Medicare Boot Camp® - Hospital Version

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Medicare Boot Camp® - Hospital Version

Product Code: MBCH

1st Attendee $1,699.00*
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Medicare Boot Camp® - Hospital Version

Course Overview


Bring predictability and stability back to your revenue by joining the nation's leading Medicare experts for the Medicare Boot Camp—Hospital Version.

Dramatic changes to the IPPS and OPPS rules could mean more revenue stability—if your team understands how to implement the new regulatory guidance. Medicare Boot Camp—Hospital Version unlocks all of the answers to your Medicare questions by teaching you the latest rules and their application.

Click here to download the 2014 Medicare Boot Camp catalog!

You will leave this program knowing how to:

  • Prevent inpatient denials
  • Conduct "self-audits" to receive Part B payment for inpatient cases
  • Properly use and bill for observation services
  • Research and resolve claims issues that delay revenue
  • Prevent missed revenue and denials
  • Implement best practices so you get the revenue you deserve while staying in compliance

Medicare Boot Camp—Hospital Version
prepares you to better manage your revenue cycle and government audits by focusing on real guidance from CMS, rather than unsupported opinions or rhetoric. You'll leave class ready to make improvements that will strengthen reimbursement and compliance for your hospital or health system. And you'll have the research tools and skills at your fingertips to answer your own Medicare questions long after the Boot Camp.

Comprehensive sections explain the complexities of:

  • The 2-midnight benchmark and presumption
  • Inpatient order and certification requirements
  • The intricacies of the three-day rule
  • Physician supervision
  • Observation services and correct use of condition code 44 and W2
  • Medically unlikely and other NCCI edits
  • ABN use and applicable billing rules
  • Self-administered drugs
  • Inpatient-only procedures

Medicare Boot Camp—Hospital Version:
See the HCPro difference for yourself.

  • Focus on the actual rules: Learn how to find and apply CMS rules and guidelines to ensure hospital services furnished to Medicare beneficiaries are billed accurately and appropriately.
  • Tools and skills to navigate Medicare rules: Our instructors provide valuable tools and resources that will help you prioritize and research Medicare questions long after the Boot Camp ends.
  • Hands-on learning: Attendees work a set of exercises/case studies after each module to ensure they understand the concepts and know how to apply them to real-world situations.
  • Small class size: A low participant-to-teacher ratio is guaranteed.
  • Highly rated, well-established program: Participants consistently give the course an overall rating of 4.75 or higher (on a 5.0 scale). We currently conduct more than 30 Medicare Boot Camp courses each year.

For more detailed information about Medicare Boot Camp—Hospital Version, contact us at 800-780-0584 or email

Medicare Boot Camp—Hospital Version is offered around the United States at various locations. For a list of upcoming courses, click "Locations/Dates" above.

Need to train a group?
Bring Medicare Boot Camp—Hospital Version to your organization. If you have a group to train, holding a Boot Camp at your organization is easy and cost-effective. Eliminate travel costs and enjoy a group discount while ensuring your staff is up to date on the latest regulations and guidelines. For more information, call 800-780-0584 or click on Train Groups Onsite in the menu above.

Medicare Boot Camp—Hospital Version

Course Locations & Dates

Below is the current course schedule for upcoming Medicare Boot Camp—Hospital Version classes.

Price: $1,699

To view our cancellation policy, click here.

Rather attend online?

Medicare Boot Camp—Hospital Version is also available as an online course. Click here for a list of start dates.

