LOD - Basics of billing and appealing

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Home ► Online learning ► LOD - Basics of billing and appealing

Last Modified: 11/18/2024 Location: FL, PR, USVI Business: Part A, Part B

Learning On Demand – Basics of billing and appealing

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Title	Line of Business	Description	Format	Duration
Medicare Part A Updates – October 2024	Part A	This course is a review of the most recent Medicare updates and typically contains a wide variety of topics which include, but are not limited to, MAC initiatives, CMS initiatives, quarterly and annual updates, as well as preventative service reminders.	Webinar	Self-paced
Medicare Part B Updates – October 2024	Part B	This course is a review of the most recent Medicare updates and typically contains a wide variety of topics which include, but are not limited to, MAC initiatives, CMS initiatives, quarterly and annual updates, as well as preventative service reminders.	Webinar	Self-paced
Modifier of the Month: Repeat Procedures: 76, 77 and 91	Part B	Claims for repeat services can deny as duplicate claims if submitted without differentiating the services with proper modifiers. We'll provide guidance on submitting claims with modifiers 76, 77 and 91 to demonstrate repeat services and required supporting documentation.	Webinar	Self-paced
Medicare Part A Updates – July 2024	Part A	This course is a review of the most recent Medicare updates and typically contains a wide variety of topics which include, but are not limited to, MAC initiatives, CMS initiatives, quarterly and annual updates, as well as preventative service reminders.	Webinar	Self-paced
Modifier of the Month: 50 Versus Anatomical Modifiers	Part B	When submitting claims for procedures performed unilaterally or bilaterally during the same operative session, the proper modifier(s) should be applied to your claim lines. This course will demonstrate how to differentiate between using anatomical modifiers or modifier 50. We'll review appropriate use of these modifiers using relative claims and appeals examples.	Webinar	Self-paced
Medicare Part B Updates - July 2024	Part B	This course is a review of the most recent Medicare updates and typically contains a wide variety of topics which include, but are not limited to, MAC initiatives, CMS initiatives, quarterly and annual updates, as well as preventative service reminders.	Webinar	Self-paced
Modifiers of the Month: 22, 52 and 53	Part B	Claims for increased procedural services, reduced services and discontinued procedures should have supporting documentation to avoid claim denials and future appeals. With this course, we'll provide guidance on properly submitting claims with documentation when applying modifiers 22, 52 and 53.	Webinar	Self-paced
StayConnected: When and How to Submit Part B Appeals	Part B	Stay connected with Medicare Part B by attending the Part B Post-pay Workshop series. This webinar will provide an overview of the Part B appeals process including the different levels of appeal and submission timeframes, clarification of non-appealable claims, and appeal status.	Webinar	Self-paced
StayConnected: What Happens After the Claim is Submitted	Part B	Stay connected with Medicare Part B by attending the Part B Post-pay Workshop series. This webinar will review the stages of the Part B financial process after claims are submitted to Medicare, including claim processing and adjudication. We'll outline how to identify claim status, define the fields on the Medicare remittance advice (RA) and demonstrate how to successfully use this resource to monitor claims processing outcomes to reconcile patient accounts.	Webinar	Self-paced
Modifier of the Month: NCCI Modifiers 59, XE, XS, XU and XP	Part B	For non-evaluation and management services, modifiers 59 & X{EPSU} are used to identify distinct procedures or services not normally reported together when performed on the same day. As these modifiers are often used incorrectly, we'll explore the proper use of these modifiers, common scenarios, and supporting documentation requirements.	Webinar	Self-paced
Medicare Secondary Payer (MSP) Series: Preparing and Submitting Part B Claims	Part B	This Part B provider course in our Medicare secondary payer (MSP) series will begin with a brief overview of the MSP program provisions and how to identify patient eligibility. We will progress to step-by-step guidance on claim completion and submission and conclude with interactive billing scenarios.	Webinar	Self-paced
StayConnected: Monitoring the Processing Status of Part A Claims	Part A	Stay connected with Part A Medicare billing by attending the Part A Post Payment Workshop series. This webinar will review the various stages of the Part A financial process after claims are submitted to Medicare, including claim processing and finalization. We will outline how to identify claim status, define the various fields on the Medicare remittance advice (RA) and demonstrate how to successfully use this resource to monitor claims processing outcomes to reconcile accounts and receivables.	Webinar	Self-paced
