Course Code: REL-PAC-0-UCB
Type: Online Course
Content Expiration Date: 12/31/2022
Define who identifies as a "resident" for consolidated billing purposes.
Describe the five Major Categories of items or services under consolidated billing.
Identify ambulance services excluded under consolidated billing.
Discuss the use of CMS HCPC files to identify items or services included or excluded from SNF consolidated billing.
List key steps in minimizing liability under SNF consolidated billing.
Section 1: Introduction
About This Course
Section 2: Key Terminology
Section 3: Introduction to Consolidated Billing
Defining Consolidated Billing
Definition of “Resident” for Purposes of Consolidated Billing
Section 4: Consolidated Billing Major Category Exclusions
Major Category I: Exclusion of Services Beyond the Scope of a SNF
Major Category II: Additional Services Excluded When Rendered to Specific Beneficiaries
Major Category III: Additional Excluded Services Rendered by Certified Providers
Major Category IV: Preventative and Screening Services
Major Category V: Part B Services Included in SNF Consolidated Billing
Section 5: Additional Excluded Services
Medicare Non-Covered Services
Section 6: HCPC Files
Introduction to the HCPC File
Section 7: Limiting Financial Liability
Limiting Financial Liability under Consolidated Billing
Best Practice Guidelines for Reviewing Provider Invoices
Medicare and Physician Fee Schedules
Section 8: Conclusion
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). Ron has also successfully completed the Infection Control Officer training through the AHCA and is an AHIMA approved ICD-10-CM trainer.
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.
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.
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