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Litmos Education - Revenue Cycle 201
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Revenue Cycle 201 -  Developing Skills

Each of the courses listed below are sold individually; $15 for NAHAM members and $35 for non-members. Click on the course title to purchase the course.  

BF80501 - Components of a Complete Physician Order V5

This course identifies the components of a complete physician order, types of physician orders, and the information obtained from a physician order.

Course Objectives
After completing this course, you will understand how to:

* Identify services that can be provided without a physician order.

* Cite the components of a complete physician order.

* Define physician order authentication methods.

* Name the methods physician orders are communicated.

* Select the key components on various inpatient and outpatient orders.

* Analyze a physician order and identify the missing key components.


Contact Hours: 0.50
Length of Course: 30 minutes 


BF80602 - Medicare - World of Medicare V5

This course introduces Medicare, a government health insurance program, through a CMS offered course entitled World of Medicare.

Course Objectives: 

As documented in the World of Medicare course offered by CMS: 
* State the purpose of Medicare.

* Describe the history of Medicare.

* Differentiate between Medicare Part A, Part B, and Medicare +Choice coverage.

* Describe the roles of agencies and contractors in the Medicare system.

* Describe the Medicare claims processing system.

* Describe the role of the provider in the Medicare system.

and more ...

 

Contact Hours: 1.25
Length of Course: 75 minutes 


BF80603 - Your Office in the World of Medicare V5

This course introduces the fundamentals of Medicare, a government health insurance program.

 

Course Objectives
After completing this course, you will understand how to:

* Recognize how Federal law, regulations, and Medicare policies impact the office practices of physicians, non-physician practitioners, and suppliers.

* Locate information of importance to you on the CMS website.

* Identify various resources provided by CMS to assist physicians, non-physician practitioners, and suppliers in effectively fulfilling Medicare requirements.

* Select applicable forms and resources to use for specific functions in a medical or suppliers office.


Contact Hours: 2.00
Length of Course: 120 minutes


BF80604 - Introduction to Medicaid V5

This course introduces Medicaid, a Federal and state funded healthcare program for low-income families and individuals, some who may have inadequate or no health insurance coverage.

 

Course Objectives
After completing this course, you will understand how to:

* Define the Medicaid program and its funding mechanism.

* Describe the three eligibility groups of the program.

* Explain who may be covered by the program.

* Describe healthcare coverage that may be offered by the program.


Contact Hours: 1.00
Length of Course: 25 minutes 


BF80605 - Introduction to TRICARE and CHAMPVA V5

This course introduces TRICARE and CHAMPVA, two military health insurance programs.

 

Course Objectives
After completing this course, you will understand how to:

* Define TRICARE. * Recognize benefit categorizes of eligible beneficiaries.

* Locate the TRICARE website as a reference tool.

* Define CHAMPVA. * Recognize eligible beneficiaries.

* Recognize the difference between TRICARE and CHAMPVA.

* Locate the CHAMPVA website as a reference tool.


Contact Hours: 1.25
Length of Course: 75 minutes 


BF80607 - Why Accurate Health Insurance Data Matters V5

This course identifies what can happen if complete and correct payer information is not obtained during patient intake.

 

Contact Hours: 0.25
Length of Course: 15 minutes 


BF80608 - Introduction to Medicare Advantage Plans V5

This course introduces Medicare Advantage Plans - otherwise known as Medicare Part C.

 

Course Objectives
After completing this course, you will understand how to:

* Define the Medicare Advantage Program

* Discuss the types / categories of Medicare Advantage Plans.

* Differentiate between traditional Medicare and the Medicare Advantage program.

* Explain when and how an individual becomes eligible for a Medicare Advantage Plan.

* Describe what is, and what is not covered by Medicare Advantage Plans.


Contact Hours: 0.75
Length of Course: 45 minutes 


BF80701 - Insurance Verification Terminology V5

This course introduces the Verification Flow and its components.

 

Course Objectives
After completing this course, you will understand how to:

* Cite key demographic information obtained and verified during the patient intake process.

* Cite key encounter information obtained and verified during the patient intake process.

* Recognize the verification flow and its steps.

* Define eligibility period.

* Define authorization.

* Define pre-certification.

* Define referral. * Define benefit level.

* Recognize the cost versus benefit of completing a verification step.


Contact Hours: 0.75
Length of Course: 45 minutes 


BF80702 - Insurance Verification Process Step by Step V5

This course identifies how to complete the Verification Flow.

