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Category: Billing

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Today’s healthcare environment demands outstanding performance across the board.
Today’s healthcare environment demands outstanding performance across the board.
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Produced by: Healthcare Financial Management Association (HFMA)
Today’s healthcare environment demands outstanding performance across the board.
Today’s healthcare environment demands outstanding performance across the board.
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Produced by: Healthcare Financial Management Association (HFMA)
This course explains the parameters of all MIPS program categories, as well as MACRA's Advanced Payment Models (APMs) and ACI.
This course explains the parameters of all MIPS program categories, as well as MACRA's Advanced Payment Models (APMs) and ACI.
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Produced by: 4MedPlus Corporation
MACRA-MIPS ‘Quality’ (CMQP) Certificate provides detailed guidance to understand and participate in the Quality Performance category of MIPS which replaces the PQRS program.
MACRA-MIPS ‘Quality’ (CMQP) Certificate provides detailed guidance to understand and participate in the Quality Performance category of MIPS which replaces the PQRS program.
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Produced by: 4MedPlus Corporation
This full certification course covers all components of MACRA/MIPS specialty and proficiency including: CMAP (Advancing Care), CMQP (Quality), CMIAP (Improvement Activities) & CMCP (Cost Features).
This full certification course covers all components of MACRA/MIPS specialty and proficiency including: CMAP (Advancing Care), CMQP (Quality), CMIAP (Improvement Activities) & CMCP (Cost Features).
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Produced by: 4MedPlus Corporation
This program provides an introduction to MACRA and MIPS, the new CMS reimbursement programs. Students will learn about performance categories, required thresholds, and the impact on reimbursement. The program...
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This program provides an introduction to MACRA and MIPS, the new CMS reimbursement programs. Students will learn about performance categories, required thresholds, and the impact on reimbursement. The program also introduces ACI (formerly MU) and Quality (formerly PQRS and VM).
This program provides an introduction to MACRA and MIPS, the new CMS reimbursement programs. Students will learn about performance categories, required thresholds, and the impact on reimbursement. The program also introduces ACI (formerly MU) and Quality (formerly PQRS and VM).
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Produced by: 4MedPlus
This program provides a comprehensive overview of MACRA and the Merit-Based Incentive Payment Incentive (MIPS), the new CMS reimbursement program. It covers all required performance categories, including...
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This program provides a comprehensive overview of MACRA and the Merit-Based Incentive Payment Incentive (MIPS), the new CMS reimbursement program. It covers all required performance categories, including Advancing Care Information (formerly MU), Quality and Cost (formerly PQRS and VM), and Improvement Activities (new). Participants who earn the CMHP certification are qualified to project manage all elements of a healthcare organization’s MIPS reporting and MACRA program oversight.
This program provides a comprehensive overview of MACRA and the Merit-Based Incentive Payment Incentive (MIPS), the new CMS reimbursement program. It covers all required performance categories, including Advancing Care Information (formerly MU), Quality and Cost (formerly PQRS and VM), and Improvement Activities (new). Participants who earn the CMHP certification are qualified to project manage all elements of a healthcare organization’s MIPS reporting and MACRA program oversight.
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Produced by: 4MedPlus
This program describes the Quality and Cost performance categories of MACRA-MIPS, which replace PQRS and the Value-Based Modifier program. It covers all required information to successfully participate in...
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This program describes the Quality and Cost performance categories of MACRA-MIPS, which replace PQRS and the Value-Based Modifier program. It covers all required information to successfully participate in MIPS Quality and Cost, which make up 60 percent of a provider’s MIPS score.
This program describes the Quality and Cost performance categories of MACRA-MIPS, which replace PQRS and the Value-Based Modifier program. It covers all required information to successfully participate in MIPS Quality and Cost, which make up 60 percent of a provider’s MIPS score.
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Produced by: 4MedPlus
This course defines an outpatient and explains two common terms used in the billing process for outpatient services. The course also explains Medicare and patient payment portions for outpatient services and...
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This course defines an outpatient and explains two common terms used in the billing process for outpatient services. The course also explains Medicare and patient payment portions for outpatient services and discusses basic Medicare regulations for billing inpatient and outpatient services.