December 2014 | January | February | March | July | August | September | October | November

December 2014

Avondale (Phoenix), AZ


Dec. 8, 2014 – Dec. 12, 2014
Day 1 & 2 8:00 am - 5:00 pm and Day 3 8:00 am - 1:00 pm

Homewood Suites by Hilton Phoenix/Avondale
11450 W Hilton Way
Avondale, AZ 85323
Hotel website

Room Rate: $ 129 / night
Room Rate Cut-Off: Nov. 14, 2014



Miami, FL


February 23–27, 2015
8:00 am - 5:00 pm

Hyatt Place Miami Airport West/Doral
3655 NW 82 Avenue
Miami FL 33166
Hotel website

Room Rate: $ 159 / night
Room Rate Cut-Off: January 23, 2015



Las Vegas, NV


March 2–6, 2015
8:00 am - 5:00 pm

Hyatt Place Las Vegas
4520 Paradise Road
Las Vegas, NV 89169

Hotel website

Room Rate: $ 109 / night
Room Rate Cut-Off: February 09, 2015



Raleigh, NC


April 20–24, 2015
8:00 am - 5:00 pm

Homewood Suites by Hilton Raleigh Crabtree
5400 Homewood Banks Drive
Raleigh, NC 27612
Hotel website

Room Rate: $ 122 / night
Room Rate Cut-Off: March 30, 2015



Minneapolis, MN


May 11–15, 2015
8:00 am - 5:00 pm

SpringHill Suites Minneapolis-Saint Paul Airport/Mall of America
2870 Metro Drive
Bloomington, MN 55425
Hotel website

Room Rate: $ 144 / night
Room Rate Cut-Off: April 19, 2015



Denver, CO


June 8–12, 2015
8:00 am - 5:00 pm

HyattPlace Denver Tech Center
8300 East Crescent Parkway
Englewood, CO 80111
Hotel website

Room Rate: $ 129 / night
Room Rate Cut-Off: May 27, 2015



Boston, MA


July 13–17, 2015
8:00 am - 5:00 pm

HYATT house™ Boston/Burlington
2 Van De Graaff Drive
Burlington, MA 01803
Hotel website

Room Rate: $ 159 / night
Room Rate Cut-Off: June 24, 2015



Anaheim, CA


August 17–21, 2015
8:00 am - 5:00 pm

SpringHill Suites by Marriott Anaheim–Maingate
1160 West Ball Road
Anaheim, CA 92802
Hotel website

Room Rate: $ 149 / night
Room Rate Cut-Off: May 15, 2015



Baltimore, MD


September 14–18, 2015
8:00 am - 5:00 pm

Hyatt Place Baltimore Owings Mills
4730 Painters Mill Rd
Owings Mills, MD 21117
Hotel website

Room Rate: $ 125 / night
Room Rate Cut-Off: August 31, 2015



Charlotte, NC


October 5–9, 2015
8:00 am - 5:00 pm

Homewood Suites by Hilton–Davidson
125 Harbour Place Drive
Davidson, NC 28036
Hotel website

Room Rate: $ 119 / night
Room Rate Cut-Off: September 11, 2015



Dallas, TX


November 2–6, 2015
8:00 am - 5:00 pm

HYATT house™ Dallas/Uptown
2914 Harry Hines Boulevard
Dallas, TX 75201
Hotel website

Room Rate: $ 119 / night
Room Rate Cut-Off: October 07, 2015



Carlsbad, CA


December 7–11, 2015
8:00 am - 5:00 pm

HYATT house™ San Diego/Carlsbad
5010 Avenida Encinas
Carlsbad, CA 92008
Hotel website

Room Rate: $ 119 / night
Room Rate Cut-Off: November 15, 2015

Medicare Boot Camp® - Hospital Version

Course Outline

1 Finding and Understanding Medicare Guidelines

  • Overview of Medicare Part A, B, C and D
  • Medicare resources: statutes, regulations, manuals, transmittals and other Medicare rules and guidelines
  • Medicare contractors, including MAC and Recovery Auditors

2 Decoding the UB-04

  • Key UB-04 fields applicable to hospital services, including revenue and HCPCS codes
  • ICD-9 coding for outpatient services
  • Present On Admission indicator coding

3 Medicare Claims Submission Fundamentals

  • Timely filing  
  • Repetitive, non-repetitive and recurring services
  • Three-day payment window and preadmission services