Reporting the Correct Place of Service	Part B	This course will focus on reporting the correct place of service (POS) codes on your Medicare claims to ensure appropriate reimbursement amounts are issued. We define the most commonly used codes and review how to use them.	Webinar	Self-paced
Medicare Covered Dermatology Services	Part A and Part B	Medicare covers medically necessary dermatology services for the prevention, diagnosis, and treatment of certain skin conditions. Join this session to review the Medicare coverage, billing and documentation requirements of services provided by dermatologists. We will conclude with an overview of recent medical review findings and identify resources to assist in preventing improper payment errors.	Webinar	Self-paced
Modifier of the Month: AS, 80, 81, 82 and 62 (Assistant-at-Surgery and Co-Surgeons)	Part B	The Office of Inspector General (OIG) released a report indicating Medicare improperly paid physicians for co-surgery and assistant-at-surgery services were billed without the appropriate payment modifiers. Medicare makes a reduced payment to physicians who work together to perform a surgical procedure on the same patient during the same operative session. This course will explore the co-surgeon and surgical assistance modifiers (62, AS, 80, 82), and review the documentation requirements and various scenarios when these modifiers should be used	Webinar	Self-paced
Medicare Secondary Payer (MSP) Series: Identifying the Primary Payer	Part A and Part B	The second course in our Medicare secondary payer (MSP) series navigates how to identify the primary payer. We will explore the role of the MSP Contractor. We will examine the MSP resources and self-service tools available.	Webinar	Self-paced
Medicare Secondary Payer (MSP) Series: Fundamentals	Part A and Part B	This first course in our Medicare secondary payer (MSP) series provides the definition and purpose of the MSP program. We will review the MSP provisions including Group Health Plans (GHPs) and Non-group Health Plans (NGHPs). We will explore MSP resources and self-service tools available.	Webinar	Self-paced
Documenting outpatient hospital services correctly	Part A	Learn about documenting outpatient hospital services accurately and completely.	Webinar	Self-paced
Drugs and biologicals billing guidance	Part A and Part B	Learn billing guidance for drugs and biologicals.	Webinar	Self-paced
Understanding the PWK Segment	Part A and Part B	Description: The paperwork segment of an electronic claim submission is commonly known as PWK. The PWK process allows you to utilize the cost-effective electronic data interchange technology and if you choose to submit paper documentation at the time of the claim submission. This video will give you a brief demonstration about the PWK segment. Please share your feedback about this webinar.	Video	0:03:50
Electronic transactions in the Medicare program (Spanish)	Part A and Part B	View this video for more information about the electronic transactions, your requirements for billing electronically, and the free software available for you. Please share your feedback about this webinar.	Video	0:09:10
Electronic transactions in the Medicare program	Part A and Part B	View this video for more information about the electronic transactions, your requirements for billing electronically, and the free software available for you. Please share your feedback about this webinar.	Video	0:06:56
Documenting and billing Medicare orders and referrals (Spanish)	Part B	Learn about enrollment and documentation requirements for providers ordering or referring services and claim requirements for providers performing and billing for services. Please share your feedback about this video.	Video	0:08:10
Documenting and billing Medicare orders and referrals	Part B	Learn about enrollment and documentation requirements for providers ordering or referring services and claim requirements for providers performing and billing for services. Please share your feedback about this video.	Video	0:05:38
Identifying if your Medicare claim Is eligible for an appeal	Part A and Part B	Before submitting an appeal on a Medicare claim, you first want to make sure that a claim determination, or decision, was made of either paid or denied. We often see providers incorrectly appealing a claim returned to provider for correction. This video covers how you can identify when a claim is eligible for an appeal. Please share your feedback about this video.	Video	00:02:51
Understanding the Medicare overpayment process	Part A and Part B	This video will help you understand the overpayment process, your responsibilities to pay the money back money, and what to do if you disagree with an overpayment decision. Please share your feedback about this video.	Video	00:10:47

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