MEDICARE DON T NAVIGATE ALONE! RULES & REGULATIONS. Medicare Boot Camp. Medicare Boot Camp. Medicare Boot Camp

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1 Over 30,000 students trained through HCPro Boot Camps TM DON T NAVIGATE MEDICARE RULES & REGULATIONS ALONE! START WITH HCPRO Medicare Boot Camp Hospital Version Medicare Boot Camp Utilization Review Version Medicare Boot Camp Critical Access Hospital Version Sign up today! HCProBootCamps.com I

2 Medicare Boot Camp Hospital Version Bring predictability and stability back to your revenue by joining the nation s leading Medicare experts As the IPPS and OPPS rules evolve, The Medicare Boot Camp Hospital Version becomes an essential course for any revenue cycle or compliance professional. Everything from coding for visits to inpatient and outpatient status has changed. If you re not up to date with your education, your revenue stream will suffer. The Medicare Boot Camp Hospital Version is completely updated to include the latest on the IPPS and OPPS rules. Our instructors debunk Medicare myths by teaching directly from CMS materials and regulations, rather than unsupported opinions or rhetoric. ONLY $1,699 PER PERSON Armed with accurate and up-to-date information, you will be prepared to better manage revenue cycle and government audits and implement improvements to strengthen reimbursement and compliance at your hospital or health system. You will leave this course knowing how to: Use the rules, edits and modifiers to get bills paid faster and drive down accounts receivable days Understand reimbursement rules to master your Chargemaster Prevent inpatient denials Conduct self-audits to receive Part B payment for inpatient cases Properly use and bill for observation services Implement best practices so you get the revenue you deserve while staying in compliance Comprehensive sections explain the complexities of: The 2-midnight benchmark and presumption Inpatient order and certification requirements The intricacies of the three-day rule Physician supervision Observation services and correct use of condition codes 44 and W2 Medically unlikely and other NCCI edits ABN use and applicable billing rules Self-administered drugs Inpatient-only procedures Laboratory packaging and separate payment 2

3 MEDICARE BOOT CAMP HOSPITAL VERSION OUTLINE The course outline is as follows: Module 1: Finding and Understanding Medicare Guidelines DATES For additional details regarding hotel reservations and discounted room rates, please visit Module 2: Decoding the UB-04 Module 3: Medicare Claims Submission Fundamentals Module 4: Medicare Edit Systems Module 5: Coverage of Hospital Outpatient Services Module 6: Outpatient Medical Necessity and Advanced Beneficiary Notices Module 7: Nuts and Bolts of the Outpatient Prospective Payment System (OPPS) Module 8: Calculating Outpatient Payment and Outliers Module 9: Outpatient Non-diagnostic Services Module 10: Diagnostic and Surgical Services Module 11: Sorting out Patient Status: Observation Services and Inpatient Admissions Seattle, WA August Hampton Inn & Suites Seattle Airport Las Vegas, NV September Hyatt Place Las Vegas San Diego, CA October 6 10 Homewood Suites by Hilton San Diego Airport/Liberty Station Nashville, TN November Homewood Suites by Hilton Nashville/ Brentwood Phoenix, AZ December 8 12 Homewood Suites by Hilton Phoenix/ Avondale Module 12: Inpatient Non-Coverage and Special Billing Issues Module 13: Inpatient Prospective Payment System (IPPS) and Patient Responsibility Module 14: Inpatient Payment Factors Module 15: Inpatient Payment Adjustments BOOT CAMP SCHEDULE Courses run 8:00 am 5:00 pm Monday through Thursday. 8:00 am 1:00 pm on Friday. *Course agenda subject to change. For complete agenda, visit CE CREDITS This boot camp offers Continuing Education Credits! Go to for more information. 3

