RAC. Fall Classes. For national class dates and locations visit Register online & save $100! INFORMATION!

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1 2009 Fall Classes For national class dates and locations visit REDESIGNED COURSE INCLUDING ESSENTIAL RAC INFORMATION! Register online & save $100!

2 2009 Dates and Locations Location Class Dates Phoenix, AZ September 28 October 2 Homewood Suites by Hilton Phoenix Metro Center 2536 West Beryl Avenue Phoenix, AZ Hotel Telephone: 602/ Discounted Room Rate: $99 Hotel Cutoff Date: September 2, 2009 Atlanta, GA October The Westin Buckhead Atlanta 3391 Peachtree Road, NE Atlanta, GA Hotel Telephone: 404/ Discounted Room Rate: $219 Hotel Cutoff Date: September 21, 2009 Dallas, TX November 9 13 Hyatt Place Dallas North 5229 Spring Valley Road Dallas, TX Hotel Telephone: 972/ Discounted Room Rate: $119 Hotel Cutoff Date: October 18, 2009 San Diego, CA November 30 December 4 Homewood Suites by Hilton San Diego/Del Mar Vista Sorrento Parkway San Diego, CA Hotel Telephone: 858/ Discounted Room Rate: $159 Hotel Cutoff Date: October 30, 2009 Class times are 8:00 a.m. 5:30 p.m. Monday Thursday and 8:00 a.m. 1:00 p.m. Friday. Special Room Rates Available! Limited Availability Register Early! Hotel Reservations We have negotiated a special rate for a limited number of rooms at each course location. Rooms are available on a first-come, first-served basis and may sell out before the cutoff date. Make your hotel reservations immediately to guarantee rate and availability, and be sure to identify yourself as a participant of HCPro s Medicare Boot Camp Hospital Version. For more dates and locations, visit Course Fee The registration fee for the five-day redesigned Medicare Boot Camp Hospital Version is $1,699, which includes all five-days of comprehensive training (including the two-days of RAC essential information) and course workbook. Medicare Boot Camp Hospital Version Alumni Special Offer Come back to Boot Camp and receive the most up-to-date information on RACs! For only $995, attend days three and four of class to become RAC ready and compliant. For information regarding administrative policies, such as cancellations, transfers, refunds, or comments, call 800/ or visit

3 Instructors Kimberly Anderwood Hoy, JD, CPC, serves as the lead instructor for the Medicare Boot Camp Hospital Version. She has served as a compliance officer and in-house legal counsel for hospitals. She has also developed and implemented corporate wide compliance programs for two hospitals. As a hospital compliance officer, she regularly provided research and guidance on coding, billing, and reimbursement issues for a wide range of hospital services. She has particular expertise in charge description master operation, development, and maintenance. She has experience conducting billing compliance audits and internal investigations. She has served as a speaker at compliance-related conferences in the areas of compliance program effectiveness and physician education. Judith L. Kares, JD, has extensive experience in the development of compliance programs, as well as training programs, risk assessments, compliance audits, and corrective action programs. Prior to beginning her current legal/consulting practice, she spent a number of years in private law practice, representing hospitals and other healthcare clients, and then served as in-house legal counsel. In that capacity, she served first as assistant general counsel and director of the legal department for Blue Cross and Blue Shield of Arizona and then as Deputy General Counsel, regulatory and contract compliance, with Blue Cross and Blue Shield of the National Capital Area in Washington, D.C. Debbie Mackaman, RHIA, CHCO, is an instructor for the Medicare Boot Camp Hospital Version and is formerly the compliance officer and director of health information for a healthcare system. She has over 16 years of experience in the healthcare industry, including both PPS and critical access coding and reimbursement systems. She addresses a wide range of coding and billing issues for hospitals, physicians, and home health and develops and manages compliance programs, with a focus on high-risk areas, auditing, and chargemaster maintenance. Debbie is an active participant with state and national committees and task forces on privacy, coding and payment policies, and education. Faculty subject to change. Faculty Disclosure Statement: HCPro, Inc., has confirmed that none of the faculty/presenters or contributors have any relevant financial relationships to disclose related to the content of this educational activity. Student testimonials... Judith is like the Meryl Streep of Medicare meaning the best in her field. In my 30 years of attending seminars and conferences, this was by far the most comprehensive and informative seminar. The reference materials are outstanding and beyond compare. Judith made sure that we knew how to use them. Linda Ostermann, Senior Financial Analyst, Inland Hospital, Waterville, ME This course is an outstanding prerequisite to prepare for RAC audits. Overall, the course has exceeded my expectations, and I consider it to be invaluable for all financial employees and utilization/case management personnel. Deborah Messina, Director Business Operations, Stamford CT Hospital The course met my objectives from a compliance officer s perspective. I took the course primarily to learn more of the Medicare rules on billing and coding. I now have a far better understanding of coding and billing issues. Karen Bolton, Ethics and Compliance Officer, Adena Health System, Chillicothe, OH

