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First Coast's Medicare Compliance Matters virtual symposium agenda
Last Modified: 8/16/2024
Location: FL, PR, USVI
Business: Part A, Part B
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- Part A (facilities services billed on a CMS UB-04 claim form or an electronic equivalent)
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- Part B (professional services billed on the CMS-1500 claim form or an electronic equivalent)
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- New provider (providers, billers, coders, office staff, etc., new to the Medicare program or looking for a refresher)
To register for the event, select the registration link next to the event and you will be navigated to WebEx to submit a pre-registration form.
• Participants may only register for one webinar per timeslot.
After submitting the WebEx registration form, you will receive email confirmation from WebEx containing an invite to save to your virtual calendar.
One the day of the event, click the link in the invite and join.
For questions, problems registering, and/or concerns, please send an email to
LearningCenterHelpDesk@fcso.com. Please include as much detailed information as possible (e.g., contact information, username, description of problem, etc.) so that we may resolve your issue.
Outlined below is a schedule for Day 1 of the symposium. Select the link in the course title to view the course description.
Class start times are listed in Eastern Time.
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Time (ET) |
Title |
Audience |
CEUs |
Register |
8:30-10:00 a.m. |
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1.5 |
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10:00-10:30 a.m. |
Break |
10:30 a.m.-12:00 p.m. |
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1.5 |
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1.5 |
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1.5 |
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1.0 |
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12:00-1:00 p.m. |
Lunch |
1:00-2:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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1.5 |
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2:30-3:00 p.m. |
Break |
3:00-4:00 p.m. |
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1.0 |
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3:00-4:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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Outlined below is a schedule for Day 2 of the symposium. Select the link in the course title to view the course description.
Class start times are listed in Eastern Time.
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Time (ET) |
Title |
Audience |
CEUs |
Register |
9:00-10:30 a.m. |
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1.5 |
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1.5 |
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1.5 |
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1.5 |
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10:30-11:00 a.m. |
Break |
11:00 a.m.-12:00 p.m. |
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1.0 |
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11:00 a.m.-12:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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12:30-1:00 p.m. |
Lunch |
1:00-2:00 p.m. |
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1.0 |
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1:00-2:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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2:30-3:00 p.m. |
Break |
3:00-4:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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1.5 |
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Outlined below is a schedule for Day 3 of the symposium. Select the link in the course title to view the course description.
Class start times are listed in Eastern Time.
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Time (ET) |
Title |
Audience |
CEUs |
Register |
9:00-10:30 a.m. |
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1.5 |
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1.5 |
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1. 5 |
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10:30-11:00 a.m. |
Break |
11:00 a.m.-12:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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1.5 |
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12:30-1:00 p.m. |
Break |
1:00-2:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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1.5 |
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2:30-3:00 p.m. |
Break |
3:00-4:30 p.m. |
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1.5 |
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1.5 |
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1.5 |
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1.5 |
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Kick off the 2024 Novitas and First Coast virtual symposium by attending our introductory session. Learn more about what to expect with this year's event and our offering of 44 webinars over the next three days focusing on what matters most: Medicare Compliance. Be the first to hear about upcoming:
• Novitas/First Coast and CMS initiatives
• Medicare compliance program and improper payments updates
• How you can become a valued partner in ensuring Medicare program integrity
The virtual symposium only comes once a year, don't miss out on these important programs.
Discharge status codes identify where the patient is discharged or transferred to at the end of the facility stay. Documenting an incorrect discharge code may not only impact the hospital's reimbursement but may affect any other facility receiving the patient post discharge, often preventing them from successfully submitting a claim to Medicare. This webinar will identify patient discharge codes and review billing guidelines to report patient transfers to other facilities. We will also review recent audit findings related to billing these services and highlight best practices to prevent future billing errors leading to costly overpayments.
Patient eligibility screening at each visit serves a valuable role in identifying the correct insurer and determining remaining and eligible benefits available to each beneficiary. Verifying patient eligibility ensures accurate billing and minimizes the risk of overpayments. During this webinar, we will define the various types of patient eligibility, how to verify it, and review how to correct claims when you discover eligibility has changed.
During this event, we will review how to determine Medicare coverage of Part B Medicare services and explore financial liability and protections communicated to beneficiaries through notices given by providers. We will specifically review in this session, how to complete the fee-for-service advanced beneficiary notice (FFS-ABN) or the CMS-R-131 form and file the claim to Medicare using the appropriate modifiers.