This course defines an outpatient and explains two common terms used in the billing process for outpatient services. The course also explains Medicare and patient payment portions for outpatient services and discusses basic Medicare regulations for billing inpatient and outpatient services.
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Produced by: HFMA - Healthcare Financial Management Association
This course presents basic information about Medicare Advantage plans. This course also explains Medicare deductibles, co-insurance, and the insurance plans that are available to cover these costs. In...
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This course presents basic information about Medicare Advantage plans. This course also explains Medicare deductibles, co-insurance, and the insurance plans that are available to cover these costs. In addition, this course explains how and where to find information on Medicare regulations, requirements, billing and claims processing, and coverage.
This course presents basic information about Medicare Advantage plans. This course also explains Medicare deductibles, co-insurance, and the insurance plans that are available to cover these costs. In addition, this course explains how and where to find information on Medicare regulations, requirements, billing and claims processing, and coverage.
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Produced by: HFMA - Healthcare Financial Management Association
This course describes Medicare coverage, billing procedures, and payment methodologies for various types of ESRD treatments. Billing requirements for blood-related services for ESRD patients as well as EPO...
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This course describes Medicare coverage, billing procedures, and payment methodologies for various types of ESRD treatments. Billing requirements for blood-related services for ESRD patients as well as EPO and Aranesp, drugs and laboratory services are described. Payment guidelines are discussed for specific services.
This course describes Medicare coverage, billing procedures, and payment methodologies for various types of ESRD treatments. Billing requirements for blood-related services for ESRD patients as well as EPO and Aranesp, drugs and laboratory services are described. Payment guidelines are discussed for specific services.
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Produced by: HFMA - Healthcare Financial Management Association
This course offers information about revenue codes and the HCPCS coding system and provides examples of proper coding. It explains NCCI edits, HCPCS validity edits, and requirements for line item dates of...
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This course offers information about revenue codes and the HCPCS coding system and provides examples of proper coding. It explains NCCI edits, HCPCS validity edits, and requirements for line item dates of service and service units. This course also describes APC groups and packaged codes.
This course offers information about revenue codes and the HCPCS coding system and provides examples of proper coding. It explains NCCI edits, HCPCS validity edits, and requirements for line item dates of service and service units. This course also describes APC groups and packaged codes.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains some basics of Medicare inpatient coverage, including duration of coverage, leave of absence, coinsurance days, the use of lifetime reserve days, psychiatric days, and the use of Part B...
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This course explains some basics of Medicare inpatient coverage, including duration of coverage, leave of absence, coinsurance days, the use of lifetime reserve days, psychiatric days, and the use of Part B for inpatient coverage. In addition, this course explains basic concepts that Medicare uses to determine payment for most inpatient hospital services, including the Prospective Payment System, diagnosis-related groups, and outliers.
This course explains some basics of Medicare inpatient coverage, including duration of coverage, leave of absence, coinsurance days, the use of lifetime reserve days, psychiatric days, and the use of Part B for inpatient coverage. In addition, this course explains basic concepts that Medicare uses to determine payment for most inpatient hospital services, including the Prospective Payment System, diagnosis-related groups, and outliers.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains the National Correct Coding Initiative procedures implemented by Medicare to ensure that bills are coded properly. The course also explains the Outpatient Code Editors (OCE) and the...
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This course explains the National Correct Coding Initiative procedures implemented by Medicare to ensure that bills are coded properly. The course also explains the Outpatient Code Editors (OCE) and the Integrated Outpatient Code Editors (I/OCE).
This course explains the National Correct Coding Initiative procedures implemented by Medicare to ensure that bills are coded properly. The course also explains the Outpatient Code Editors (OCE) and the Integrated Outpatient Code Editors (I/OCE).
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Produced by: HFMA - Healthcare Financial Management Association
This course describes the functions of the Medical Records Department (also known as Health Information Management or HIM) and its interactions with the Patient Accounts Department. It also explains the...
