Medicare Boot Camp®—Audits, Appeals, and Denials Version (blr) S, Renaissance Orlando at SeaWorld®, Thursday, 17. October 2019

Medicare Boot Camp®—Audits, Appeals, and Denials Version
Course Overview
Get expert guidance on preventing denials and focusing appeals efforts for success. The evolution of reimbursement models and uncertainty regarding healthcare laws mean that to keep the doors open, organizations can’t afford write off appealable denials. Organizations need sound, practical information on overturning denials. Medicare Boot Camp®—Audits, Appeals, and Denials Version is your key to proven strategies for success and will answer all of your questions on denials management and appeals processes.
This Boot Camp teaches you about the latest claim audit and appeal issues based on official guidance. You’ll leave the class armed with a thorough understanding of the audit and appeal process and ready to put your new knowledge into action.
You will leave this program knowing how to:

Prepare for CMS audits

Navigate the appeals process up to the Administrative Law Judge level

Research denials and upcoming audit focus areas

Implement policies to support efficient appeals and identify appropriate denials to appeal

Who should attend?

Revenue cycle directors and managers

Revenue integrity directors, managers, and staff

HIM directors, managers, and staff

CDI directors, managers, and specialists

Compliance directors, officers, and auditors

Business office managers

Case management directors and managers

Case managers

Utilizations review staff

Utilization management staff

Physician advisors

Audit directors and coordinators


Appeals coordinators

Patient financial services directors

See the HCPro Difference for Yourself

Focus on the actual rules: Learn how to prepare for CMS audits and navigate the appeals process up to the Administrative Law Judge level.

Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research questions long after the Boot Camp ends. 

Hands-on learning: Attendees work a set of exercises/case studies after each module to ensure they understand the concepts and know how to apply them to real-world situations.

Small class size: A low participant-to-teacher ratio is guaranteed.

Highly rated, well-established program: Participants consistently give the course an overall rating of 4.75 or higher (on a 5.0 scale). We currently conduct more than 30 Medicare Boot Camp courses each year.

Learning Objectives
At the conclusion of this educational activity, participants will be able to:

Research the appeals process and related regulations

Identify key steps in the appeals process up to the Administrative Law Judge level

Explain common causes of Medicare denials

Develop policies and practices to support compliance, reduce denials, and expedite appeals

Analyze denied claims to select appropriate appeals

Module 1: Medicare Overview and Resources
The Four Parts of Medicare Medicare Contractors Independent Government Agencies-Medicare Involvement
Module 2: Medicare Research and Resources
Web-Based Resources Key Sources of Authority Medicare Coverage Center, including LCDs NCDs, CED and Lab Coverage Manual Ways to Stay Current
Module 3: Medicare Program Safeguards and Medicare Notices
Medicare Policy Development, Financing, the Trust Funds, the need for Program Safeguards Improper Payments Program Safeguards Limitation on Liability provisions of the Social Security Act Notices of Non-Coverage
Module 4: Prepayment Claim Reviews/Audits
Prepayment Reviews Overview Automated Prepayment Reviews Prepayment Non-Medical Record Reviews Prepayment Medical Record Reviews
Module 5: Postpayment Claim Reviews/Audits
Establishment of Postpayment Claim Review/Audits Process Postpayment Claim Reviews/Audits Overview Postpayment Non-Medical Record Reviews Statistical Sampling and Extrapolations Postpayment Medical Record Reviews
Module 6: Medicare FFS Claim Appeals Process (Part 1)
Initial Determinations Reopenings and Overlap with Appeals Process Level 1 Appeal Process: Redetermination Level 2 Appeal Process: Reconsideration
Module 7: Medicare Appeals Process Overview (Part 2)
Level 3 Appeal Process: Administrative Law Judge (ALJ) Hearing Level 4 Appeal Process: Medicare Appeals Council Level 5 Appeal Process: Judicial Review in U.S. District Court
Module 8: Current Medicare Claim Audits and Appeals Issues Overview
Two Midnight Expectation and QIO Review Expedited Judicial Review Medicare Overpayments Appeals Backlog Ways to Stay Current: Audit Topics Ways to Stay Current: ALJ Decisions, Appeals Council Decisions and Federal Court Decisions
Course Agenda/Outline is subject to change.

Please contact the event manager Marilyn ( ) below for:- Multiple participant discounts- Price quotations or visa invitation letters- Payment by alternate channels (PayPal, check, Western Union, wire transfers etc)- Event sponsorshipsNO REFUNDS ALLOWED ON REGISTRATIONSService fees included in this listing.-----------------------------------------------------------------BUSINESS & LEGAL RESOURCES-BLR - New York Events Listhttp://

Thursday, 17. October 2019, Renaissance Orlando at SeaWorld®, Medicare Boot Camp®—Audits, Appeals, and Denials Version (blr) S

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