ABOUT THE MEDICARE UNIVERSITY PROGRAM
Medicare University is a three-day intensive seminar designed to meet the needs of clinicians and anyone involved in billing who finds him/herself mired in confusing, complex and ever-changing regulations and requirements.
Fundamentals of Medicare: Understand Medicare Part A, Part B, Part C, and Part D in a skilled nursing facility. Define the SNF benefit period, technical eligibility, and skilled coverage requirements. Ensure regulatory compliance with meeting the daily skilled need. Detail the criteria for direct and indirect skilled services and understand SNF beneficiary notice requirements when Medicare ends.
Managing Medicare A in a SNF: From admission to discharge, there are important system processes to have in place. Make sense of management considerations for pre-admission screening, the admissions process, making correct coverage decisions, and best practices for facility interdisciplinary responsibility in daily management of the SNF program and discharge planning. Learn strategies for growing and keeping SNF market share, and proactively managing publicly reported data like Five-Star rating system and Nursing Home Compare data.
Managing the SNF documentation process: Don’t let your Medicare documentation fall short, resulting in denied claims. We’ll examine reasons for sound documentation, how to consistently show SNF need, and discuss charting best practices. You will receive charting resources and charting guidelines for nursing, social services, dietary, and activities that support skilled need. Learn tips and tools for auditing daily, weekly, monthly and quarterly charting. Examine the importance and process for conducting interdisciplinary Medicare and PPS meetings.
Rehabilitation Therapy under PPS: With the MAC, RAC, and OIG audits focus on therapy services, SNF and therapy services must be closely aligned. Define what constitutes qualified therapy service for Part A, provide pros and cons of in-house vs. outsourced therapy, supply best practices for coordinating therapy disciplines and schedules, detail the therapy documentation requirements and discuss RUGS management. Examine guidelines and management of Part B therapy in a nursing facility, including therapy caps and G-codes.
PPS Payment System and MDS Assessment Scheduling: Increase your understanding around the concept of SNF ‘bundled services’ in the daily PPS rate, components of the daily rate, and current CMS initiatives and their potential effect on the SNF PPS. We’ll detail the requirements of the PPS scheduled and unscheduled MDS assessments (COTs, EOTs, SOTs and combining). Learn about the PPS assessment scheduling rules and payment periods for each type of assessment, financial penalties for noncompliance with the PPS schedule, and how to strategically set the ARDs to capture the care and services given.
RUG-IV: Take a deep dive into the RUGS-IV, 66 group acuity-based payment system which results in the PPS daily rate. Learn how to compute the all-important ADL score, understand case mix index maximization for capturing all services provided on each PPS MDS assessment. RUGs management is a crucial element which cannot be left to MDS coordinators and rehab directors alone. It requires teamwork. The Medicare team must be able to recognize and react to daily events in the course of a beneficiary’s SNF stay that impact reimbursement. Learn best practices for ensuring that facility staff provides the care and services that match the resident needs and are appropriately reflected in the RUG.
Consolidated Billing for Facility Management Teams: Does consolidated billing have you tied up in knots? No worries! We’ll cover how to recognize the major categories of consolidated billing, how to determine if a service is included or excluded from consolidated billing, and clarify the common CB issues that arise every day in a SNF. Gain insight into strategies for ensuring that the SNF pays what it owes and does not pay if the service is excluded from consolidated billing.
Medical Review/Additional Development Requests: Don’t be unprepared when an auditor requests to review your Medicare claims. Increase you command of the Medicare medical review process, including types of reviews and possible outcomes. Discover how to respond to additional development requests, review your rights as a provider to appeal Medicare decisions, and understand the Medicare appeals process.
Lake Elmo, MN - Pathway, 11240 Stillwater Blvd N, Lake Elmo, MN 55042
AANAC Members: $575, non-members: $775
If you currently are a member of AANAC and you want the discount applied at the time of order, please call 651-407-8699, prior to entering information into the website, and we will assist you with your order. Have your member number ready when you call.
Interested in becoming an AANAC member: Visit https://www.aanac.org/pages/member_app.asp