines to ensure skilled nursing services furnished to Medicare beneficiaries are assessed and billed accurately and appropriately.
Hands-on learning—Participants complete a set of exercises at the end of each module to ensure they understand the concepts and know how to apply them to real-world situations.
Custom-designed course materials—Materials are developed by instructors and editors specifically for this intensive learning format. Each participant receives comprehensive course materials and convenient access to current Medicare statutes, regulations, and guidelines.
Small class size—Class size is limited to ensure individual attention.
Highly rated—Course participants consistently give the course an overall rating of 4.8 or higher (on a 5-point scale).
Post-program support—Two weeks after the program, you'll have the opportunity to participate in a follow-up call with your instructor, in which you can ask additional questions about what you learned, address any implementation issues, or get help prioritizing your to-do list.

Agenda/Course Outline


Module 1: Overview of the Medicare Program & Healthcare Reform

Types and basics for Medicare programs: A, B, C, and D
Verification of benefits
Healthcare reform themes
Conditions of Participation (CoP)
New survey process
Quality and value-based care
Alternative payment models (ACOs, bundled payments, etc.)
Patient-Driven Payment Model reimbursement model

Module 2: SNF Coverage and Documentation

Medicare technical requirements for admission to a SNF
Starting and ending a benefit period
"Skilling" basics
Identifying covered services and documenting to support the skilled service

Module 3: SNF Beneficiary Notices Initiative

Types of notices: SNF ABN, ABN, NEMB, DENC, and NOMNC
QIO and expedited review
Scenarios for ABN use

Module 4: The Resident Assessment Instrument and the Minimum Data Set 3.0

Critical review of the MDS 3.0
Concepts, constructs, and updates
Coding for accuracy and payment


Module 5: SNF PPS Payment

Reimbursement based on the Patient-Driven Payment Model
Linking payment to the MDS assessment and the medical record
Computing reimbursement rates and projecting revenue
Challenges of PDPM
Preadmission screening, ICD-10 coding accuracy, therapy utilization, etc.

Module 6: SNF Billing Under Part A

Completing the UB-04 claim form
Special claim scenarios: LOA, benefits exhaust, no-pay
Medicare as a secondary payer (MSP)

Module 7: SNF Consolidated Billing

Five major categories of consolidated billing
Medicare allowable amounts
Internal bill review processes
Tools and resources

Module 8: Part B Outpatient Therapy and Ancillary Billing

Rules, regulations, and documentation requirements for Part B therapy
Completing the UB-04
Using codes and modifiers appropriately


Module 9: Diagnosis Coding for SNFs

ICD-10-CM coding conventions and structure
Frequent LTC coding scenarios
Decision-making process regarding codes
Linking ICD-10-CM coding to admission, skilled services, MDS, and billing

Module 10: Medicare Medical Review and Appeals Process: Medicare A, B, C

Types of medical review agencies: MAC, CERT, RAC, ZPIC, SMRC
Triggers for medical reviews/audits
Tips to mitigate risk of improper payments
Appeals process and timelines

Module 11: Medicare Documentation

The basics
Therapy and nursing collaboration
Strategies to improve outcomes, support claims, and improve communication

Module 12: Medicare Compliance and Risk Management

Components of an effective compliance and ethics plan
Auditing for compliance
Triple-check review

Medicare Boot Camp®—Long-Term Care Version

Learning Objectives

Identify key sources of authority for Medicare in a SNF
Describe the Medicare Part A coverage criteria requirements
Describe the political landscape and the evolution of healthcare reform
Explain how quality impacts payment through the SNF Quality Reporting Program, Value-Based Purchasing Program, and public reporting
Explain how the MDS 3.0 impacts resident care, survey outcomes, and payment
Identify the components of the UB-04 for the purposes of SNF billing
Demonstrate how to select appropriate ICD-10-CM diagnosis codes and the impact of coding on reimbursement
Compare the Medicare medical review entities, their review focus, and the levels of the appeals process
Demonstrate documentation techniques to support skilled services
Identify the components of an effective compliance and ethics plan
Discuss methods to enhance Medicare compliance

What is the focus of the Medicare Boot Camp®—Long-Term Care Version?

Medicare Boot Camp—Long-Term Care Version is a comprehensive, three-day course that covers all the latest Medicare regulations and rules to help you locate the answers to your most troublesome Medicare questions, enhance your skilled documentation to meet medical necessity and level of care requirements, determine the correct RUG-IV payment category driven by the MDS, seamlessly manage blending scheduled and unscheduled MDS assessments, and analyze your ICD-10 coding system implementation. It also follows a Medicare patient from preadmission through discharge, addressing the patient needs and the related function of each department as well as identifying the pitfalls along the way to ensure that your staff is providing quality resident care, performing accurate documentation, and properly billing for services. Participants of the boot camp not only receive a wealth of knowledge, but also guidance on how to implement effective processes and systems to mitigate the risks associated with survey concerns, improper payments, and audits.

Who should attend this course?

• Reimbursement directors and staff members
• Finance directors and staff members
• Business office managers and staff members
• Directors of nursing and nursing department staff members
• SNF coding professionals
• Therapy staff members
• Administrators and owners
• MDS coordinators
• Quality assurance managers and staff members
• Compliance officers and auditors
• State surveyors
• MAC personnel
• Long-term care lawyers, consultants, and CPAs
• Legal department personnel
• Staff nurses
• Nurse managers
• Medical records professionals
• EMR/EHR developers

Continuing Education Credit

American Health Information Management Association (AHIMA)
This program has been approved for 21 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.

Nursing Home Administrators (NAB/NCERS)
This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 21 clock hours and 21 participant hours.

American Nurses Credentialing Center (ANCC)
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 21 nursing contact hours is provided by HCPro.

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 25.2 nursing contact hours. California BRN Provider #CEP 14494.

National Association of State Boards of Accountancy (NASBA) *
* Earn up to 25 CPE Credits!
Program Level: Intermediate
Delivery Method: Group-Live

Please contact the event manager Marilyn (marilyn.b.turner(at) ) below for:
- Multiple participant discounts
- Price quotations or visa invitation letters
- Payment by alternate channels (PayPal, check, Western Union, wire transfers etc)
- Event sponsorships

Service fees included in this listing.
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