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.
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

Introduction to Medicare and Medicaid Programs

Introduction to Cost Report Forms for Acute Care Hospitals
Break

Medicare Inpatient Prospective Payment System: MS-DRGs

Wage Index Adjustments and Geographic Adjustment Factors

Medicare Outpatient Prospective Payment System: APCs
Break

Medicare Outpatient Prospective Payment System: APCs - part II

Medicare Disproportionate Share Hospital Adjustment and Uncompensated Care
Lunch Break

Medicare Uncompensated Care Reimbursement
Break

Physician Fee Schedule Reimbursement Systems

Cost Report Certification, PRRB Appeals and Re-openings

Worksheet S Series

Worksheet A
Break

Worksheet B, Worksheet C & D Series
Lunch Break

Worksheet E Series