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This course describes the functions of the Medical Records Department (also known as Health Information Management or HIM) and its interactions with the Patient Accounts Department. It also explains the structure of revenue codes and the need for detail-level billing in certain situations. The course explains requirements related to pass-through medical devices, implantable devices, and non-implantable devices. Also covered are the use of codes in billing Medicare outpatient emergency and clinic services, including HCPCS visit levels, typical revenue codes, and code modifiers.
This course describes the functions of the Medical Records Department (also known as Health Information Management or HIM) and its interactions with the Patient Accounts Department. It also explains the structure of revenue codes and the need for detail-level billing in certain situations. The course explains requirements related to pass-through medical devices, implantable devices, and non-implantable devices. Also covered are the use of codes in billing Medicare outpatient emergency and clinic services, including HCPCS visit levels, typical revenue codes, and code modifiers.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains how to bill for physical and occupational therapy and what financial limitations apply. The course identifies portions of the billing process for speech therapy, including the...
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This course explains how to bill for physical and occupational therapy and what financial limitations apply. The course identifies portions of the billing process for speech therapy, including the general rules of coverage and basic definitions. This course also introduces the new nonpayable functional G-codes and the 7 modifiers that are required on selected claims for physical therapy, occupational therapy, and speech-language pathology services.
This course explains how to bill for physical and occupational therapy and what financial limitations apply. The course identifies portions of the billing process for speech therapy, including the general rules of coverage and basic definitions. This course also introduces the new nonpayable functional G-codes and the 7 modifiers that are required on selected claims for physical therapy, occupational therapy, and speech-language pathology services.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains basic concepts surrounding end-stage renal disease (ESRD), including definitions, covered services, ESRD prospective payment system, Medicare as secondary payer (MSP), and the...
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This course explains basic concepts surrounding end-stage renal disease (ESRD), including definitions, covered services, ESRD prospective payment system, Medicare as secondary payer (MSP), and the coordination period. In-facility bill processing is also covered, including which services are still separately billable under the ESRD PPS.
This course explains basic concepts surrounding end-stage renal disease (ESRD), including definitions, covered services, ESRD prospective payment system, Medicare as secondary payer (MSP), and the coordination period. In-facility bill processing is also covered, including which services are still separately billable under the ESRD PPS.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains Medicare coverage for drugs and biologicals that are prescribed for patients. It also presents guidelines for coding and billing for special drugs and biologicals. The course...
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This course explains Medicare coverage for drugs and biologicals that are prescribed for patients. It also presents guidelines for coding and billing for special drugs and biologicals. The course explains the mechanisms and uses of immune globulins, erythropoietin and darbepoetin, and provides guidelines for coding and billing these special drug categories. In addition, the course describes the competitive acquisition program (CAP) for physicians.
This course explains Medicare coverage for drugs and biologicals that are prescribed for patients. It also presents guidelines for coding and billing for special drugs and biologicals. The course explains the mechanisms and uses of immune globulins, erythropoietin and darbepoetin, and provides guidelines for coding and billing these special drug categories. In addition, the course describes the competitive acquisition program (CAP) for physicians.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains Medicare’s billing requirements for services provided to patients with End Stage Renal Disease (ESRD). The course describes billing for services such as organ procurement that are part of...
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This course explains Medicare’s billing requirements for services provided to patients with End Stage Renal Disease (ESRD). The course describes billing for services such as organ procurement that are part of renal transplant. Requirements for Certified Transplant Centers (CTCs) and Organ Procurement Organizations (OPOs) are explained, and required documentation by suppliers is discussed.
This course explains Medicare’s billing requirements for services provided to patients with End Stage Renal Disease (ESRD). The course describes billing for services such as organ procurement that are part of renal transplant. Requirements for Certified Transplant Centers (CTCs) and Organ Procurement Organizations (OPOs) are explained, and required documentation by suppliers is discussed.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains Medicare’s hospice benefits, including how to complete a notice of election, the different levels of hospice care and their payment rates, what deductibles and coinsurance amounts apply...
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This course explains Medicare’s hospice benefits, including how to complete a notice of election, the different levels of hospice care and their payment rates, what deductibles and coinsurance amounts apply under hospice benefits, the caps and limits on hospice payment, how physicians’ services are paid, and medical review of claims.