This course will cover purposeful documentation requirements for medical records and provide guidance regarding acceptable signature requirements. We will highlight identified improper payment errors stemming from poor documentation and discuss best practices regarding how to prevent those errors. Take advantage of this opportunity to learn more about compliant documentation and signature practices.
This course will provide a comprehensive review of the essentials of evaluation and management (E/M) services, covering the importance of purposeful documentation to minimize coding errors, and offering tips on how to select the correct code family for services provided. Additionally, the course will delve into the topics of split (or shared) E/M services and the add-on code G2211, providing attendees with a clear understanding of how to accurately bill for these services.
This course will provide an overview of inpatient and outpatient critical access hospital (CAH) billing for Method I and Method II facilities, including specialty items/services such as ambulance, observation, laboratory and therapy, and explore purposeful documentation requirements. We will also address recently identified improper payment errors and provide resources to assist in preventing them.
Do you use a third-party vendor or outsourced company for your Medicare credentialing, billing and account receivables? We recently observed an increase in third-party billers conducting unnecessary phone calls and submitting inappropriate information to Medicare on your behalf. These transactions could be costing you money and wasting Medicare dollars. Join us to learn about how you can monitor these activities and help decrease these wasteful activities to the Medicare program and you.
Are you considering enrollment in the Medicare program? Did you know you have options regarding the type of Medicare enrollment that best suits your business structure? Join this presentation to discover the requirements for enrollment as a participating or non-participating provider who bills Medicare for services rendered, a non-billing provider who orders and certifies or a provider who opts out of Medicare. We will review the compliance requirements for each of these enrollment types and outline how to complete and submit the enrollment to Medicare.
The Office of Inspector General and Recovery Auditor findings have reported noncompliance with cardiac, intensive cardiac and pulmonary rehabilitation coverage and documentation requirements. We will review the coverage, billing and purposeful documentation guidelines in an effort to reduce improper payment errors associated with these services.
This course was developed in response to improper payment errors identified by the Comprehensive Error Rate Testing (CERT) program. We will review coverage, billing and documentation requirements and highlight best practices for recording the trip/run sheet, obtaining the physician certificate statement (PCS), and proper billing for transport mileage.
The Medicare Integrity Program was established to identify improper payments and promote compliance with Medicare guidelines. This presentation will identify each review contractor and outline steps providers and suppliers may have to take when contacted by them.
This course will explore the wide range of Medicare-covered behavioral health services, including mental health and substance use services, to improve patient outcomes and overall wellness. We'll identify the types of Medicare providers who can offer these services, outline billing and coverage guidelines, and share valuable resources.
This course will emphasize the importance of accurate reporting of place of service (POS) codes on your claims to ensure appropriate Medicare reimbursement. We will define the most commonly used POS codes, identify resources to assist in determining the correct code to use and lastly provide options for how to correct claims when an incorrect POS code is reported.
This session will demonstrate how to locate Medicare coverage policies, including national and local coverage determinations, and explore how to use them. We will also illustrate how to utilize various tools to assist with locating Medicare policies.
As a service billed more frequently to Medicare, laboratory services are also one of the most frequently audited by a variety of program integrity contractors. Join us as we review laboratory service ordering requirements, documentation to support the order, Clinical Laboratory Improvements Amendment (CLIA), and resources to help mitigate improper payment errors.
This course will provide billing guidance for radiology services and diagnostic procedures. We will review the professional and technical component indicators, modifiers, place of service requirements and the multiple procedure payment reduction. We will conclude with a review of orders and purpose documentation requirements and address recent targeted probe and educate (TPE) improper payment errors.
Medicare covers use of investigational, non-experimental devices under investigational device exemptions (IDEs) when reasonable and necessary for diagnosis and treatment of an injury or illness or to improve the functioning of a malformed body member. IDEs allow devices for use in clinical studies to collect data required to support the pre-approval process for clinical trials and submission to the Food and Drug Administration (FDA). Under an agreement with the FDA, certain devices could be viewed as "reasonable and necessary" by Medicare and treatment covered if applicable Medicare coverage requirements are met. Through this course, we'll explore how to research IDEs and clinical trials by discussing the background of these programs, indication and limitations of coverage and categories of classes of IDEs.