4 Medicare Boot Camp Utilization Review Version Master Medicare rules for utilization review Medicare Boot Camp Utilization Review Version is an intensive two-day boot camp focusing on the new Medicare requirements for patient status and the role of the utilization review (UR) committee. UR is no longer the responsibility of a few. No matter your role, the Medicare Boot Camp Utilization Review Version will teach you how to implement the new rules and leverage them for your facility. Armed with accurate and up-to-date information, you will be prepared to better manage revenue cycle and government audits and implement improvements to strengthen reimbursement and compliance at your hospital or health system. ONLY $1,099 PER PERSON Executives, CMOs, VPMAs: Learn how to build an effective UR committee and ensure physician advisors are ready to implement the new rules UR committee members and physician advisors: Get the information you need to make decisions regarding patient status that will be compliant while not leaving any money on the table. Compliance officers: Get a complete understanding of the UR rules so you can ensure your facility is in compliance. Nurse administrators/case managers: Understand the details of the rules so you can educate physicians on them. Revenue cycle staff: Learn how managing patient status plays a critical role in correct reimbursement, and can stabilize inpatient reimbursement. You will leave the course knowing: How to apply the 2-midnight benchmark and 2-midnight presumptions The importance of continued monitoring of physician practice patterns The advantages of post discharge versus concurrent patient status reviews When self-denial is appropriate to take advantage of Part B payment for an inpatient case How NCDs, LCDs, and CEDs affect coverage of cases that meet the 2-midnight benchmark The observation coverage rules and how they interact with the new benchmark When ABNs should be used for extended stays that don t meet medical necessity 4

5 COURSE OUTLINE The course outline is as follows: Module 1: Introduction to Medicare Module 2: Medicare Coverage and Notices Module 3: Patient Status: Outpatient Observation and Inpatient Admission Module 4: Utilization Review and Billing Implications DATES For additional details regarding hotel reservations and discounted room rates, please visit San Diego September Homewood Suites by Hilton San Diego Airport/Liberty Station Hotel Phone Number Module 5: Payment for Outpatient Services, Including Observation Module 6: Payment for Inpatient Admissions, Including Patient Responsibility BOOT CAMP SCHEDULE Courses run from 8:00am 5:00pm. *Course agenda subject to change. For complete agenda, visit CE CREDITS This boot camp offers Continuing Education Credits! Go to for more information. SAVE ON OUR LIVE OR ONLINE CLASSES Register up to 90 days before course start date and SAVE $100 Coupon code: BC14SV100 Register up to 60 days before course start date and SAVE $50 Coupon code: BC14SV50 5

6 Medicare Boot Camp Critical Access Hospital Version Master Medicare rules for critical access hospitals Medicare Boot Camp Critical Access Hospital Version is an intensive three-day Boot Camp that teaches you the complex Medicare rules applicable to this unique setting, including Medicare coverage, billing, coding, and payment. With the evolving CMS regulations, your revenue stream will suffer if you re not up to date with your education. Our instructors show you which rules apply to CAHs so you can successfully submit claims and get paid appropriately. Armed with accurate and up-to-date information, you will be prepared to better manage revenue cycle and government audits and implement improvements to strengthen reimbursement and compliance at your hospital or health system. You will leave this course knowing how to: Apply the 2-midnight benchmark Avoid compliance pitfalls Ensure appropriate reimbursement Ensure compliant inpatient orders and certifications Properly use and bill for observation services Submit accurate claims to Medicare, including Part A to B rebilling ONLY $1,199 PER PERSON 6

7 COURSE OUTLINE The course outline is as follows: Module 1: Finding and Understanding Medicare Guidelines Module 2: Overview of Critical Access Hospital (CAH) Designation Module 3: Decoding the UB-04 Claim Form and Medicare Claims Submission Fundamentals Module 4: Medicare Systems and Processes Related to Claims Module 5: National Correct Coding Initiative (NCCI) Edits, Including the Proper Use of Modifiers DATES For additional details regarding hotel reservations and discounted room rates, please visit Denver, CO September Hyatt Place Denver Tech Center Dallas, TX November Courtyard by Marriott Dallas DFW Airport South/Irving Module 6: Outpatient Medical Necessity and Advance Beneficiary Notices Module 7: Overview of the Cost-Based Reimbursement System Module 8: Coverage, Coding, and Billing for Outpatient Services: Hospital Provider-Based Clinics, Emergency Departments, Drugs, and Therapy Services Module 9: Coverage, Coding, and Billing for Outpatient Services: Surgery, Radiology, and Laboratory Module 10: Patient Status: Observation Services and Inpatient Admissions CE CREDITS This boot camp offers Continuing Education Credits! Go to for more information. Module 11: Coverage and Billing for Swing Bed Admissions BOOT CAMP SCHEDULE Courses run from 8:00am 5:30pm Monday through Wednesday *Course agenda subject to change. For complete agenda, visit 7

