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Medicare Training

Medicare Training. By FBC Services. 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

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Medicare Training

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  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

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