This course will define the requirements for incident to and split/shared evaluation and management (E/M) services. We will review Medicare billing and purposeful documentation requirements for services rendered incident to or split/shared between physicians and other qualified healthcare professionals. We will also review various web-based resources to assist in complying with these requirements.
During this session, we'll examine differences between solicited and unsolicited overpayments, while exploring the options available to facilitate the recoupment process. We'll review how to submit voluntary refunds, request immediate offsets or extended repayment schedules, and identify self-service tools to access the repayment process. We will also outline the monetary penalties that may accrue if Medicare is not repaid in a timely manner.
Revalidating your enrollment record to ensure it reflects the most current information is a requirement for compliance in the Medicare program. This course will provide you with an overview of the provider enrollment revalidation process, including how to determine you are up for revalidation, how to complete and submit a revalidation application, and how to monitor the processing status of the application once submitted. We will also review the new interim status called a "stay of enrollment" if the requirement to revalidate is not completed in its entirety.
Medicare covers a variety of chronic pain management (CPM) interventions and treatments in support of promoting non-opioid pharmacological patient care. During this webinar, we will highlight Medicare coverage of acupuncture for chronic lower back pain and review chronic pain management (CPM) and treatment services.
This course will review Medicare Part B requirements for reporting critical care evaluation and management (E/M) services, ensuring compliance with coding and billing regulations and emphasizing strategies to reduce the risk of improper payment errors. The course will cover essential topics such as coding and purposeful documentation requirements, highlighting the importance of accurate and complete documentation, proper coding techniques, and available resources.
This course will provide best practice tips for information validation before billing Medicare. Verifying these critical elements of information will prevent improper payments and mitigate administrative rework with claim correction and/or resubmission. We will review resources for screening the Medicare patient for eligibility, identifying the most accurate procedure and diagnosis code for the service, determining Medicare coverage, verifying coding and unit reporting accuracy, and using modifiers to report unique service situations. We will conclude with an overview of claim submission tips and reminders.
Medicare will consider payment for drugs and biologicals after administration of the appropriate dosage for the patient’s condition. Errors related to drug dosage reporting and lack of medical necessity are top reasons contributing to incorrect claim billing and loss of revenue. This session will provide coverage and billing guidelines for drugs and biologicals for Part A services. We will review topics such as purposeful documentation requirements and the correct reporting of units. The highlight of this session will be reviewing the proper use of the JW and JZ modifiers.
This course will provide an overview of the various types of Medicare policies, including National Coverage Determinations (NCD), Local Coverage Determination (LCD) policies and Local Coverage Articles (LCA) and outline how they aid in determining medical necessity, billing compliance and documentation requirements. We will also review how to determine if an appeal or clerical reopening of a denied claim is appropriate and steps to take to submit these requests.
This session will provide guidance on skilled nursing facility (SNF) coverage requirements, including the SNF benefit period. We'll include information on the three-day qualifying hospital stay requirement and purposeful documentation requirements. We will also review recently identified improper payment errors and provide valuable resources to comply with Medicare’s guidelines.
Effective January 1, 2024, Medicare coverage and payment for intensive outpatient program (IOP) services are available for individuals with mental health conditions (including substance use disorders). This course will provide an overview of IOP service coverage criteria and review IOP billing guidelines. We will also review purposeful documentation requirements and provide helpful resources related to IOP coverage and billing.
Are you preparing to submit an enrollment application to Medicare? In this course, we will provide you with the information necessary to submit your enrollment application correctly the first time to avoid development and unwanted processing delays. Keeping your enrollment information active and current is important and part of your responsibility as a Medicare provider/supplier. Join this presentation to review the steps for submitting the correct application(s), avoid common application errors, and ensure all required documentation is included in your first submission.
Novitas Solutions, First Coast Service Options, and Palmetto GBA, are hosting a collaborative event focused on physician certification requirements for hospice care. We will review important information regarding certifying physician enrollment requirements and physician hospice management service certification to prevent costly claim denials.
During this course, you'll discover the basics of the global surgery concept, as well as the correct use of modifiers for visits and other procedures within the global surgical period. We'll explore evaluation and management (24, 25, 57 and FT), surgical (58, 78 and 78), and postoperative co-management modifiers (54, 55), while demonstrating appropriately using these modifiers and guiding you through billing scenarios and reimbursement methodologies for surgical situations.
