ComplianceOnline

Compliant Managed Medicare Medical Review Claim Submissions

Instructor: Elisa Bovee
Product ID: 705296
  • 6
  • July 2017
    Thursday
  • 10:00 AM PDT | 01:00 PM EDT
    Duration: 60 Min

Live Online Training
July 06, Thursday 10:00 AM PDT | 01:00 PM EDT | Duration: 60 Min

$149.00
One Dial-in One Attendee
$429.00
Group-Max. 10 Attendees/Location
(For Multiple Locations Contact Customer Care)
Get CD free on purchase of Group ticket

recorded version

$199.00
1x Person - Unlimited viewing for 6 Months
(For multiple locations contact Customer Care)
Recorded Link and Ref. material will be available in My CO Section 48 hrs after completion of Live training

Training CD

$249.00
One CD is for usage in one location only.
(For multiple locations contact Customer Care)
CD and Ref. material will be shipped within 15 business days after completion of Live training

Combo Offers

Live + Recorded Version

$249.00

Live + Training CD

$329.00

Customer Care

Fax: +1-650-565-8542

Email: customercare@complianceonline.com

Read Frequently Asked Questions

This training program will review the changes to the Medicare advantage program enacted in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). It will provide a step by step approach to ensure accurate appropriate reimbursement.

Why Should You Attend:

Managed Medicare claims are becoming more and more scrutinized by Contractors. Small errors or oversights in preparation of claim documents will result in denial of payment and recoupment of monies paid for skilled services.

This course will provide an overview of the critical steps to take when responding to managed Medicare claim review requests. Medical review of claims is an extremely detailed oriented task that must follow the Managed Care Contractor steps to a T. The facility claim manager must employ the interdisciplinary team to manage these claim requests. Managers and support staff will learn how to initiate the process, maintain organizational programs and succeed in insulating claim payments. The process of preparing for claim investigations can be intimidating and overwhelming. Precise protocols will support the team in establishing best practices for successful processing of managed care Medicare claims.

Areas Covered in the Webinar:

  • Medical Necessity
  • CMS Coverage Manuals
  • Medicare Advantages Contracting
  • Managed Care Claim Preparation Steps
  • Interdisciplinary Expectations
  • Claim Submission
  • Tracking Strategies
  • Denied Claim Approaches

Who Will Benefit:

  • Administrators
  • Nurse Managers
  • Rehabilitation Managers
  • Business Office Manager
  • MDS Coordinators
  • Nursing Staff
  • Social Workers
  • Therapists
Instructor Profile:
Elisa Bovee

Elisa Bovee
MS OTR/L, Regulatory Expert, Harmony Healthcare International

Elisa Bovee has been working in the healthcare environment advocating for patients through education and clinical guidance. With a degree in Occupational Therapy she has managed a national operations team performing audits and analysis across the US for skilled nursing home providers.

Her expertise includes compliance programs, reimbursement and regulatory, development of education programs, skilled documentation for nursing and therapy and managing claims through the development request and denial phases.

Elisa has presented programs targeting all interdisciplinary groups throughout the country for audiences seeking guidance and clarity on a multitude of regulatory and clinical topics. Additionally, she has written and contributed to articles for national trade publications.

Topic Background:

Medicare contractors must employ the Centers for Medicare & Medicaid Services (CMS) regulatory guidelines. In addition, these contractors have the latitude to establish contractual guidelines for providers. The skilled nursing facility operations team must abide by the Federal and Contractor regulations to maintain a successful and fruitful program. Misfiring during the claim submission process can immobilize and disable a healthcare provider.

Managed Medicare claim medical reviews are rampant throughout the US. This places skilled nursing facilities at high risk for denied claims and revenue take-backs. What does your team know about the Medicare Managed Care Manual? A clear understanding of Medicare advantage contract provisions and requirements will play a critical role in ensuring accurate and appropriate reimbursement. Providers must dive into the CMS' interpretation of the provisions of the Medicare advantage statute and regulations (Chapter 42 of the Code of Federal Regulations, Part 422) which pertain to application procedures and contract requirements.

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Refund Policy

Registrants may cancel up to two working days prior to the course start date and will receive a letter of credit to be used towards a future course up to one year from date of issuance. ComplianceOnline would process/provide refund if the Live Webinar has been cancelled. The attendee could choose between the recorded version of the webinar or refund for any cancelled webinar. Refunds will not be given to participants who do not show up for the webinar. On-Demand Recordings can be requested in exchange.

Webinar may be cancelled due to lack of enrolment or unavoidable factors. Registrants will be notified 24hours in advance if a cancellation occurs. Substitutions can happen any time.

If you have any concern about the content of the webinar and not satisfied please contact us at below email or by call mentioning your feedback for resolution of the matter.

We respect feedback/opinions of our customers which enables us to improve our products and services. To contact us please email customercare@complianceonline.com call +1-888-717-2436 (Toll Free).

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