February 20, 2009
Joint Part B and DME MAC Medicare Survival Guide Workshops
The Practical Guide to Improved Medicare Billing
Your CIGNA Government Services (CGS) Provider Outreach and Education (POE) team announces our new Joint Medicare Part B and DME MAC workshop series, "Medicare Survival Guide." During this full-day workshop, Medicare Survival Experts will field test your knowledge of Medicare issues and provide you with the skills to survive every day billing challenges. Offering education for Medicare Part B and DME in the same workshop setting provides you with a unique opportunity to expand your Medicare knowledge. Whether you are a new or seasoned Medicare Survivalist, you will gain valuable knowledge from this straightforward and easy to follow Medicare Survival Guide.
Workshop Coordinates:
April 9, 2009
Sheraton Imperial Hotel
4700 Emperor Blvd.
Durham, North Carolina 27703
April 21, 2009
Embassy Suites Concord
5400 John Q. Hammons Dr. NW
Concord, North Carolina 28027
Workshop Details:
Each Medicare Survivalist may navigate a variety of Medicare survival topics through a series of customized breakout training sessions.
Part B and DME Joint Medicare Survival Topics:
Medicare Audits: Survival of the Fittest
When you consider that a Medicare audit can be conducted by several entities including the Comprehensive Error Rate Testing (CERT) Contractor and the upcoming Recovery Audit Contractors (RAC), it is easy to say that all Medicare Survivalists have the potential to receive an audit request. Accurate preparation and prompt response is the key to a successful result. In this session, you will learn the vital steps you should take to prepare for, and respond to, a Medicare audit and how a lack of response could negatively impact your business. Surviving a Medicare audit is the ultimate survival challenge; are you ready?
Medicare Secondary Payer (MSP): Traversing the Course
Understanding the MSP process can be one of the most challenging endeavors a Medicare Survivalist could endure. In an easy to understand format, we will discuss the responsibilities of each party involved: Medicare beneficiary, provider of service, Attorney, COBC, etc. You will also learn how and when to complete the MSP questionnaire and understand how to correctly submit claims for Medicare Secondary payment. Upon completing this session you will be equipped with the skills needed to negotiate the MSP journey.
Resources: Your Tools of the Trade
Most everyone has, at one time, reached a point of feeling lost in a sea of Medicare rules and regulations. The information shared in this session can be used as your compass to finding the key tools and self-service options you need to guide your business to success. From efficient navigation of the CMS and CGS Web sites, to exploring online education tools, tips, and tricks, this session is guaranteed to point you in the right direction. You will learn to use these natural resources effectively to navigate your way around a potential claim denial.
Advance Beneficiary Notices (ABN's): Securing Your Shelter
When the certainty of a downpour is in the forecast, it is recommended you find shelter from the rain. The same holds true with an ABN, since its primary purpose is to shelter you from the unexpected elements of Contractual Obligation (CO) claim denials. Ask yourself, "Am I securing my ABN correctly?" "Am I using the correct materials issued by CMS?" "What are the consequences if I'm not acquiring it correctly!?" Is your shelter strong enough to withstand a "CO denial downpour?" We can help!
DME Medicare Survival Topics:
Respiratory Coverage: Orienting New Directions
Some of the most experienced Medicare Survivalists find it difficult to explore the fundamentals of Medicare's Oxygen and PAP coverage criteria. This session will test your mental fitness by challenging you to find your way through the basic, new, and unfamiliar territory of Oxygen and PAP policy changes.
Mobility Equipment: Getting Your Bearings
Power and manual wheelchairs, walkers, canes, crutches; all of these items have conveniently been grouped into a single classification entitled, Mobility Equipment. It's important you understand the instructions associated with each type of Mobility Equipment. Not understanding each policy can steer you down the wrong path; resulting in claim denials, claim audits, overpayment requests, etc. We will provide you with the skills to maintain your bearings and guide you to mobility policy expertise.
Documentation Requirements: Preparation is Key
In this session, we will show you how to pack the essential information needed to complete your intake process. We will demonstrate proper intake processes, explain practitioner requirements, review required forms, etc. Developing and practicing a thorough intake process will improve your business's survival strength. Mastering these techniques will give you the skills needed to properly recognize and resolve claim, audit, or appeal situations that may arise.
