Post on 14-Jan-2016
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Medicare TrainingBy FBC Services
Medicare General Information Medicare A General Information
◦ NO-Pay and Benefit Exhaust Bills◦ SNF Denial Information◦ MSP Medicare Secondary Payer◦ Assessments and OMRA’s
Medicare B General Information◦ What’s Covered◦ Bundling and Therapy Caps◦ 59 and KX codes
Training Outline
DDE Information◦ Claims Correction◦ CWF
Roster Billing Questions and Answers
Training Outline Cont’d
The Medicare Program Eligibility Benefit Period
Medicare Overview
No Pay and Benefit Exhaust Bills SNF Denial Information MSP Medicare Secondary Payer Assessments and OMRA’s
Medicare A Overview
How and When to do a No-Pay Bill Appropriate Codes No-Pay Bill Vs. Demand Bills
No-Pay and Benefit Exhaust Bills
Denial on Admission UR Denials Denial Paragraphs For CMS Denial Letters Go To The CMS site
at
http://www.cms.hhs.gov/BNI/04_FFSSNFABNandSNFDenialLetters.asp
SNF Denial Information
MSP Overview When and How to Submit an MSP Claim
Medicare Secondary Payer (MSP)
ARD’s and Grace Days OMRA’s Assessment Schedule Assessment Tracker
Assessments and OMRA’s
MedicareMDS Assessment Type
Reason for Assessment (AA8b code)
Assessment Reference Date
Applicable Medicare Payment Days
5 day 01 Days 1 – 5 1 through 14
14 day 07 Days 11 – 14 15 through 30
30 day 02 Days 21 – 29 31 through 60
60 day 03 Days 50 – 59 61 through 90
90 day 04 Days 80 – 89 91 through 100
Medicare Assessment Schedule
What’s Covered To Bundle or Not to Bundle Therapy Caps 59 and KX codes What to do when you’re out of space
Medicare B General Information
F2, F10 and F6
F10 and F6
DDE Information Menu’s Claims Corrections and Adjustments CWF Roster Billing
Main Menu
Inquiry Menu’s
Claims-Special OC Codes Return to History Rejected Claims Claim Change Codes
Claims, Corrections and Adj
How to Read the CWF Insurance Codes
(CWF) Common Working File
CWF (Insurance codes)
FLU and PPV HCPCS Rates Format
Roster Billing
Roster Bill
Questions and Answers
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