4 The regulatory environment is moving fast can you keep up? Hospitals are under increasing financial pressure, and Medicare can account for a large portion of their revenue. With the RAC permanent program well underway, hospitals will be scrutinized more closely than ever before. Get it right for revenue integrity on the front end. Understand the rules to protect that revenue from audits and recoupments on the back end. Attend the Medicare Boot Camp Hospital Version and learn how to successfully:» Prepare for RAC audits» Prevent missed revenue and denials» Maintain compliance with the latest rules and regulations Redesigned course including essential RAC information! The Medicare Boot Camp Hospital Version, has been redesigned focusing on RACs and outside audits to assist in risk assessment and future appeals. These comprehensive sections will cover information you need to be RAC ready. Leave this program with an understanding of:» How RACs identify issues» How much time you have for responses and reviews» The limitations on claims available for RAC review» How to appeal the RACs» What over 700 of your peers are doing to prepare for RACs in HCPro s NEW benchmarking report» And more! Medicare Boot Camp Hospital Version Alumni Attend two days for only $995 and stay RAC ready and compliant! Course Participants Receive the RAC BenchmarkING Report for FREE! Unlock the ANSWERS to your most troublesome Medicare questions Using a combination of lecture, class discussion, and hands-on exercises, this intensive four-and-a-half-day course gives you the knowledge and tools to find the answers to your most pressing Medicare concerns. The Medicare Boot Camp Hospital Version not only teaches you the rules and their application, but gives you the tools and skills to research your own Medicare billing questions long after the Boot Camp, enabling you to end your confusion and find what you need. Medicare Boot Camp : See the HCPro difference for yourself This isn t just any revenue cycle and compliance course; this is the most comprehensive course available today. Check out all the benefits of the Medicare Boot Camp :» Focus on the Actual Rules Learn how to find and apply CMS rules and guidelines to ensure that hospital services furnished to Medicare beneficiaries are billed accurately and appropriately.» Hands-On Learning Attendees work a set of exercises/case studies after each module to ensure that they understand the concepts and know how to apply them to real-world situations.» Live Instruction Classes are taught by an experienced, highly credentialed live instructor.» Small Class Size A low participant-to-teacher ratio is guaranteed.» Highly Rated Participants consistently give the course an overall rating of 4.75 or higher (on a 5.0 point scale).» Well-Established Program We currently conduct more than 24 Medicare Boot Camp Hospital Version courses each year.

