Course Agenda:

• Understanding Medicare’s Correct Coding Initiative
• RBRVS and your Medicare fee schedule
• How to get a list of all non-covered services
• Advance Beneficiary Notice guidelines
• Proper use of the GA modifier for successful payment
• What “assignment” means under Medicare law
• Determining whether Medicare is primary or secondary payer
• Improve understanding of audit triggers
• The dangers of fragmenting, bundling, unbundling
• Correct use of comprehensive and mutually exclusive codes
• Preventive vs. problem-oriented services
• Differences between PAR, non-PAR and opting out of Medicare
• Caring for the indigent Medicare patient
• Stark laws and the dangers of courtesy discounts and kickbacks
• Your rights during a carrier audit
• Billing for services that are not medically necessary
• Proper documentation for medical necessity
• Uncovering the Medicare appeals process and review
• Your rights in making sure you receive a fair hearing
• Interacting with an administrative law judge