HCM Marketplace

AUDIOCONFERENCE ON TAPE OR CD

Sponsored by Billing Alert for Long-Term Care
presented on June 13, 2006

Stop struggling with the new Medicare CCI edits

As of January 1st, SNFs for the first time have to contend with Medicare's national correct coding initiative (CCI) edits. The result? SNFs are beginning to see claims partially paid with non-covered charges per the new edits. Improper use of CCI edits will impact revenue, therapy cap calculations, and exceptions to the therapy cap process.

Get ALL the reimbursement you deserve

This 90-minute audioconference from HCPro will help facilities navigate Medicare billing in the CCI era. Expert Theresa A. Lang, RN, BSN, RAC-C, WCC, will focus on practical and easy-to-implement advice and strategies to solve operational and billing challenges. She’ll instruct listeners on how to reopen claims and fix billing errors, and through appropriate use of modifiers obtain timely payment upon first submission of the claim.

Protect your facility’s revenue by listening to SNFs Face Correct Coding Initiative: Improper CCI Edit Use Threatens Revenue and Therapy Cap Exceptions.

Listening to SNFs Face Correct Coding Initiative will help participants to:

• Prevent charges from moving to non-covered charges due to lack of -59 modifiers
• Deal with the therapy caps calculations in relationship to the CCI Edits and properly use the new KX modifier
• Avoid misuse/overuse of the -59 modifier when billing Part B SNF services

Note: Participants listening to this audioconference should already have a basic understanding of SNF Part B billing, therapy caps, and CCI edits.

AGENDA:

1. CCI Edits: Mutually Exclusive/Column 1- Column 2
2. Appropriate use of -59 modifiers and supporting medical records documentation
3. Non-covered charges are not denied charges: Reopening of claims to fix billing errors
4. Impact of CCI edits on therapy caps
5. Therapy cap exceptions: automatic versus manual request
6. Q & A

LEARNING OBJECTIVES:

1. Identify the therapy documentation which must be present in order to use the -59
2. Differentiate mutually exclusive CCI edits from Column 1/Column 2 edits
3. Define non-covered charge versus denied charge
4. Discuss claim reopening versus claim appeal for CCI Edit errors
5. Describe how the CCI edits will impact therapy cap calculations
6. List the requirement of a manual therapy cap exception request
7. Identify appropriate use of the KX modifier for therapy cap exceptions 

BONUS TOOLS INCLUDED IN YOUR MATERIALS PACKET:

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and tools including:

1. Sample Notice of Exclusion from Medicare Benefits (NEMB)
2. Claims scenarios
3. Therapy billing checklist

These materials will be provided with PDF links.

MEET THE SPEAKER:

Theresa A. Lang, RN, BSN, RAC-C, WCC, is the Senior Health Services Consultant at Specialized Medical Services, Inc. in Milwaukee, WI. Ms. Lang has worked in long-term care for more than thirty years. She has been a director of nursing, corporate nurse consultant, and assistant administrator of a rural hospital, clinic, and nursing home before joining Specialized Medical Services, Inc. 10 years ago. Ms. Lang has a broad range of experience including Medicare coverage and documentation, SNF and rehab agency corporate compliance, sub-acute program development, and managed care contracting and pricing.

WHO SHOULD LISTEN:

SNF coders and billers, billing office managers, finance managers, Medicare managers, CFOs, CORF and HHA coders and billers.

Purchase a tape or CD of the program and listen when you can. It's a perfect training tool for new staff or as a refresher for veteran staff.

• Audioconferences

• Other Long-Term Care Products