Medical Review: Improving Your Audit Strategy
Understanding Medical Review's 2009 pre-/post-claim payment audit initiatives helps you improve your audit strategy by understanding how coverage policies and documentation requirements impact audits. Learn about common errors discovered during audits of diabetic supplies, group II support surfaces, nebulizers and medications, power wheelchairs, and enteral nutrition. Skills gained from this course will improve your audit survival strategy.
DME Updates and FAQs: One Step Ahead
When preparing for Medicare survival, it's important to plan for change. For example, Medicare has revised instructions/policy as they pertain to the 2009 fee schedule, signature requirements, overpayment processing, Zone Program Integrity Contractors (ZPICS), supplier standards, and accreditations. After this session, Medicare Survivalists will be one step ahead of these challenging survival topics.
Top Denials: Pushing Through the Sting
This session will provide each Medicare Survivalist with a stocked first aid kit of tools, instructions, and tips to resolve claim denials. This mission will be accomplished by teaching you, step-by-step, how to effectively review your Medicare Remittance Notice (MRN) with the aid of CGS' Denial Guide. We will outline the process for appealing claims through the Redetermination department and show you when it is okay to correct a claim through Reopenings. You will discover how to push through the sting of a claim denial and begin the process of healing.
Part B Medicare Survival Topics:
Part B Updates and FAQs: Updating Your Survival Knowledge
Medicare policies and survival situations are the same in that conditions are subject to change at a moment's notice. This session will focus on key Part B Medicare Program updates for Calendar Year 2009, including changes to the Initial Physical Preventive Exam (IPPE), Proposed ICD-10/ 5010 regulations, Internet-based PECOS for the online submission of provider enrollment applications, and other timely topics. We will also review FAQs from Customer Service, Medical Review, and CMS. Remaining up-to-date on Medicare policy additions/revisions will ensure you are prepared for any Medicare survival situation.
Documentation Requirements: Laying the Groundwork
In life, business, and Medicare survival, it is important to properly build a foundation of education and training. In this session, we will provide you with the fundamental principles of medical record documentation as it pertains to patient and family history, examinations, procedures and treatment, time requirements, etc. Developing and honing these skills to appropriately obtain, document, and retain this information will help to lay the groundwork for all of Medicare's potential survival challenges.
Claim Exceptions: When Edits "bite" – Treatments and Cures
If you haven't already…you will! You will experience the effects of Medicare's claim processing edits. Learn how the Common Working File (CWF), beneficiary eligibility, frequency of use, units and place of service, Medicare Advantage enrollment, etc., can positively and negatively affect claim payment. Learning proactive billing tips, claim submission strategies, and the claims process from a carrier's perspective, will provide you with the skill to survive the effects of a claim edit.
Physician Quality Reporting Initiative (PQRI): Expanding Your Horizons
Did you know that you can earn a 2% bonus payment for PQRI reporting as well as an additional 2% incentive for E-prescribing in 2009? This is your opportunity to learn how these programs can increase quality and earn dollars for your practice. Find out more in this session where we will discuss how you can plot a course into each program.
Evaluation & Management (E/M): The Keys to Survival
Just as acquiring food, water, and shelter are critical for long-term survival, understanding E/M is critical for your overall success. Given that most of you can perform E/M in a variety of settings; these services are the most frequently billed charges to Medicare. It is important for you to know and understand the CMS guidelines for E/M visits in order to properly bill Medicare for reimbursement. Attend this session for your keys to long-term survival.
- Course 1
This course will address key E/M concepts such as the basics of E/M coding and modifiers, consultations, and prolonged services as well as common errors and frequently asked questions.
- Course 2
Take advantage of this opportunity to learn more about advanced E/M concepts such as locum tenens/ reciprocal billing guidelines, incident to criteria, scribing, hospital visits, and critical care.
Compliance: Protecting Your Practice
When drafting or evaluating your internal compliance standards, audit survival knowledge, skill, and preparation are the keys to success. This session is unique in that you will learn specific instruction related to documentation retention and recommended compliance principles directly from CMS' Medicare Learning Network. Share ideas and best practices in this open forum setting. You will leave this session with CMS tools and guidance to self-evaluate your compliance process.