4 Medicare Edit Systems

  • Outpatient Code Editor (OCE) and Medicare Code Editor (MCE)
  • National Correct Coding Initiative (NCCI); including Procedure to Procedure (PTP) Edits, Mutually Exclusive Edits (MUEs), and add-on code edits
  • Modifiers used with NCCI edits

5 Coverage of Hospital Outpatient Services

  • Coverage of outpatient therapeutic services
  • Coverage of drugs, including self-administered drugs
  • Coverage of outpatient diagnostic services
  • Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs) including Coverage with Evidence Development (CED)
  • National Coverage Determination manual for laboratory services

6 Outpatient Medical Necessity and Advanced Beneficiary Notices

  • Limitations of liability statute and notice requirements
  • The advanced beneficiary notice (ABN) form and instructions
  • Billing of non-covered outpatient service

7 Nuts and Bolts of the Outpatient Prospective Payment System (OPPS)

  • Outpatient Prospective Payment System and ambulatory payment classifications (APCs)
  • Addendum A and B and status indicators
  • Separate and packaged payment under OPPS
  • Composite APCs
  • Review of Comprehensive APCs

8 Calculating Outpatient Payment and Outliers

  • How to calculate the Medicare allowable for a HCPCS code
  • How to calculate the patient's coinsurance
  • How to calculate outpatient outlier payments

9 Outpatient Non-diagnostic Services

  • E/M coding for provider-based services: clinics, emergency departments, critical care
  • Trauma activation
  • Modifier 25
  • Packaged and separately paid drugs and biologicals
  • Biological skin substitutes
  • Discarded Drugs
  • Blood and blood products
  • Outpatient therapy caps
  • Outpatient therapy functional status reporting
  • "Sometimes" and "always" therapy

10 Diagnostic and Surgical Services

  • Packaged and separately paid laboratory services
  • Reference Laboratory Services
  • Clinical diagnostic laboratory fee schedule
  • Multiple procedure discount for surgical services
  • Terminated/discontinued surgical and radiology procedures
  • Bilateral procedures
  • Procedure to device edits
  • Pass through devices
  • Value code FD for free and reduced cost devices
  • Never events procedures

11 Sorting out Patient Status: Observation Services and Inpatient Admissions

  • Coverage and billing of observation services
  • Extended Assessment and Management Composite
  • Inpatient-only procedures
  • Inpatient order and certification requirements
  • Inpatient  2-Midnight Benchmark and Presumption

12 Inpatient Non-Coverage and Special Billing Issues

  • Hospital Issued Notices of Non-Coverage (HINNs)
  • Proper use of Condition Code 44 and W2
  • Part B Inpatient payment
  • Conditions arising during or from a non-covered stay

13 Inpatient Prospective Payment System (IPPS) and Patient Responsibility

  • Inpatient Prospective Payment System (IPPS) and Medicare-severity diagnosis related groups (MS-DRGs)
  • Hospital Acquired Conditions (HACs)
  • Inpatient deductible, coinsurance, and life time reserve days

14 Inpatient Payment Factors

  • Standardized amounts and wage indices
  • Indirect Medical Education(IME) and Disproportionate Share Hospital (DSH) adjustments
  • Value Based Purchasing (VBP)
  • Hospital Readmission Reduction Program (HRRP)
  • Hospital Acquired Condition Reduction Program
  • Medicare inpatient pricer

15 Inpatient Payment Adjustments

  • Payment for transfers and post-acute care transfers
  • Free and reduced cost devices for inpatients
  • New technology add-on payment
  • Inpatient outlier basics

Course agenda subject to change

Medicare Boot Camp® - Hospital Version

Learning Objectives

Module 1: Finding and Understanding Medicare Guidance

  • Identify differences between Medicare Parts A, B, C, and D
  • Understand how to find Medicare resources
  • Identify where to find statutes, regulations, manuals, transmittals, and other Medicare rules and guidelines
  • Understand the role of Medicare contractors, including MACs and Recovery Auditors

