Medicare Bootcamp Virtual Workshop

Tuesday, March 31

9:00 a.m. – 4:00 p.m. Eastern Time

A strong foundation in the Medicare Basics is essential to compliance with SNF Medicare program requirements and accurate reimbursement for each Medicare resident’s Part A stay. The course will provide an overview of the Medicare benefit period rules, the technical and skilled coverage criteria, the beneficiary notice requirements, and documentation requirements to support coverage and reimbursement under the Patient Driven Payment Model. 

PDPM was implemented in October 2019 to improve reimbursement for Medicare Part A beneficiaries in a SNF based on patient characteristics instead of the volume of services provided. The course will also detail documentation requirements to support key components of the payment model including accurate assignment of ICD 10 diagnosis codes, functional status as coded in section GG and the other key sections of the MDS the impact payment. 

An overview of the medical review process will be provided including strategies to validate compliance and avoid payment denials.

Objectives:

1. Identify the technical and skilled coverage criteria required for a Medicare beneficiary to utilize their Part A benefit during a SNF stay
2. Clarify the correct use of the NOMNC and the SNF ABN when services are deemed to be no longer covered under Medicare
3. Describe the documentation requirements to support Medicare coverage and avoid denial under medical review
4. Recognize the criteria for classification with each of the key components of PDPM
5. Clarify the process for assigning the primary diagnosis for the SNF stay and how to utilize the PDPM clinical mapping
6. Identify the documentation necessary to support the coding of key MDS items that impact PDPM classification

Target Audience

Administrators, DON/ADON, MDS, business office managers

CEUs

6 total contact hours through the Kentucky Board of Nursing. Proactive Medical Review & Consultants, LLC is an approved provider of continuing education by the Kentucky Board of Nursing, #5-0065. To receive the maximum number of contact hours, you must complete the entire program. Partial credit may be issued based on time actually attended. Certificates may be printed once the program evaluation is submitted. Disclaimer Statement: The Kentucky Board of Nursing approval of an individual continuing education provider does not constitute endorsement of program content.

Presented By:

Christine Twombly

CRN-BC, RAC-MT, RAC-MTA, HCRM, CHC
Senior Consultant