This course explains Medicare’s hospice benefits, including how to complete a notice of election, the different levels of hospice care and their payment rates, what deductibles and coinsurance amounts apply under hospice benefits, the caps and limits on hospice payment, how physicians’ services are paid, and medical review of claims.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains what constitutes observation and how to bill for it.
This course explains what constitutes observation and how to bill for it.
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Produced by: HFMA - Healthcare Financial Management Association
This course defines basic terms associated with billing for laboratory tests and explains how payment is made for tests in a variety of settings. Other topics include how rural health clinics bill for...
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This course defines basic terms associated with billing for laboratory tests and explains how payment is made for tests in a variety of settings. Other topics include how rural health clinics bill for laboratory services, where and when deductibles and coinsurance apply to services, and what methods of payment are used for services in various circumstances. The course also presents the rules of payment and billing for hospital-based laboratory services. In addition, the course explains what providers of laboratory services must do to comply with the Clinical Laboratory Improvement Amendments (CLIAs), including licensure, procedures, CLIA numbers, certificates of waiver, HCPCS codes, and notification of denials.
This course defines basic terms associated with billing for laboratory tests and explains how payment is made for tests in a variety of settings. Other topics include how rural health clinics bill for laboratory services, where and when deductibles and coinsurance apply to services, and what methods of payment are used for services in various circumstances. The course also presents the rules of payment and billing for hospital-based laboratory services. In addition, the course explains what providers of laboratory services must do to comply with the Clinical Laboratory Improvement Amendments (CLIAs), including licensure, procedures, CLIA numbers, certificates of waiver, HCPCS codes, and notification of denials.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains how clinical laboratory tests are generally paid and coded and describes the circumstances in which specimen collection fees may be claimed for laboratory tests. The course also describes...
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This course explains how clinical laboratory tests are generally paid and coded and describes the circumstances in which specimen collection fees may be claimed for laboratory tests. The course also describes the circumstances in which travel allowances for specimen collection services are covered as well as what lab tests qualify as anatomic pathology services in CPT. In addition, this course explains how combinations of lab tests typically performed together are billed, coded, and paid. The course also outlines the activities of the blood bank and describes blood transfusions, blood and blood products, and coding and billing for blood and blood services.
This course explains how clinical laboratory tests are generally paid and coded and describes the circumstances in which specimen collection fees may be claimed for laboratory tests. The course also describes the circumstances in which travel allowances for specimen collection services are covered as well as what lab tests qualify as anatomic pathology services in CPT. In addition, this course explains how combinations of lab tests typically performed together are billed, coded, and paid. The course also outlines the activities of the blood bank and describes blood transfusions, blood and blood products, and coding and billing for blood and blood services.
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Produced by: HFMA - Healthcare Financial Management Association
This course explains Medicare’s requirements for billing for outpatient surgical services, including surgery that normally is provided only in inpatient settings and surgery provided in the emergency...
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This course explains Medicare’s requirements for billing for outpatient surgical services, including surgery that normally is provided only in inpatient settings and surgery provided in the emergency department. Outpatient surgery for implants such as pacemakers, surgery for cataracts, and gastrointestinal surgery are discussed.
This course explains Medicare’s requirements for billing for outpatient surgical services, including surgery that normally is provided only in inpatient settings and surgery provided in the emergency department. Outpatient surgery for implants such as pacemakers, surgery for cataracts, and gastrointestinal surgery are discussed.
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Produced by: HFMA - Healthcare Financial Management Association
This course identifies the various types of radiation therapy and discusses coding and billing for radiation therapy services. This course also explains payment and coding for physicians’ services...
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This course identifies the various types of radiation therapy and discusses coding and billing for radiation therapy services. This course also explains payment and coding for physicians’ services associated with weekly radiation therapy management, including bundled and separate services.
This course identifies the various types of radiation therapy and discusses coding and billing for radiation therapy services. This course also explains payment and coding for physicians’ services associated with weekly radiation therapy management, including bundled and separate services.
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Produced by: HFMA - Healthcare Financial Management Association