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Medicare Part B: Reimbursement Guidelines

Medicare Part B: Reimbursement Guidelines

Get answers to your most pressing Medicare questions

Find out why you should never appeal a Medicare claim before reviewing Medicare’s National Correct Coding Policy.

5 Reasons to Attend

  1. This class provides an interactive environment where participants will get answers to Medicare reimbursement questions and learn from faculty and peers.
  2. Get the latest information on documentation guidelines for E&M services, and CMS’s Correct Coding Policy.
  3. Receive tips on how to work with the CMS and Medicaid regional offices and tools for improved handling of Medicare claims.
  4. This class may satisfy a compliance training component, as recommended by the Office of the Inspector General.
  5. Billing staff that are up-to-speed on current Medicare billing requirements help improve your office’s bottom line.

Billing errors and denials cost providers millions of dollars each year in lost income and productivity.

This class will cover all the statutory obligations, rights, roles and responsibilities of the Medicare provider. Participants will return to the office with new knowledge and skills aimed at improving Medicare claim accuracy.

Class Highlights:

  • Understanding Medicare’s Correct Coding Initiative for correct use of comprehensive and mutually-exclusive codes
  • RBRVS and your Medicare fee schedule
  • How to get a list of all non-covered services.
  • Advance Beneficiary Notice guidelines
  • What "assignment” means under Medicare law
  • Determining whether Medicare is primary or secondary payer
  • The dangers of fragmenting, bundling and unbundling
  • Preventive vs. problem-oriented services
  • Differences between PAR, non-PAR and opting out of Medicare
  • Caring for the indigent Medicare patient
  • Improve understanding of audit triggers
  • Stark laws and the dangers of courtesy discounts and kickbacks
  • Your rights during a carrier audit
  • How to avoid billing for services that are not medically necessary
  • Proper documentation for medical necessity
  • Uncovering the Medicare appeals process and review
  • Your rights in making sure you receive a fair hearing
  • The role of the administrative law judge in handling appeals

Who Should Attend

This class is designed for physicians, coding and billing staff, and compliance officers seeking a detailed overview of the Medicare reimbursement system.


The content covered in this course assumes a basic to inter-mediate understanding of Medicare Part B billing principles.

What to Bring

A course manual will be provided to each participant. No additional reference books are needed for this class.


Program Schedule

There are no classes scheduled for this topic at this time. PMI offers a number of distance learning options. Browse Audio Downloads, Live Webinars, and the Online Learning Center.

Continuing Education Units (CEUs)

PMI CEU APPROVED Earn 3 PMI CEUs for attendance at this program. Practice Management Institute grants CEUs for its certified professionals based on total number of instructional hours (1 CEU per hour of classroom instruction). CEUs may be applied to annual recertification requirements, as directed in the certification renewal requirements for your credential(s).

If you are seeking CEU credits for other certifications or organizations, please contact your organization for pre-approval and credit guidelines. A certificate of attendance will be provided for attendance at this program. HOME | Curriculum | Locate a Class | Products | Discussion Forum | Sitemap | Policies | Contact Us!
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