Hospice and Medicare Part B Billing

Hospice and Medicare Part B Billing 

Billing of Medicare Part B services for hospice patients is an area of scrutiny for CMS and the OIG. It is imperative that hospices have appropriate systems in place for the coordination of Part B services with non-hospice providers. This course will discuss CMS data related to non-hospice Part B spending, communication and coordination systems with Part B providers, as well as risk areas related to palliative care billing.

Note that throughout this course the terms “Part A” and “Part B” are used to denote Medicare Part A and Medicare Part B billing, respectively.

The content in this course is applicable to administrator professionals, managers, leaders, nursing professionals, and billing staff in hospice and palliative care.



$15.00

Hours: 1.25
REL-PAC-WB-HMPBB

Certificates

Certificates provided by accrediting body (15 Match)

California Board of Registered Nursing

1.25 HOURS


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

Nurses will receive 1.25 contact hours for participating in this course.

District of Columbia Board of Nursing

1.2 HOURS


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

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Nursing

1.0 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center

1.25 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 1.25 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

Georgia Nursing Home Administrators Board

1.25 HOURS


Course approved by the Georgia Nursing Home Administrators Board.
Provider # 50-290
This activity is approved for 1.25 contact hours.

South Carolina Board of Nursing

1.25 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]

West Virginia Board of Registered Nursing

1.25 HOURS


New Mexico Board of Nursing

1.25 HOURS


New Mexico Board of Nursing (CEBroker Provider # 50-290)

This course awards 1.25 contact hours upon successful completion.

Arkansas State Board of Nursing

1.25 HOURS


National Association of Long Term Care Administrator Boards (RCAL)

1.25 HOURS


This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.25 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]

National Association of Long Term Care Administrator Boards (NHA)

1.25 HOURS


This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.25 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]

Florida Board of Nursing Home Administrators

1.0 HOURS


Course approved by the Florida Board of Nursing Home Administrators.
Provider # 50-290
NHA/RCAL
This activity is approved for 1.00 contact hours.

Texas Health and Human Services Commission

1.25 HOURS


Texas HHSC has determined that Relias Learning’s submitted training meets or exceeds the minimum standards for HCSSA administrator training in the following categories: Hospice. Texas HHSC also recognizes Relias Learning provides continuing education for administrators and alternate administrators. This activity is approved for 1.25 contact hours.

California Nursing Home Administrator Program - non-P type

1.0 HOURS


This educational offering is approved by the California Nursing Home Administrator Program (NHAP) for full credit as a course relating directly to duties, functions, or responsibilities of the nursing home administrator. Provider # CEP 1701; Course Approval # 1701001-7718. This activity is approved for 1.00 contact hours.

Course Details

Course Code: REL-PAC-WB-HMPBB
Hours: 1.25
Type: Online Course
Content Expiration Date: 11/30/2022
Learning Objectives:
Identify areas of concern with non-hospice Part B spending for hospice patients.
Discuss actions that hospices can take to help reduce inaccurate billing by non-hospice providers.
List steps to mitigate risks related to billing palliative care physician services.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: An Area of Concern: Non-hospice, Part B Spending

Why Focus on Part B Billing?

Requirements for Coordination

Medicare Interpretive Guidelines on Coordination

Coverage Under Part B

Coverage of “Virtually All” Care and Services

Determining Related Services

Review

Summary

Section 3: Physician and Other Part B Services

Attending Physician Services

Professional Services: Attending Provider

Technical Services: Attending Provider

Non-Independent Attending Physicians

Consulting Physicians

Other Part B Services

Review

Summary

Section 4: What Does the Data Show?

OIG Report – 2010

Current OIG Project

FY2013 Non-Hospice Spending

Medicare A and B Outside the Hospice Benefit

DME Billed to Medicare in CY 2013

CMS Case Studies

CMS Concerns

Patient Spending

FY 2019 Update to Data Analysis

FY 2020 Proposed Rule Discussion

Election Statement Revisions

Part B Provider Risk

Review

Summary

Section 5: Care Coordination and Quality Management

Actions to Address Non-Hospice Spending

CMS Guidance to Part B Providers

Example 1

Example 2

Documentation and Internal Audits

Actions to Ensure Correct Claims

Review

Summary

Section 6: Palliative Care Risks

Scrutiny of Palliative Care Services

Risk Areas

OIG Work Plan for Physician Services

Mitigating Palliative Care Billing Risk

Quality Management of Physician Services

Documentation and Mitigating Risk

CBRs Identify Potential Risks

LCSW Services

Review

Summary

Section 7: Conclusion

Summary

Course Contributor

Resources

References

Instructor: Annette Kiser, MSN, RN, NE-BC, CHC
Annette Kiser is the Chief Compliance Officer for Teleios Collaborative Network, a member organization devoted to equipping and elevating community-based not-for-profit hospices. With 33 years of experience, she is widely regarded as a regulatory and compliance expert in the hospice and palliative care industry. She spent more than 20 years working in community-based hospices, both in patient care and in compliance and quality. Annette then spent more than 6 years as the quality and compliance specialist with a two-state hospice and palliative care association. For the past two years, she has worked alongside staff in multiple hospices to help them implement best practices and elevate their compliance and quality efforts. In addition, Annette consults with other providers and industry leaders as an expert on hospice regulations and related processes. She serves on the National Hospice and Palliative Care Organization (NHPCO) Regulatory Committee and is an active member of the Palmetto GBA Hospice Coalition where she advocates for hospice providers with the Medicare Administrative Contractor’s staff. Disclosure: Annette Kiser, MSN, RN, NE-BC, CHC 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: Hospice, Palliative 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.