Medicare Training

1. Medicare Training By FBC Services

2. Training Outline • Medicare General Information • Medicare A General Information • NO-Pay and Benefit Exhaust Bills • SNF Denial Information • MSP Medicare Secondary Payer • Assessments and OMRA’s • Medicare B General Information • What’s Covered • Bundling and Therapy Caps • 59 and KX codes

3. Training Outline Cont’d • DDE Information • Claims Correction • CWF • Roster Billing • Questions and Answers

4. Medicare Overview • The Medicare Program • Eligibility • Benefit Period

5. Medicare A Overview • No Pay and Benefit Exhaust Bills • SNF Denial Information • MSP Medicare Secondary Payer • Assessments and OMRA’s

6. No-Pay and Benefit Exhaust Bills • How and When to do a No-Pay Bill • Appropriate Codes • No-Pay Bill Vs. Demand Bills

7. SNF Denial Information • Denial on Admission • UR Denials • Denial Paragraphs • For CMS Denial Letters Go To The CMS site at http://www.cms.hhs.gov/BNI/04_FFSSNFABNandSNFDenialLetters.asp

8. Medicare Secondary Payer (MSP) • MSP Overview • When and How to Submit an MSP Claim

9. Assessments and OMRA’s • ARD’s and Grace Days • OMRA’s • Assessment Schedule • Assessment Tracker

10. Medicare Assessment Schedule

11. Medicare B General Information • What’s Covered • To Bundle or Not to Bundle • Therapy Caps • 59 and KX codes • What to do when you’re out of space

12. F2, F10 and F6

13. F10 and F6

14. DDE Information • Menu’s • Claims Corrections and Adjustments • CWF • Roster Billing

15. Main Menu

16. Inquiry Menu’s

17. Claims, Corrections and Adj • Claims-Special OC Codes • Return to History • Rejected Claims • Claim Change Codes

18. (CWF) Common Working File • How to Read the CWF • Insurance Codes

19. CWF (Insurance codes)

20. Roster Billing • FLU and PPV HCPCS • Rates • Format

21. Roster Bill

22. Questions and Answers GOOD BYE