Description

Designed for SNF staff who manages Medicare benefits for beneficiaries receiving care in the facility. This course includes the rules and regulations for beneficiary access to the program and the best practices for internal processes to manage Medicare and receive the appropriate reimbursement for services.

Throughout the course, participants will join their colleagues in small group discussions, case scenario analysis and practice with Medicare processes. These “hands-on” experiences facilitate a thorough understanding of the material presented. Tested and proven tools will be provided so that participants will be equipped to implement their knowledge at the end of the course.

Objectives

1. Examine Medicare Part A eligibility criteria.
2. Review the documentation standards necessary to support Medicare claims
3. Apply Medicare compliance guidelines within skilled nursing facility scenarios, such as conducting audits and Medicare reviews.
4. Discuss common billing challenges and appeals related to Medicare claims
5. Examine the aspects of consolidated billing
6. Describe the process for effectively addressing an Additional Developmental Request.
7. Explain the important elements of the physician certification process.
8. Analyze the strategies to manage Medicare and submit a clean claim.

Downloadable Medicare Reimbursement Resource Manual included.

Approved for 7 Nursing and Administrator (NAB) Credits