 

Course Objectives
After completing this course, you will understand how to:

* List the steps in the Verification Flow.

* Define the payer confirmation steps - eligibility, authorization, and benefit.

* Differentiate between eligibility, authorization, and benefit.

* Cite eligibility confirmation methods.

* Identify information needed for eligibility confirmation.

* Cite authorization confirmation methods.

* Identify information needed for authorization confirmation.

* Cite benefit confirmation methods.

* Identify information needed for benefit confirmation.

and more....


Contact Hours: 1.00
Length of Course: 75 minutes 


BF80703 - Why Insurance Verification Matters V5

This course identifies what can happen if verification of the demographic, payer, and encounter information is not completed.

 

Course Objectives
After completing this course, you will understand how to:

* Recognize the impact incorrect payer information has on several clinical and financial processes within the revenue cycle.


Contact Hours: 0.25
Length of Course: 10 minutes 


BF80704 - Medical Necessity Concepts and the ABN V5

This course teaches the relationship of Medical Necessity and the conditions under which the Advance Beneficiary Notice of Noncoverage (ABN) needs to be communicated to your patient with traditional Medicare coverage for noncovered services. It also teaches why it is important to complete the ABN accurately and in a timely manner.

 

Course Objectives
After completing this course, you will understand how to:

* Identify how medical necessity affects healthcare coverage and payment decisions.

* Describe the purpose of an Advance Beneficiary Notice of Noncoverage (ABN) and the part it plays in the Medicare Program.

* State when a provider is expected to complete and present an ABN to a patient.

* Describe what constitutes a valid ABN.

* Explain the ramifications if the ABN is not completed accurately and presented in a timely manner.


Contact Hours: 0.75
Length of Course: 45 minutes 


BF80705 - Explaining the ABN to Medicare Beneficiaries V5

This course teaches you how to better explain the ABN to patients and how to effectively collect the information needed from them.

 

Course Objectives
After completing this course, the learner should be able to:

* Better explain the ABN to patients.

* Effectively collect all necessary information.


Contact Hours: 0.75
Length of Course: 45 minutes 


BF80804 - MSP Determination Process V5

This course identifies the Medicare Secondary Payer Determination Process.

 

Course Objectives
After completing this course, you will understand how to:

* Identify if the Patient is a Medicare Beneficiary.

* Categorize the MSP Determination Process steps.

* Apply the MSP Determination Process to determine if Medicare is the secondary payer.


Contact Hours: 0.50
Length of Course: 30 minutes 

 

BF80805 - MSP Requirements Documentation V5

This course identifies information that should be gathered and documented to support the Medicare Secondary Payer requirements.

 

Course Objectives
After completing this course, you will understand how to:

* Define CMS's common working file (CWF).

* Recognize information maintained in the CWF.

* Apply the MSP Determination Process to determine the payer documentation requirements.


Contact Hours: 0.25
Length of Course: 20 minutes 


BF80806 - Workers' Compensation Assignment V5

This course identifies the Workers’ Compensation Assignment Process.

 

Course Objectives
After completing this course, you will understand how to:

* Identify methods for obtaining an acknowledgement.

* Complete the acknowledgement gathering process for Workers' Compensation plans.

* Define eligibility period for Workers' Compensation plans.

and more.....


Contact Hours: 1.00
Length of Course: 60 minutes 


BF80807 - Auto Insurance Assignment V5

This course identifies the Auto Insurance Assignment Process.

 

Course Objectives
After completing this course, you will understand how to:

* Apply the COB Flow and Accident Determination Process to determine if the Patient's visit is an auto related accident/injury.

* Complete the Auto Insurance Assignment Process.

* Define no-fault auto insurance.

* Determine auto insurance assignment priority via the use of the no-fault assignment criteria (Michigan).

* Define eligibility period for auto insurance plans.

and more ...


Contact Hours: 1.00
Length of Course: 70 minutes


BF80808 - Residential Accident Assignment V6

This course identifies the Residential Accident Assignment Process.

 

Course Objectives

After completing this course, you will understand how to:

* Apply the COB Flow and Accident Determination Process to determine if the Patient's visit is a residential accident/injury.

* Complete the Residential Accident Assignment Process.

* Determine the location of the residential accident.

* Determine payer assignment priority based on the residential accident location.

* Define authorization for a residential accident/injury.

* Complete the authorization gathering process for the identified payers.

and more ...


