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      Medicare Boot Camp® — Audits, Appeals, and Denials Version in Westminster

      • Medicare Boot Camp® — Audits, Appeals, and Denials Version Photo #1
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      October 8, 2020

      Thursday   8:00 AM - 5:00 PM (daily for 2 times)

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      Medicare Boot Camp® — Audits, Appeals, and Denials Version

      Medicare Boot Camp®—Audits, Appeals, and Denials Version
      About this Event


      Course Overview

      Get expert guidance on preventing denials and focusing appeals efforts for success. The evolution of reimbursement models and uncertainty regarding healthcare laws mean that to keep the doors open, organizations can’t afford write off appealable denials. Organizations need sound, practical information on overturning denials. Medicare Boot Camp®—Audits, Appeals, and Denials Version is your key to proven strategies for success and will answer all of your questions on denials management and appeals processes.

      This Boot Camp teaches you about the latest claim audit and appeal issues based on official guidance. You’ll leave the class armed with a thorough understanding of the audit and appeal process and ready to put your new knowledge into action.

      You will leave this program knowing how to:

      Prepare for CMS audits
      Navigate the appeals process up to the Administrative Law Judge level
      Research denials and upcoming audit focus areas
      Implement policies to support efficient appeals and identify appropriate denials to appeal
      Who should attend?

      Revenue cycle directors and managers
      Revenue integrity directors, managers, and staff
      HIM directors, managers, and staff
      CDI directors, managers, and specialists
      Compliance directors, officers, and auditors
      Business office managers
      Case management directors and managers
      Case managers
      Utilizations review staff
      Utilization management staff
      Physician advisors
      Audit directors and coordinators
      Appeals coordinators
      Patient financial services directors
      See the HCPro Difference for Yourself

      Focus on the actual rules: Learn how to prepare for CMS audits and navigate the appeals process up to the Administrative Law Judge level.
      Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research 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.

      Module 1: Medicare Overview and Resources

      The Four Parts of Medicare

      Medicare Contractors

      Independent Government Agencies-Medicare Involvement

      Module 2: Medicare Research and Resources

      Web-Based Resources

      Key Sources of Authority

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

      Ways to Stay Current

      Module 3: Medicare Program Safeguards and Medicare Notices

      Medicare Policy Development, Financing, the Trust Funds, the need for Program Safeguards

      Improper Payments

      Program Safeguards

      Limitation on Liability provisions of the Social Security Act

      Notices of Non-Coverage

      Module 4: Prepayment Claim Reviews/Audits

      Prepayment Reviews Overview

      Automated Prepayment Reviews

      Prepayment Non-Medical Record Reviews

      Prepayment Medical Record Reviews

      Module 5: Postpayment Claim Reviews/Audits

      Establishment of Postpayment Claim Review/Audits Process

      Postpayment Claim Reviews/Audits Overview

      Postpayment Non-Medical Record Reviews

      Statistical Sampling and Extrapolations

      Postpayment Medical Record Reviews

      Module 6: Medicare FFS Claim Appeals Process (Part 1)

      Initial Determinations

      Reopenings and Overlap with Appeals Process

      Level 1 Appeal Process: Redetermination

      Level 2 Appeal Process: Reconsideration

      Module 7: Medicare Appeals Process Overview (Part 2)

      Level 3 Appeal Process: Administrative Law Judge (ALJ) Hearing

      Level 4 Appeal Process: Medicare Appeals Council

      Level 5 Appeal Process: Judicial Review in U.S. District Court

      Module 8: Current Medicare Claim Audits and Appeals Issues Overview

      Two Midnight Expectation and QIO Review

      Expedited Judicial Review

      Medicare Overpayments

      Appeals Backlog

      Ways to Stay Current: Audit Topics

      Ways to Stay Current: ALJ Decisions, Appeals Council Decisions and Federal Court Decisions

      Course Agenda/Outline is subject to change.

      Learning Objectives

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

      Research the appeals process and related regulations
      Identify key steps in the appeals process up to the Administrative Law Judge level
      Explain common causes of Medicare denials
      Develop policies and practices to support compliance, reduce denials, and expedite appeals
      Analyze denied claims to select appropriate appeals


      Coming Soon!

      Cost: $1,139

      Categories: Conferences & Tradeshows

      This event repeats daily for 2 times: Oct 8, Oct 9

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