8 EXPERT TRAINERS KIMBERLY A. HOY BAKER, JD Baker is the director of Medicare and compliance for HCPro. She is the lead instructor for HCPro s Medicare Boot Camp Hospital Version and Medicare Boot Camp Utilization Review Version, as well as an instructor for Medicare Boot Camp Critical Access Hospital Version. She is a former hospital compliance officer and in-house legal counsel, and has developed and implemented corporatewide hospital compliance programs. In addition, Baker has experience conducting billing, compliance audits, and internal investigations. DEBBIE MACKAMAN, RHIA, CPCO Mackaman is an instructor for HCPro s Medicare Boot Camp Hospital Version and lead instructor for Medicare Boot Camp Critical Access Hospital Version. She has over 20 years of experience in the healthcare industry, including both inpatient and outpatient prospective payment system and critical access hospital documentation, coding, and reimbursement issues. Mackaman most recently held the position of compliance officer and director of health information services for a healthcare system. JUDITH KARES, JD, CPC Kares is an instructor for HCPro s Medicare Boot Camp Hospital Version. She is a practicing attorney and compliance consultant with 24 years of experience representing hospitals, third-party payers, and other healthcare clients in the areas of healthcare contracting and regulatory compliance. HUGH E. AARON, MHA, JD, CPC, CPC-H Aaron is the original developer of and an instructor for HCPro s Medicare Boot Camp Hospital Version. He is a senior advisor for healthcare for Virginia Capital Partners, LLC, a private equity fund based in Richmond, Va. He also owns The Aaron Group, LLC, a consulting firm focused on coding and reimbursement issues. Aaron is an adjunct assistant professor at the University of Richmond, where he teaches healthcare regulation. Who should attend an HCPro Medicare Boot Camp Hospital or Critical Access Hospital Version? Admitting staff Auditors and analysts Billers Billing Specialists Case Managers CDI specialists Chargemaster coordinators and managers Clinical department heads and managers Coding managers and supervisors Compliance officers CPAs and lawyers Directors of case management Finance managers Healthcare consultants Health plan financial analyst, claims processing and provider relations professionals HIM directors and managers Medicare administrative contractors Patient access staff Provider-based clinical personnel Physician advisors Quality Vice President Recovery audit coordinators Reimbursement managers Vice presidents of patient services Vice presidents of quality Who should attend an HCPro Medicare Boot Camp Utilization Review Version? Case managers CMOs CNOs Compliance officers and auditors Fiscal intermediary personnel Healthcare lawyers and consultants Nurse managers UR coordinators UR committee members UR physician advisors Revenue cycle staff VPMAs 8

9 Medicare Boot Camp Advantage Our expert instructors teach right from the Medicare regulations, and do not rely on unsupported opinions or rhetoric. They show you where to find the rules and provide citations so you can find answers to your questions long after the Boot Camp is over. See the HCPro difference for yourself. Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure hospital services furnished to Medicare beneficiaries are billed accurately and appropriately. Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research Medicare questions long after the Boot Camp ends. Hands-on learning: Attendees work a set of exercises after each module to ensure they understand the concepts and know how to apply rules 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 (open registrations and onsites) each year. What your peers have said: It was very much worth the time and tuition. Debbie was very patient and knowledgeable. She made the experience fabulous. She is a very valuable asset and happy to have had her as our instructor. Tami Lawson-Churchill, Bartlett Regional Hospital, Juneau, AK I have attended several of Kim s workshops and find that she is an outstanding teacher and very knowledgeable. Janie Kellogg, Education Specialist, Billings Clinic, Billings, MT Overall, the class was very good. Kimberly s knowledge base is exceptional. She manages the class extremely well, answering questions but keeping the class on track. Coleen Owens, Director of Utilization and Admissions, Henry Ford Health System 2-midnight rule explanation was great! Best conference I ve been to. I learned a lot. Julie Ducheney, Director of Case Management, Lima Memorial Hospital 9