Contact Hours: 0.75
Length of Course: 40 minutes 


BF80809 - Public Location Accident Assignment V6

This course identifies the Public Location Accident Assignment Process.

 

Course Objectives

After completing this course, you will understand how to:

* Apply the COB Flow and Accident Determination Process to determine if the Patient's visit is a public location accident/injury.

* Complete the Public Location Assignment Process.

* Define acknowledgement.

* Identify methods for obtaining an acknowledgement.

* Complete the acknowledgement gathering process for a public location accident.

and more ....

Contact Hours: 0.50
Length of Course: 30 minutes 


BF80810 - Entity Request Determination Process V6

This course identifies the Entity Request Determination Process.

 

Course Objectives
After completing this course, you will understand how to:

* Apply the COB Flow to determine if the Patient's visit is the result of an entity request.

* Complete the Entity Request Determination Process.

* Define acknowledgement.

* Identify methods for obtaining an acknowledgement.

* Complete the acknowledgement gathering process for an entity request.

* Complete the authorization gathering process for an entity request.

* Complete the payer information gathering requirements.

* Assign, if appropriate, another entity/payer as part of the COB determination process.

and more ....


Contact Hours: 0.50
Length of Course: 30 minutes 


BF80811 - Multiple Plan COB Determination Process V5

This course identifies the Multiple Plan COB Determination Process.

 

Course Objectives
After completing this course, you will understand how to:

* Apply the COB Flow to determine if there are multiple health insurance plans involved.

* Complete the Multiple Plan COB Determination Process.

* Cite information gathering methods and techniques.

* Recognize issues regarding the Patient's relationship to the Insured and how they relate to health plan COB assignment.

* Apply the Patient relationship rules as part of the COB assignment process.

* Define the birthday rule.

and more ....


Contact Hours: 0.75
Length of Course: 50 minutes 


BF81301 - How Bills are Processed Through the Revenue Cycle V5

This course introduces the revenue cycle (life) of a bill.

Course Objectives

After completing this course, you will understand:

* Identify the various stages of the life of a bill.

* Specify when a Patient's account is created.

* Differentiate between scheduled, unscheduled, and pre-registered Patients.

* Identify when charges are entered onto a Patient's account and how diagnoses are entered for various types of services.

* Distinguish between DNFB and AR.

* Distinguish between CCI edits, scrubber edits, and payer edits.

* List the activity of the Cash Posting team.

Contact Hours: 0.25
Length of Course: 20 minutes 


BF81302 - Payer Follow-Up Part I V6

This course identifies the reasonable time frame for payment and the tools available for accurate and timely follow-up on outstanding account balances.

Course Objectives

After completing this course, you will understand:

* Define the term follow-up and when payment maybe expected.

* Specify who is responsible for an unpaid balance.

* Categorize reasons why follow-up is needed.

* Cite the three R's of follow-up: review, research, and react.

* List the steps on the roadmap to follow-up what's the patient type and service code, dates of service, insurance or payer codes, account notes, and charge and payment transactions.

* Name several resources to assist with follow-up from the hospital, the payer, and the Patient.

* Specify the payment documents that assist with follow-up.

* Distinguish between the HIPAA data standards ANSI 835 and 837.

* Select various follow-up techniques: online claims tracking, sending status bills, ATBs, telephone, and fax.

* Differentiate between non-paid claims, rejections, pends, and partial payments.

* Identify methods that credit balances may be followed up.

Contact Hours: 0.75
Length of Course: 45 minutes 


BF81303 - Payer Follow-Up Part II V6

This course identifies common rejections and suggestions for follow-up.

Course Objectives

After completing this course, you will understand:

* Identify examples of when follow-up occurs: unpaid balances, no activity, partial payment, and patient balances.

* Decide what activity to do when the payer states it did not receive the claim.

* List which payers are usually billed electronically.

* Analyze an account when a partial payment is received and determine follow-up steps, such as rebill the payer, bill the Patient, or adjust off the unpaid balance.

* Analyze the account and determine how to follow-up, including review of third party payer’s billing rules or regulations, question if the service provided is covered, assess the HCPCS/CPT and ICD-9-CM coding, evaluate the information on the UB, and communicate with various departments to resolve the issue.

* List reasons for a patient balance.

* List that denials and rejections may mean different things to various payers and select the differences between a contracted payer vs a non-contracted payer.

and more...

Contact Hours: 1.00
Length of Course: 60 minutes 


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