LTC US: Understanding Consolidated Billing - 2019

LTC US: Understanding Consolidated Billing - 2019 

This module will cover terminology, defining consolidated billing, the definition of "resident" for purposes of consolidated billing, manor category I-IV exclusions, the HCPC file, professional versus techincal component, principles to limit financial liability, best practice guidelines for reviewing provider invoices, under arrangement, and medicare and physician fee schedules

$35.00

Hours: 1.75
REL-PAC-0-US-LTCCB19

Certificates

Certificates provided by accrediting body (6 Match)

California Board of Registered Nursing

1.75 HOURS


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.75 contact hours for participating in this course.

Georgia Board of Nursing

1.75 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.75 contact hours for participating in this course.

District of Columbia Board of Nursing

1.75 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.75 contact hours for participating in this course.

Florida Board of Nursing

1.75 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.75 contact hours for participating in this course.

American Nurses Credentialing Center

1.75 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.75 contact hours for participating in this course.

South Carolina Board of Nursing

1.75 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

Course Details

Course Code: REL-PAC-0-US-LTCCB19
Hours: 1.75
Type: MDSRAI
Content Expiration Date: 12/31/2019
Learning Objectives:
Introductions & Definitions - The learner will be able to define and use the terminology related to SNF consolidated billing and Medicare PPS. Using this terminology, they will be able to explain the details of the current regulations with respect to which residents and which providers consolidated billing applies to under specific circumstances.
Exclusions - The learner will be able to identify the services that are excluded from consolidated billing.
HCPC Help File - The learner will be able to identify, locate and be able to interpret the carrier files which outline exclusions and inclusions for the purposes of consolidated billing. This topic also enables the user to differentiate between the physician professional and technical components with respect to how they relate to consolidated billing.
Financial Liability - The learner will be able to identify and implement principles to limit financial liability with respect to consolidated billing. Leaners will also be able to implement best practices for reviewing provider invoices. Additionally learners will be able to perform lookups and interpret Medicare and Physician Fee Schedule amounts.

Outline:
1.1  Terminology 1.2  – Defining Consolidated Billing 1.3  – Definition of “Resident” for purposes of Consolidated Billing 1.4  – Review Questions 2.1 – Consolidated Billing Major Category I Exclusions 2.2 – Consolidated Billing Major Category II Exclusions 2.3 – Consolidated Billing Major Category III Exclusions 2.4 – Consolidated Billing Major Category IV Exclusions 2.5 – Consolidated Billing Major Category V Exclusions 3.1 – Introduction to the HCPC File 3.2 – Professional vs Technical Component 3.3 – Review Questions Principles to Limit Financial Liability 4.2 – Best Practice Guidelines for reviewing Provider Invoices 4.3 – Under Arrangement 4.4 – Medicare and Physician Fee Schedules 4.5 – Review Questions

Instructor: Ron Orth RN, CHC, CMAC, AHIMA-Approved ICD-10-CM Trainer
Ronald Orth, RN, CMAC, CHC  obtained a nursing degree from Milwaukee Area Technical College in 1985 and a B. A. in Health Care Administration from Concordia University in 1996. Mr. Orth possesses over 30 years of nursing experience with over 20 of those in the Skilled Nursing industry. Mr. Orth has extensive experience in teaching Medicare regulations to healthcare providers both in the US and internationally. Mr. Orth is currently the Post Acute Care Curriculum Designer and is certified in Healthcare Compliance through the Compliance Certification Board (CCB). Disclosure: Ron Orth RN, CHC, CMAC, AHIMA-Approved ICD-10-CM Trainer has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Nurses; in the following settings: Post-Acute Care.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.