10 BRING HCPRO s BOOT CAMPS TO YOUR FACILITY! HCPro s industry-leading instructors will travel to your facility, on your schedule to provide consistent training to all of your staff on the latest rules and guidance. Our onsites offer all the same HCPro Boot Camp benefits: CEs from a variety of healthcare organizations Instructors who have a unique combination of in-the-field and adult education expertise Course materials developed by instructors specifically for an intensive learning format Exercises and hands on learning activities The opportunity for your staff to network HCPro s onsite Boot Camps are a convenient and cost-effective way to train your staff. By avoiding the costly expense of travel your facility can save up to 60%.* Choose from our catalogue of Boot Camps or work with our industryleading instructors to develop a customized course. Contact HCPro at or at sales@hcpro.com for more information about HCPro Onsite Boot Camps. *Savings based on the training and travel costs of 20 staff members. 10

11 Mail REGISTRATION Easy ways to register for your HCPro Boot Camp HCPro P.O. Box 5094 Brentwood, TN Upon receipt of this form and your course fee, we will send confirmation of your registration, information about any manuals/texts required for class as well as hotel information so you can make your reservations. This information is also available on our website 1. COURSE REGISTRATION m $1,699 Medicare Boot Camp Hospital Version m $1,199 Medicare Boot Camp Critical Access Hospital Version m $1,099 Medicare Boot Camp Utilization Review Version 2. TOTAL REGISTRATION RATE: 3A. COURSE LOCATION (HOSPITAL VERSION): m Seattle, WA August m Las Vegas, NV September m San Diego, CA October 6 10 m Nashville, TN November m Phoenix, AZ December B. COURSE LOCATION (CRITICAL ACCESS HOSPITAL VERSION): m Denver, CO September 8 10 m Dallas, TX November C. COURSE LOCATION (UTILIZATION REVIEW VERSION): m San Diego, CA October SOURCE CODE: MT ATTENDEE INFORMATION Phone Fax URL to order: customerservice@hcpro.com Organization Name Organization Title Address City State Zip Phone 6. PAYMENT TYPE m A check for my course fee is enclosed (made payable to HCPro, Inc.) m Charge my course fee to (circle one) VISA Mastercard Am Ex Discover Name on Card Cardholder Street Address Zip Card Number Exp. Date Copyright 2014 HCPro, a division of BLR. All rights reserved. *MAGNET, MAGNET RECOGNITION PROGRAM, and ANCC MAGNET RECOGNITION are trademarks of the American Nurses Credentialing Center (ANCC). The products and services of HCPro are neither sponsored nor endorsed by the ANCC. The acronym MRP is not a trademark of HCPro or its parent company. HCPro is not affiliated in any way with The Joint Commission, which owns the JCAHO (Joint Commission on Accreditation of Healthcare Organizations) and Joint Commission trademarks, the Accreditation Council for Graduate Medical Education, which owns the ACGME trademark, or the Accreditation Association for Ambulatory Health Care (AAAHC) MT314641

12 P.O. Box 5094 Brentwood, TN Your Source Code is: PRESORTED STD US POSTAGE PAID HCPRO MT Register today and save! DON T NAVIGATE MEDICARE RULES & REGULATIONS ALONE! START WITH HCPRO Medicare Boot Camp Hospital Version Medicare Boot Camp Utilization Review Version Medicare Boot Camp Critical Access Hospital Version Register up to 90 days before course start date and SAVE $100 Coupon code: BC14SV100 Register up to 60 days before course start date and SAVE $50 Coupon code: BC14SV50 Sign up today! HCProBootCamps.com I