Finance & Reimbursement

Classroom

PPS Reimbursement & Medicare Cost Reporting Virtual Boot Camp

*Part of the Healthcare Providers Reimbursement Series

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Get the training and information you need to help improve Medicare reimbursements and financial operating results at hospitals subject to the Medicare Prospective Payment System.

QHR Health’s PPS Reimbursement & Medicare Cost Reporting Virtual Boot Camp is designed to provide an in-depth review of the Medicare reimbursement system for acute care hospitals subject to the Medicare Prospective Payment Systems and Medicare Physician Fee Schedule System.

This 3-day virtual event will include discussions of:

  • The CMS Hospital Inpatient and Outpatient Prospective Payment Systems and the Medicare Physician Fee Schedule System (RVRVSU)
  • PPS hospital-specific reimbursement issues including patient transfers, outlier reimbursements, twice midnight rule and other material reimbursement issues
  • Wage index compilation and wage index cost reporting
  • Medicare Disproportionate Share Hospital and Uncompensated Care Reimbursements, including reimbursement formulary, cost report worksheets specific to UCC
  • Medicare Physician Fee Schedule Reimbursement System, specifying when a service can be billed by a hospital as an outpatient service, and Medicare provider-based regulations
  • The Medicare cost reporting forms and compilation of the forms with emphasis on cost report worksheets directly impacting a hospital’s current year and future years reimbursement
  • Settlement worksheets including Medicare Bad Debts, DSH and UCC reporting
  • Wage Index Survey and Uncompensated Care Costs worksheets
  • Medicare cost compilations derived on Worksheets A, B, C and D, with a review of the cost report, the flow of the worksheets and data elements required to compile the forms

This program is an introduction to the ever-changing and complex Medicare reimbursement systems. With basic knowledge gained, attendees will be well-positioned to attend QHR Health’s Healthcare Providers Reimbursement Webinar Series* in 2021. The series will consist of 1-hour webinars covering a full range of reimbursement issues such as Medicare Geographic Reclassification, Medicare Rural Health Clinics, and Provider-Based Regulatory Requirements allowing 340B program participation by physician practices. Webinars will also be conducted addressing unique hospital designations (such as Sole Community Hospital, Rural Referral Centers, and Medicare Dependent Hospitals) qualifying criteria, applications and reimbursement advantages that accrue with these specific designations. Later in 2021, we will offer webinars covering reimbursement systems for sub-acute providers and PPS-exempt psychiatric and rehabilitation hospitals.

Join reimbursement experts John Waltko and Mike Donahue to gain an understanding of the Medicare Prospective Payment Systems, critical reimbursement opportunities, Medicare cost reporting and basis to assist hospital finance function.

15.5
CPE Credits

Field of Study: Specialized Knowledge
Prerequisites: None
Who Should Attend: CFOs, revenue cycle and reimbursement professionals, controllers, accounting staff and others involved in the hospital cost report compilation process, CEOs, COOs, compliance officers, and other hospital executives
Advanced Preparation: None
Program Level: Basic to Intermediate
Delivery Method: Group Internet Based

QHR Health Learning Institute (QLI) is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org.

QLI may cancel or reschedule a live webinar program at its discretion due to unforeseen circumstances. We will use reasonable efforts to notify registrants of the cancellation at least two weeks (10 business days) in advance of the original live webinar program.

If QLI cancels a live webinar program, refunds of the webinar registration fee will not be given. However, all current registrants at time of cancellation will obtain a credit to be applied to a future live webinar program of their choice.

For more information regarding refunds, program cancellation policies and/or grievances please contact our client support team at (615) 371-7979 or learning_institute@qhr.com.

Learning Objectives:

  • Understand the Medicare program’s Prospective Payment Systems (PPS) for Hospital Inpatient and Outpatient Services and Physician Fee Schedule.
  • Learn major quality program initiatives within the Patient Protection and Affordable Care Act (ACA) such as value-based purchasing, hospital re-admissions, hospital-acquired conditions, and ACA demonstration projects (ACOs and Bundled Payments).
  • Determine if a hospital qualifies for certain Medicare designations and the reimbursement differentials that accrue with such designations.
  • Understand Physician Fee Schedule reimbursement methodology.
  • Review Medicare Cost Report forms, the Medicare cost apportionment formula, and compilation process within the forms.
  • Grasp Medicare Wage Index Survey, Uncompensated Care cost worksheets, and related cost report instructions.
  • Review cost report worksheets, including key compilation requirements and preparation pointers.
  • Comprehend Medicare allowable cost principles, including costs not allowable on the cost report, the general service costs allocation methodology, and the Medicare cost apportionment process.
  • Review cost report settlement worksheets, reporting of payments, and other reimbursements that impact the annual cost report settlement amount.

Who Should Attend:

  • CFOs
  • Revenue cycle and reimbursement professionals
  • Controllers
  • Accounting staff and others involved in the hospital cost report compilation process
  • CEOs
  • COOs
  • Compliance officers
  • Other hospital executives

Presenters

John Waltko, headshot
2:00 pm - 3:00 pm | Live

Introduction to Medicare and Medicaid Programs

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
Michael Donahue, headshot
2:30 pm - 3:15 pm | Live

Introduction to Cost Report Forms for Acute Care Hospitals

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
3:15 pm - 3:30 pm | Live

Break

John Waltko, headshot
3:30 pm - 4:40 pm | Live

Medicare Inpatient Prospective Payment System: MS-DRGs

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health

Michael Donahue, headshot
9:00 am - 10:00 am | Live

Wage Index Adjustments and Geographic Adjustment Factors

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
John Waltko, headshot
10:00 am - 11:00 am | Live

Medicare Outpatient Prospective Payment System: APCs

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
11:00 am - 11:15 am | Live

Break

John Waltko, headshot
11:15 am - 11:45 am | Live

Medicare Outpatient Prospective Payment System: APCs - part II

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
Michael Donahue, headshot
11:45 am - 12:15 pm | Live

Medicare Disproportionate Share Hospital Adjustment and Uncompensated Care

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
12:15 pm - 1:15 pm | Live

Lunch Break

John Waltko, headshot
1:15 pm - 2:45 pm | Live

Medicare Uncompensated Care Reimbursement

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
2:45 pm - 3:00 pm | Live

Break

Michael Donahue, headshot
3:00 pm - 3:45 pm | Live

Physician Fee Schedule Reimbursement Systems

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
Michael Donahue, headshot
3:45 pm - 4:15 pm | Live

Cost Report Certification, PRRB Appeals and Re-openings

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health

John Waltko, headshot
9:00 am - 9:30 am | Live

Worksheet S Series

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
Michael Donahue, headshot
9:30 am - 10:30 am | Live

Worksheet A

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
10:30 am - 10:45 am | Live

Break

10:45 am - 12:15 pm | Live

Worksheet B, Worksheet C & D Series

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
12:15 pm - 1:15 pm | Live

Lunch Break

Michael Donahue, headshot
1:15 pm - 2:15 pm | Live

Worksheet E Series

Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health
2:15 pm - 3:00 pm | Live

Review / Wrap-Up / Q&A Session

John Waltko, Vice President, Regulatory & Financial Reporting, QHR Health
Michael Donahue, Associate Vice President, Healthcare Finance & Reimbursement, QHR Health