5 Course Agenda Day one Medicare Research: End your confusion over the CMS Web site and find what you need» Researching Medicare Issues and Finding Medicare Resources on the Web» How to Understand Statutes, Regulations, Manuals, Transmittals and Other Medicare Rules and Guidelines» The Role of Medicare Contractors and Medicare Part A and Part B UB-04, ICD-9-CM, NPI and Other Must Know Billing Fundamentals» Key UB-04 Fields Applicable to Hospital Services, Including Proper Use of Condition Codes, Revenue Codes, HCPCS Codes, Diagnosis Codes and Present on Admission Indicators» Review of ICD-9 Coding for Outpatient Services Medicare Claims Processing Fundamentals» Repetitive, Non-Repetitive and Recurring Services, Including Claims Frequency» Inpatient Billing Issues» Date of Admission» Pre-Admission Services and the Three Day Rule» Medicare Claims Flow and Processing Systems, Including the Outpatient Code Editor and Medicare (Inpatient) Code Editor Day Two Medical Necessity and Noncoverage: What to know when Medicare is not paying the bill» Overview of Limitations of Liability and when Advanced Notice is Required» The Outpatient Advanced Beneficiary Notice (ABN) Forms and Instructions» Application of Limitation on Liability to Inpatient Services, Including Hospital Issued Notices of Noncoverage (HINN)» Discharge Appeals Process» How to Bill for Noncovered Services NCCI, MUEs, Modifiers, and Other Must-Know Coding Fundamentals» Composition and Application of NCCI Edits, Including Column 1/Column 2, Mutually Exclusive, and Medically Unlikely Edits» Proper Use of Modifiers with NCCI Edits» Special Considerations and Practical Issues for Hospitals Related to NCCI Edits Tools for Understanding and Predicting Medicare Outpatient Revenue: Overview of the OPPS system» Overview of the OPPS System and Ambulatory Payment Classifications (APC)» How to Use Addendum A and B and Status Indicators to Understand APCs» Determining Separately Paid Services and How They are Paid» Determine Services that are Packaged» Understand Composite APCs» Low Dose Rate Prostate Brachytherapy» Cardiac Electrophysiology Evaluation and Ablation» Extended Assessment and Management» Radiology Family Composites» How to Calculate Medicare Allowable, Patient Coinsurance» Understand and Calculate Outpatient Outlier Payments Day Three The Requirements and Operation of the Recovery Audit Contractor (RAC) Program» Overview of the RAC Program Requirements and Contractors» How RACs Identify Issues and the Role of the CMS Issue Review Board in Approving Issues for Review» Limitation on Claims Available for RAC Review» Process for Automated and Complex Reviews» Medicare Records Limits and Payments for Records» Time Frames for Responses and Reviews» Results Review Letters and Demand Letters» Differences Between Discussion Period and the Appeal Process» Timing of Recoupments Hot Topics: Medical Necessity of Inpatient Admissions and Observation Services» Coverage and Proper Billing of Observation Services» Identification and Billing of Inpatient-Only Procedures» Inpatient Coverage Rules» Requirements for Utilization Review» Changing Patient Status from Inpatient to Outpatient, Including Proper use of Condition Code 44» Payment Under Part B for Services Furnished to Inpatients» Conditions Arising During or From a Non-Covered Stay Day Four Hot Topics: Outpatient Coverage, Coding and Billing Topics» Issues Related to Provider-Based Departments:» Coverage of Hospital Outpatient Services Under the Hospital Incident-To Provisions» Proper E/M Coding, Including Clinic, Emergency Department, Critical Care, and Trauma Activation» Proper Application of Modifier 25» Issues Related to Drugs, Biologicals, and Devices» Coverage of Drugs, including Self-administered Drugs» Billing of Packaged Drugs, Biologicals, and Devices» Pass Through and Non-Pass Through Payment for Drugs, Biologicals, and Devices

6 Course Agenda» Issues Related to Surgical, Radiology, and Laboratory Procedures» Modifiers for Terminated/Discontinued Surgical and Radiology Procedures» Surgical Procedures Implanting Devices Received at Reduced or No Cost» Proper Reporting of Bilateral Procedures» National Coverage Determinations for Laboratory Services» Reference Laboratory Billing» Blood, Blood Products, and Blood Processing and Storage The Medicare Appeals Process» Limitations on Recoupment and Interest on Recoupments» Appeal Levels and Time Frames Day Five Tools for Understanding and Predicting Medicare Inpatient Revenue: Overview of the IPPS system» Overview of IPPS» Medicare Severity Diagnosis Related Groups (MS-DRGs), including MS-DRG Grouping and the Effect of Hospital Acquired Conditions» IPPS Payment Calculation» The Standardized Amounts» How to Find and Use the Medicare Wage Index and Geographic Adjustment Factor» Patient Responsibility, including Deductible, Coinsurance and Life Time Reserve Days When the DRG Payment Is Not What you Expect: Special Payments and Adjustments to the IPPS System» Medicare Dependent Hospitals and Sole Community Hospitals» Payment for Transfers and the Postacute Care Transfer Payment Policy» Payment Adjustment for Devices Received without Cost or with Substantial Credit» The Disproportionate Share Hospital (DSH) Adjustment» Indirect Medical Education (IME) Adjustment» New Technology Add-On Payment» Inpatient Outlier Basics Course agenda subject to change. HCPro certifies that this Boot Camp meets one or more of the following criteria:» The main topic contains substantive information about a RAC-identified error» The course will assist you in your appeals preparation» The Boot Camp will help you operationalize your RAC strategy/process. For more information on RAC Readiness visit HCPro s Revenue Cycle Institute specializes in consulting, education, and training customized to your organization s unique needs. Areas covered include:» RAC education and training» Coding and billing audits» Observation services and one day stay training» Chargemaster reviews» Regulatory watchdog services, including on-call consulting» Physician practice operations assessments Visit us at or call 888/ for more information.

