Are you a Medicare provider who provides ambulance transportation? Do you and/or your staff need help understanding the benefit structure for ambulance services? If you answered yes to both questions, then this course is for you. Learn how Congress defines the ambulance benefit and how the Centers for Medicare & Medicaid Services (CMS) enforces the benefit through its claims process. This course will introduce and explain the following topics: Coverage, certification, and documentation requirements, as well as provide coding guidance for billing ambulance transport services.

Completion of this course helps members of physician and other suppliers billing staff navigate the time-sensitive Medicare Appeals process, which impacts cash flow. Included is an overview of the claims process, followed by detailed scenarios for each level of appeal -- clerical error reopening, redetermination, reconsideration, administrative law judge, departmental appeals board, and federal district court review.

Do you submit claims for Chiropractic services to the Medicare Program? Do you need help understanding this benefit structure? Do you need clarification on documentation requirements contained within the Local Coverage Determination (LCD) for Chiropractic Services? Are you a provider currently on review and need assistance in reducing your claims error rate? This course is for you. Learn how Congress defined this benefit structure and how the Centers for Medicare & Medicaid Services (CMS) enforces the benefit through its claims process. This course provides information to help you improve you documentation and billing practices.

This course provides a brief overview of the Comprehensive Error Rate Testing (CERT) program. Learn about the purpose and importance of the CERT program and discover how contractors and providers can work together to improve the accuracy of the claims payment process.

This course is designed to give the student a general understanding of Current Procedural Terminology (CPT) and the process required to translate a physician's service into a Level I CPT code. Complete this course and earn 1 CEU.

Duplicate claims cost Medicare providers and the Medicare program valuable time and money. Learn how you can be proactive and avoid these types of claim submission errors -- saving time and money.

Calling all physicians and their billing staff… Each of you plays a critical role in the process of coding Evaluation and Management (E/M) services provided to Medicare beneficiaries. The level of code for these services is driven by the documentation describing the physician/beneficiary encounter. Take this course to learn about the documentation guidelines, key components of E/M services, and documenting medical necessity.

The Centers for Medicare & Medicaid Services (CMS) instituted performance standards for Independent Diagnostic Testing Facilities (IDTFs). Complete this course to learn about these standards, which must be met in order to obtain or maintain Medicare billing privileges. These standards can also be found in 42 C.F.R Section 410.33(g).

Do you regularly contact Medicare to obtain information about your Medicare claims? Do you know the easiest, most efficient way to obtain patient information? In the Interactive Voice Response (IVR) Features and Information course, you'll learn how you can leverage this time-saving resource. This one-hour course will provide a defined overview of the IVR, benefits of using the IVR, acronyms, IVR background, how the IVR works, how to use the IVR, the hours of operation, and specific IVR features. The course does not offer CEU credits.

Learn how to determine which services are included in a Global Surgery period and which services are paid separately. This course takes you through scenarios in which a Medicare beneficiary receives services before, during, and after a surgical procedure -- and you make the decisions.

Are you receiving requests for additional medical documentation? Have your claims been denied due to medical documentation errors? Or, have you had claims denied due to issues with signatures (i.e., illegible)? Complete this course to learn of common reasons for these errors, and what processes you can put into place to address these issues.

Have you received a request for medical documentation in support of a claim you submitted to Medicare? This course addresses key components of the documentation request, including which Medicare contractors are likely to request records, timeframes in which to respond to requests, recommended items to include , and acceptable submission methods. You’ll also learn how to avoid insufficient documentation denials and how to access documentation related resources. Note: Revised June 2011.

Learn ways to identify situations in which Medicare is considered the secondary payer (MSP) to a beneficiary's other insurance. There are tools available to you from the Coordination of Benefits Contractor (COBC), and you'll learn how to leverage these resources by completing this course. You'll also learn how to calculate MSP benefits and how complete the MSP-related fields prior to submitting claims to Medicare.

This course will provide the principals behind Medicare’s claim review programs and processes. Topics discussed: the importance being familiar with the different review programs, contractors responsible for administering those programs, program differences and how they work, the importance of timely provider responses to requests for documentation, and what you can do to be proactive in your practice in preparation and anticipation of a request for documentation.

Designed for Mental healthcare professionals, this course covers the following topics: Mental healthcare professionals, medical necessity, documentation requirements, partial hospitalization program (PHP), reimbursement terminology, and sample documentation This updated course was previously named Psychiatric Services.

The purpose of this course is to learn how Modifier 24 is applied to claims. The learner will be presented with general information about Modifier 24 as well as how to use the associated decision flowchart to determine the correct course of action to take when applying the modifier.

The purpose of this course is to learn how Modifier 25 is applied to claims. The learner will be presented with general information about Modifier 25 as well as how to use the associated decision flowchart to determine the correct course of action to take when applying the modifier.

The purpose of this course is to learn how Modifier 58 is applied to claims. The learner will be presented with general information about Modifier 58 as well as how to use the associated decision flowchart to determine the correct course of action to take when applying the modifier.

The purpose of this course is to learn how Modifier 78 is applied to claims. The learner will be presented with general information about Modifier 78, as well as how to use the associated decision flowchart to determine the correct course of action to take when applying the modifier.

The purpose of this course is to learn how Modifier 79 is applied to claims. The learner will be presented with general information about Modifier 79, as well as how to use the associated decision flowchart to determine the correct course of action to take when applying the modifier.

The National Correct Coding Initiative (NCCI) was implemented to prevent improper payment when incorrect code combinations occur. Complete this course to learn the background on this initiative, NCCI Policies, NCCI Indicators, claims denied due to incorrect coding combinations, and the use of modifiers.

The goal of the Progressive Corrective Action (PCA) process is to safeguard the Medicare Trust Fund. Learn about the mission and goal of the medical review process and how data analysis drives the identification of aberrances. Learn the proper way to submit medical records when requested and how Local Coverage Determinations (LCDs) are developed and implemented. Through completion of this course, you'll gain an understanding of how to enhance your documentation and billing processes.

Are you a physician or provider new to the Medicare Program? Or do you need to change information with your Medicare contractor, such as address or organization name? Complete this course to learn step-by-step how to complete the CMS-855 form enabling you to bill the Medicare Program for services provided to Medicare beneficiaries.

Designed for Mental healthcare professionals, this course covers the Medicare psychiatric services benefit, including requirements for documenting medical necessity and the partial hospitalization program (PHP).

Have you ever heard of the terms local coverage determinations (LCDs) and national coverage determinations (NCDs) and wondered what they mean, in definition and to you as a provider? This course will provide you with those answers. The path you are about to travel will explain what NCDs and LCDs are, where they are located, and how they are different from each other. You will also be provided an overview of the layouts of both, including the key content areas to which you should pay particular attention. Finally, you will become skilled at reading these policies and applying them to your medical records and claims, resulting in accurate payment received for accurate billing.

This course provides an overview of background/definitions, beneficiary information and entitlement, services performed, provider information and entitlement, and referring or ordering physician's identification number.