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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To register multiple attendees, please call Customer Service at (800) 650-6787.

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.

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 is over.

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

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

Who should attend?

  • 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

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 customer service at 800-650-6787 or email


Medicare Boot Camp—Hospital Version

Course Locations & Dates

Below is the current course schedule for upcoming classes of Medicare Boot Camp—Hospital Version. We update this schedule on a regular basis.

Registrations are processed in the order received. Class size is limited and classes often sell out. We recommend against making travel arrangements until after we have confirmed your course registration.

To register for a class, click the "Register" button. If you would like to register multiple attendees, click the "Register Multiple Attendees" button.

Locations marked as "Tentative" are subject to change. To view our cancellation policy, click here.

November December 



Dallas, TX


November 2–6, 2015
Monday through Thursday – 8:00 am - 5:00 pm
Friday – 8:00 am - 1:00 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
Monday through Thursday – 8:00 am - 5:00 pm
Friday – 8:00 am - 1:00 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/Agenda

Module 1:  Medicare Overview and Resources

  • Overview of Medicare Part A, B, C and D
  • Medicare source laws, including statutes and regulations
  • Medicare sub-regulatory guidance, including manuals and transmittals
  • Links to Medicare information and resources for staying current
  • The role of the Medicare Administrative Contractors (MACs)


Module 2:  Coverage of Hospital Outpatient Services

  • Incident-to coverage of outpatient therapeutic services
  • Physician supervision requirements and definitions
  • Coverage of observation services
  • Coverage requirements for outpatient diagnostic services


Module 3:  Coverage of Hospital Inpatient Services

  • Inpatient  criteria and the 2-Midnight Benchmark
  • Inpatient order and certification requirements


Module 4:  Medical Necessity, Coverage Determinations, and Notice Requirements

  • Medicare Coverage Center, including Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs) and Coverage with Evidence Development (CED)
  • Limitations of liability statute and notice requirements
  • The advanced beneficiary notice (ABN) form and instructions
  • Hospital Issued Notices of Non-Coverage (HINNs)


Module 5:  Medicare Claims Submission Fundamentals

  • The UB-04 claim form and key fields applicable to hospital services
  • Time Limitations on Filing Claims
  • Medicare claims flow


Module 6:  Medicare Edit Systems

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


Module 7:  Special Medicare Outpatient Billing Issues

  • Outpatient repetitive, non-repetitive and recurring services
  • Three-day payment window; outpatient services billed on inpatient claims
  • Billing of non-covered outpatient services


Module 8: Utilization Review and Inpatient Billing Issues

  • Utilization review determinations and Condition Codes 44 and W2
  • Inpatient Part B payment, including for non-covered inpatient services
  • Treatment of conditions arising during or from a non-covered stay


Module 9:  Adjustments, Audits and Appeals

  • Adjustment claims and automated reopenings
  • Reopenings and revised determinations
  • Recovery Audit Program and other Audit Contractors
  • Levels of Appeal and Appeal Considerations


Module 10:  Nuts and Bolts of the Outpatient Prospective Payment System

  • OPPS and Ambulatory Payment Classifications (APCs)
  • Addendum B and status indicators
  • Separate, packaged and conditionally packaged payment under OPPS
  • Addendum A and review of composite and comprehensive APCs
  • How to calculate the Medicare allowable for a HCPCS code
  • How to determine the hospital’s wage index
  • How to calculate the patient’s coinsurance
  • How to calculate outpatient outlier payments


Module 11:  Visits, Observation, and Therapy

  • E/M coding for clinics, emergency departments, critical care and trauma activation
  • Proper use of modifier 25
  • Billing of observation services
  • Extended Assessment and Management Composite APC
  • Critical Care Composite APC
  • “Sometimes” and “always” therapy
  • Outpatient therapy caps
  • Outpatient therapy functional status reporting


Module 12:  Outpatient Surgical and Radiology Services

  • Multiple procedure discount for surgical services
  • Terminated/discontinued  and bilateral procedures
  • Inpatient-only procedures
  • Surgical Composite APC
  • Comprehensive APCs
  • Radiology Family Composite APCs
  • Never events procedures


Module 13:  Outpatient Drugs, Biologicals, and Devices

  • Coverage of drugs, including self-administered drugs
  • Packaged and separately paid drugs and biologicals
  • Biological skin substitutes
  • Discarded Drugs
  • Procedure to device edits
  • Pass through devices
  • Value code FD for free and reduced cost devices


Module 14:  Hospital Laboratory Services

  • National Coverage Determination manual for laboratory services
  • Packaged and separately paid laboratory services
  • Reference Laboratory Services
  • Clinical diagnostic laboratory fee schedule
  • Blood and blood products


Module 15:  Inpatient Prospective Payment System and Patient Responsibility

  • Inpatient Prospective Payment System (IPPS) and Medicare-severity diagnosis related groups (MS-DRGs)
  • Complications and co-morbidities and the effect of a hospital acquired condition (HAC)
  • Inpatient deductible, coinsurance, and life time reserve days


Module 16:  Inpatient Payment Factors

  • Standardized amount adjustments: Hospital Quality Reporting Program and Electronic Health Record (EHR) Meaningful User
  • Quality adjustments:  Value Based Purchasing (VBP), Hospital Readmissions Reduction Program (HRRP) and Hospital Acquired Condition (HAC) Reduction Program
  •  Payment add-ons: New Technology and outlier
  • Medicare inpatient pricer
  • Payment for transfers and post-acute care transfers


Course Outline/Agenda subject to change

Medicare Boot Camp® - Hospital Version

Learning Objectives

At the end of this boot camp, participants will be able to:

  • Locate key sources of Medicare authority on the Internet
  • Interpret Medicare guidance and apply it to the services provided
  • Describe how Medicare covers inpatient and outpatient services at hospitals
  • Describe limitations on coverage under the Medicare program
  • Recognize the effect of coding rules on the services the provider reports
  • Discuss how documentation of patient care affects billing of the services the provider renders
  • Explain how Medicare pays for inpatient and outpatient services
  • Employ outpatient and inpatient status rules and regulations

Medicare Boot Camp® - Hospital Version

This program has been approved by the AAPC for 34.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. 

American Health Information Management Association (AHIMA)
This program has been approved for 34 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Compliance Certification Board (CCB)
The Compliance Certification Board (CCB) has approved this event for up to 42 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this program content or of the program sponsor.

American Nurses Credentialing Center (ANCC)
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 34.5 nursing contact hours is provided by HCPro.

California Board of Registered Nursing
HCPro is approved by the California Board of Registered Nursing to provide 41.4 nursing contact hours. California BRN Provider #CEP 14494.

National Association of State Boards of Accountancy (NASBA)
Earn up to 42 CPE Credits!
Program Level: Basic
Delivery Method: Group-Live

HCPro 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:

Disclosure Statement:
HCPro has confirmed that none of the faculty/presenters, planners, or contributors have any relevant financial relationships to disclose related to the content of this educational activity.

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 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, it is not primarily designed as 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 customer service at or 800-650-6787.

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. 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. In addition, please bring the following to all classes:

  • A highlighter
  • A notebook for taking notes
  • Sticky notes/flags
  • A 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."

Contact customer service at 800-650-6787 or email

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.