Medicare providers will experience overpayments at some point either through self-identification or through an external audit. Understanding the options available to correct claims, appeal, or repay the overpayment within stringent timeframes are an essential next step to avoiding disruptive recoupments or costly interest accruals. Let us equip you during this session with the knowledge, skills and resources to successfully navigate this process.
This course will provide an overview of Medicare covered psychiatric services including diagnostic evaluations, psychological and neuropsychological testing, psychotherapy, family and group therapy and behavioral health integration (BHI) services. We'll identify who can provide services, review billing guidelines, explore medical necessity and documentation requirements, and conclude with an overview of recently identified improper payment errors and best practices to avoid them.
This webinar will provide an overview of the end-stage renal disease (ESRD) Medicare benefit. We will review the Part A and B provider's role in compliance, including meeting purposeful documentation requirements and avoiding improper billing errors commonly identified by the Comprehensive Error Rate Testing (CERT) program and Targeted Probe and Educate (TPE) reviews.
This webinar will review coverage and billing guidelines for the Medicare initial preventive physical examination (IPPE) and annual wellness visit (AWV). We will also review the recent policy update allowing a social determinants of health (SDOH) risk assessment as an optional part of the AWV. Using improper payment errors identified by the Comprehensive Error Rate Testing (CERT) program and medical review, we will highlight best practices to prevent these billing and documentation errors from occurring in your practice.
As telemedicine use expands under the Medicare program, so do the risks for improper billing and insufficient documentation. This webinar will define the Medicare requirements associated with the various types of telemedicine services, including telehealth, virtual check-ins, E-visits, and telephone services. We will use recent reports from the Office of Inspector General (OIG) to identify improper payment errors and review best practices to prevent them from occurring.
This webinar will provide coverage and billing guidelines for drugs and biologicals for Part B services. We will review topics such as documentation and the correct reporting of units. The highlight of this webinar will be reviewing the proper use of the JW modifier and the JZ modifier.
This course is designed to provide a thorough examination of different Medicare fee schedules. We will begin with a review of the Medicare physician fee schedule (MFPS) and define the various payment indicators available in our self-service tools. Additionally, we will provide an overview of other payment schedules including clinical laboratory fees, drugs and biologicals, immunizations, and anesthesia.
This course will review how to stay compliant with medical record documentation and authentication requirements. During this session, we will review general principles of medical record documentation, how to effectively respond to additional development requests (ADRs), common documentation errors and identify resources to help avoid them. We will also address signature guidelines and proper avenues for maintaining medical records.
This course will review coverage and billing guidelines for physical, occupational and speech therapy and rehabilitation services provided by Part A outpatient facilities and Part B private practice providers. Using errors identified by the Comprehensive Error Rate Testing (CERT) program and First Coast and Novitas’ medical review, we will highlight best practices to prevent common billing and documentation errors by reviewing coverage guidelines, therapy modifier utilization, purposeful documentation requirements and proper billing of time-based codes.
During this webinar, we will explore Medicare's coverage criteria, billing guidelines and purposeful documentation requirements for skin debridement procedures (CPT 11042 - 11047). We will conclude with an overview of recent medical review findings including billing errors and highlight critical resources to help prevent errors.
Protecting the Medicare trust fund isn't just for Medicare review contractors, it is the responsibility of everyone involved in the Medicare program, including our providers. Help prevent fraud, waste and abuse by establishing a compliance program focused on improper payment prevention. Join us as we review critical resources to assist in the development of an internal review process.
This course will review the coverage and purposeful documentation requirements for inpatient rehabilitation facility (IRF) services. We will examine common errors identified by the Office of the Inspector General (OIG), Comprehensive Error Rate Testing (CERT) program and recent medical review activities and outline resources and best practices to improve compliance with Medicare program requirements for IRF services.
This course will cover the three levels of supervision in Medicare, which include general supervision, direct supervision, and personal supervision. We will also identify the physicians who may supervise each level and review the requirements for supervision each level, such as the presence of the supervising physician, the level of monitoring and guidance, and the type of services that can be performed under each level. Additionally, this session will define and identify the supervision levels for outpatient diagnostic services, including laboratory tests, imaging studies, and other diagnostic procedures.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.