Module 2: Decoding the UB-04

  • Identify key UB-04 fields applicable to hospital services
  • Describe how to select proper revenue codes and HCPCS codes 
  • Understand ICD-9 coding for outpatient services
  • Understand POA coding guidance

Module 3: Medicare Claims Submission Fundamentals

  • Understand timely filing requirements
  • Describe the proper way to bill repetitive, non-repetitive, and recurring services
  • Understand the three-day payment window and proper billing of preadmission services

Module 4: Medicare Systems and Processes Related to Claims

  • Describe Medicare claims processing systems, including the outpatient code editor and Medicare (inpatient) code editor
  • Identify situations where Medicare is secondary to other payers, including conditional payments
  • Differentiate between the five levels of the Medicare appeals process and applicable time frames

Module 5: Coverage of Hospital Outpatient Services

  • Understand the requirements for coverage of outpatient therapeutic services
  • Understand the requirements for coverage of outpatient diagnostic services
  • Understand the coverage of drugs, including self-administered drugs
  • Describe how to apply national and local coverage determinations
  • Locate and understand national coverage determinations for laboratory services

Module 6: Outpatient Medical Necessity and Advance Beneficiary Notices

  • Understand the limitations of liability statute and when notice is required
  • Understand the advance beneficiary notice (ABN) form and instructions
  • Describe how to bill for non-covered outpatient services

Module 7: National Correct Coding Initiative (NCCI) Edits and Proper Use of Modifiers

  • Understand how to look up procedure-to-procedure bundling and mutually exclusive edits
  • Understand medically unlikely edits (MUE) for excess units of service
  • Identify add-on edits
  • Determine the proper use of modifiers with NCCI edits

Module 8: Nuts and Bolts of the Outpatient Prospective Payment System (OPPS)

  • Understand the OPPS payment system and ambulatory payment classifications (APC)
  • Use Addendum A and Addendum B and status indicators to understand payment for a specific HCPCS code
  • Determine whether particular services are paid separately or packaged
  • Understand comprehensive APCs and identify services that are packaged into them
  • Understand composite APCs and identify the services that trigger composite payment

Module 9: Calculating Outpatient Payment and Outliers

  • Determine how to calculate the Medicare allowable for a HCPCS code
  • Calculate the patient's coinsurance for a specific HCPCS code
  • Understand and calculate outpatient outlier payments

Module 10: Outpatient Therapeutic Services, Including Provider-Based and Emergency Departments

  • Understand E/M and modifier -25 coding guidance for clinics and emergency departments
  • Understand the application of outpatient therapy caps to hospital outpatient therapy services
  • Understand how to use therapy functional status codes and modifiers, including documentation requirements
  • Differentiate between "sometimes" therapy and "always" therapy

Module 11: Drugs, Biologicals, and Devices

  • Understand how to properly bill for packaged drugs, biologicals, and devices
  • Use status indicators to determine how drugs, biologicals, and devices are separately paid
  • Determine when to bill for discarded drugs

Medicare Boot Camp® - Hospital Version

Continuing Education

This program has been approved by the American Academy of
Professional Coders
for 36 continuing education hours.
Granting of prior approval in no way constitutes endorsement
by AAPC of the program content or the program sponsor.

Compliance Certification Board (CCB)

This program has been approved for 42 Certification Compliance (CCB) Continuing Education Units in Compliance Training and Education and Auditing and Monitoring for Compliance. Granting of prior approval in no way constitutes endorsement by CCB of the program content or the program sponsor.

American Nurses Credentialing Center (ANCC)

HCPro, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center Commission on Accreditation.

This educational activity for 35 nursing contact hours is provided by HCPro, Inc.

Nurses should only claim credit commensurate with the extent of their participation in the activity.