7 additional Courses, and Services On-Site Training Bring the Medicare Boot Camp Hospital Version to your facility. If you have a group to train, holding a Boot Camp at your organization is easy and cost-effective. Eliminate travel costs and enjoy a group discount while ensuring your staff is up to date on the latest regulations and guidelines. Courses can be customized to meet the specific needs of your facility. Additional Boot Camps offered by HCPro:» Accreditation Specialist Boot Camp» Certified Coder Boot Camp Inpatient Version» Certified Coder Boot Camp» Clinical Documentation Improvement Boot Camp» Evaluation & Management Boot Camp» HealthLaw Boot Camp Hospital Version» Medicare Camp Long-Term Care Version For a complete course listing and more information, including a current class schedule, visit or contact us at 800/ common questions Are continuing education credits provided? Visit us at for complete information about continuing education credits. The Medicare Boot Camp Hospital Version offers continuing education credits from the following organizations:» American Academy of Professional Coders (AAPC)» Virginia State Bar» Healthcare Compliance Certification Board (HCCB)» American Nurses Credentialing Center (ANCC)» National Association of State Boards of Accountancy (NASBA)» Accreditation Council for Continuing Medical Education (ACCME) Are there any prerequisites? Two-day RAC Training The two-day RAC Training requires knowledge covered in the Medicare Boot Camp Hospital Version. This option is only open to Medicare Boot Camp Hospital Version alumnae. Medicare Boot Camp Hospital Version. Due to the fast-paced nature of the course, it is recommended but not required that participants have at least one year of experience working in a hospital. However, the course starts with Medicare fundamentals and does not assume that participants have any particular background or experience. Familiarity with the ICD-9-CM and CPT coding systems is helpful but not required. This course is taught on a basic to intermediate level. Who should attend?» Finance and reimbursement personnel» Chargemaster personnel» Billers and coders» Medical records/health information personnel» Clinical department personnel» Case managers» CDI professionals» Provider-based clinic personnel» RAC coordinators» Compliance officers and auditors» Revenue managers» Fiscal intermediary personnel» Registration personnel» Legal department personnel» Healthcare lawyers, consultants, and CPAs Upon receipt of the registration form and your registration fee, we will send confirmation of your registration, including hotel information and information about any manuals/texts required for class. (This information is also available on our Web site, We recommend against making travel arrangements until after we have confirmed your course registration. Registrations are accepted in the order they are received. Classes sometimes sell out before the registration deadline. The registration fees for our courses are subject to change. Check or call 800/ for our current course fees. We update this form whenever any course fee is changed. In the event that we receive an out-of-date registration form, we will contact you before processing.

8 Course Registration Registration Rates: Please mail or fax the completed form to: HCPro, Inc. 200 Hoods Lane Marblehead, MA Phone: 800/ Fax: 800/ $1,699 Full five-day course (includes the $995 two-day RAC preparation training) $995 Two-day RAC preparation training only Course Location Course Dates Name Nickname Organization Title Address City State ZIP Phone Fax Address Payment Type A check for my course fee is enclosed (made payable to HCPro, Inc.) Charge my course fee to (circle one): Visa MasterCard American Express Discover Name on Card Signature Cardholder Street Address ZIP Card Number Exp. Date Upon receipt of this form and your course fee, we will send confirmation of your registration, including hotel information and information about any manuals/texts required for class (this information is also available on our Web site at MT Hoods Lane P.O. Box 1168 Marblehead, MA Register online and SAVE $100! Enter the source code on your address label to receive this discount. Visit