Cost:

Free for HFMA Members
Buy HFMA Membership to Attend

Delivery Method:

Self Study

Course Availability:

18 Months

Recommended for:

Billing

Career level:

Early Careerist
Experienced Professional
Student

Audience:

Business Partners
Hospitals and Other Providers

Advance Preparation:

None

Prerequisites:

None
News | Medicare Payment and Reimbursement

Healthcare finance policy events for the week of Sept. 16.

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News | Medicare Payment and Reimbursement

Senate appropriators will vote on funding for the U.S. Department of Health and Human Services, among other key healthcare finance events around the country next week.

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News | Medicare Payment and Reimbursement

Healthcare finance policy events for the week of Sept. 2.

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News | Medicare Payment and Reimbursement

CMS Administrator Seema Verma plans to address a gathering of health information data exchange advocates on Aug. 19.

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Blog | Medicare Payment and Reimbursement

A review of why a couple of the key changes to the CMS FY2020 IPPS Rule may not bring the desired results.

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Course | Overview | Medicare Payment and Reimbursement

Compl: Reimbursement Issues

Course | Overview | Medicare Payment and Reimbursement

Compl: Reimbursement Issues

Description

This course provides an overview of the prospective payment systems used in the Medicare program and as well as Medicare fee schedules. This course provides a general discussion and overview of Medicare reimbursement under the Inpatient Prospective Payment System (IPPS) and discusses specific instances in which a hospital may receive additional payments under the IPPS.
After this program, you'll be able to..
  • Identify the general structure of a prospective payment system
  • Recognize the statutory history behind the implementation of the prospective payment system
  • Identify which Medicare programs are reimbursed using a prospective payment system
  • Recognize the physician fee schedule
  • Recognize the DMEPOS fee schedule
  • Recognize the clinical laboratory fee schedule
  • Identify the steps necessary to determine payment under the IPPS
  • Identify which services are not included in payment made under the IPPS
  • Recognize the purpose of an outlier payment and identify when an outlier payment may be made
  • Recognize the purpose of a disproportionate share adjustment and when such an adjustment may be made
  • Identify indirect medical education (IME) and recognize when an IME adjustment may be made

Related Courses | Medicare Payment and Reimbursement

On Demand Webinar | Update | Billings and Collection

The latest on healthcare regulatory and legislative issues with Andy Bressler

A look at the latest healthcare regulatory and legislative issues moving through Congress, Health and Human Services (HSS) and the Center for Medicare & Medicaid Services (CMS).

Course | Overview | Compliance

Compl: The Outpatient Prospective Payment System

This course provides a general discussion and overview of reimbursement provided by Medicare under the outpatient prospective payment system. It also discusses the use of ambulatory payment classifications in the outpatient prospective payment system. The course can be used as a basis for understanding compliance issues relating to the OPPS.

Course | Overview | Compliance

Compl: Medicare Compliance Concerns

This course addresses specific Medicare compliance and coding issues. It will review terms such as MS-DRG window, Two-midnight rule, Correct coding initiative (CCI), modifiers, and Medicare secondary payer (MSP).

On Demand Webinar | Intermediate | Medicare Payment and Reimbursement

Developing and operationalizing a successful Medicare Advantage strategy

As the senior population continues to outpace the relative growth of the general population, and Medicare Advantage is accounting for about one-third (and growing every year) of all new Medicare eligible enrollees, providers are increasingly faced with the strategic questions of how best to engage with this rapidly expanding segment of their business portfolio. This question is further complicated by market disruptors, who are entering markets across the U.S. to aggregate independent physicians to manage this population.

The focus of this webinar is to raise awareness and understanding of the key considerations for:

  • Develop a market-tailored Medicare Advantage strategy
  • Define payer/contracting approaches and value propositions
  • Identify appropriate infrastructure and analytics
  • Establish high-performance networks and realizing successful execution