California Board of Registered Nursing

HCPro, Inc., is approved by the California Board of Registered Nursing to provide 42 nursing contact hours. California BRN Provider #CEP 14494.

Earn up to 42 CPE Credits!

Program Level: Basic

Delivery Method: Group-Live

HCPro, Inc. is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN, 37219-2417. Web site:

Medicare Boot Camp® - Hospital Version



What is the focus of the Medicare Boot Camp?

Medicare Boot Camp - Hospital Version is an intensive, five-day course on Medicare coverage, billing, coding and payment for hospital outpatient and inpatient services. The course is technically oriented and focuses on the Medicare regulations and guidelines applicable to hospital services. The objective of the course is to provide course participants with a detailed understanding of the Medicare "rules" with a particular emphasis on the operational application of those rules.

Where is the course offered?

Open registration Medicare Boot Camps are offered at various locations around the country, typically at mid-priced business hotels such as Hyatt Place or Hilton Garden Inn. For a current schedule of upcoming open registration Medicare Boot Camps, click on "Locations/Dates" above.

Does this course prepare participants for coding certification?

The Medicare Boot Camp - Hospital Version contains a review of pertinent coding issues as they relate to Medicare coverage, billing and payment, however, the course is not designed as primarily a coding course. HCPro does offer two courses focused on coding fundamentals. The Certified Coder Boot Camp® - Original Version focuses on coding for physician and hospital outpatient services. The Certified Coder Boot Camp® - Inpatient Version focuses on hospital inpatient facility services. These courses may assist participants in preparation for national coding certification. For more information, please review the information for these courses using the links above or contact the office at or (877) 727-1728.

Does HCPRO offer "on-site" Medicare Boot Camps?

In addition to our open registration courses, we also offer the Medicare Boot Camp as an on-site program (with a substantial discount) for organizations that have a number of employees who need training. For more information on hosting an on-site Medicare Boot Camp, click on Host an On-Site Course.

What if I need to cancel or transfer my registration?

To view our Cancellation Policy, click here.

Who typically attends the Medicare Boot Camp?

  • Finance and Reimbursement Personnel
  • Chargemaster Personnel
  • Billers and Coders
  • Medical Records/Health Information Personnel
  • Clinical Department Personnel
  • Provider-Based Clinic Personnel
  • Revenue Managers
  • Compliance Officers and Auditors
  • Registration Personnel
  • Fiscal Intermediary Personnel
  • Healthcare Lawyers, Consultants, and CPAs
  • Legal Department Personnel

What material does the course cover?

To view the course outline, click on "Course Outline" above.

Does the course require any previous experience or training?

No. However, because of the fast-paced nature of the course, it is recommended (but not required) that participants have at least one year of experience working in a hospital. However, the course starts with Medicare fundamentals and does not assume that participants have any particular background or experience. Familiarity with the ICD-9-CM and CPT coding systems is helpful, but not required.

How is the course taught?

The course is taught using a combination of lecture, class discussion and hands-on exercise/case studies.

What do I need to bring to class?

When you arrive at class, you will receive an extensive notebook of course materials.

Please bring the following to all classes:

  • A highlighter
  • Notebook for taking notes
  • Sticky notes/flags
  • Pen/pencil
  • A handheld calculator

Does HCPro ever share contact information (e.g., name, address, phone number, email address, etc.) with other companies?

Historically, we have not shared contact information with anyone outside of our company. However, it is possible that at some point we might share contact information with other companies that offer products and services that we think would be of interest to our customers. If you would like us to keep your contact information confidential, please let us know so that we can flag your information in our customer database as "Do Not Share."

How do I get more information:

Contact Customer Service at 800/780-0584 or

Need to train a group?

Bring our industry-leading instructors to your facility! Hosting a Boot Camp is a cost-effective and convienient solution for training your staff on the latest regulations. For more information, call 877-233-8734 or contact one of our account managers.