Cost:

Free for HFMA Members
Buy HFMA Membership to Attend

Audience:

Hospitals and Other Providers
Physicians and Other Practitioners

Career level:

Experienced Professional
Student
Early Careerist

Recommended for:

Claims
Collections
Patient Accounts
Patient Financial Services
Physician Practice
Reimbursement
Revenue Cycle

Delivery Method:

Self Study

Advance Preparation:

None

Prerequisites:

None

Course Availability:

18 Months

News | Medicare Payment and Reimbursement
Hospitals and health systems need to develop a well-informed plan of action to deal the the short-term and long-term financial impacts of COVID-19.
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Blog | Medicare Payment and Reimbursement
Summary of the top five CARES Act provisions impacting hospital finances and the open questions associated with those provisions.
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News | Medicare Payment and Reimbursement
Hospitals would garner $100 billion in funding support — as well as some desired policy tweaks — from a pending coronavirus stimulus package.
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Course | Basic | Medicare Payment and Reimbursement
In this course we will address scheduling processes, including<div><ul><li>Patient identification</li><li>Requested service</li><li>Medical necessity screening</li><li>Medicare Advance Beneficiary Notice of Noncoverage processing</li><li>Pa...
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News | Medicare Payment and Reimbursement
A complete listing of healthcare finance-related hearings, conferences, webinars, public forums and deadlines for the week of March 9.
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Course | Intermediate | Medicare Payment and Reimbursement

Compliance: Reimbursement Issues

Course | Intermediate | Medicare Payment and Reimbursement

Compliance: 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.

Estimated course completion time: 1 hour
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

Course | Basic | Medicare Payment and Reimbursement

Scheduling

In this course we will address scheduling processes, including

  • Patient identification
  • Requested service
  • Medical necessity screening
  • Medicare Advance Beneficiary Notice of Noncoverage processing
  • Patient instructions
  • Scheduler instructions
  • Order requirements
Estimated course completion time: 30 minutes

Course | Basic | Payment, Reimbursement, and Managed Care

The UB-04 Billing Form: Form Locators 1 through 41

This course explains how to complete FL 1-41 of the UB-04 billing form. This course covers the use of this form for all payers, including Medicare, Medicaid, and commercial payers. The course describes each form locator and provides detailed information about the codes needed to fill in these data areas.


Estimated course completion time: 1 hour and 30 minutes

We also offer The UB-04 Billing Form: Form Locators 42 through 81 here.

Course | Basic | Payment, Reimbursement, and Managed Care

The UB-04 Billing Form: Form Locators 42 through 81

This course explains how to complete FL 42-81 of the UB-04 billing form. The codes needed to fill in these data areas are described. The course covers the use of this form for all payers, including Medicare, Medicaid, and commercial payers.

Estimated course completion time: 1 hour and 30 minutes

We also offer the UB-04 Billing Form: Form Locators 1 through 41 here.

On Demand Webinar | Update | Legal and Regulatory Compliance

2020 Final Rule changes to Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Centers (ASC)

The ambulatory surgery center (ASC) payment system continues to evolve with the proposed changes to the hospital payment system (OPPS) for calendar year 2020. Fnd out what changes are proposed for implementation on January 1, 2020 for ASCs and hospital outpatient services in the CY2020 final rule. Physician practice managers will want to keep a close watch on the ASC and OPPS developments as more services migrate from one setting to another. Prepare your organization now for the proposed changes.

Topics Include:

  • Latest update on CMS' pricing transparency initiatives
  • 2020 OPPS changes to drugs, biological, and radiopharmaceuticals
  • 2020 340B drug rules
  • 2020 changes to OPPS for cancer hospitals and partial hospitalization services
  • 2020 changes to OPPS packaging
  • 2020 methods to control outpatient volume increases related to clinic visits
  • 2020 changes for ASCs
  • 2020 changes to hospital outpatient and ASC quality requirements
  • Additional changes to other policy areas such as prior authorizations and laboratory date of service rules
Original Live Webinar Date: 12/17/19