Medicare Coverage and Benefit Verification

Event Information
Product Format
Prerecorded Event
Marilyn Mines, RN, BC, RAC-CT
60 minutes
Product Description

Verify Coverage for Medicare A, B, C and Identify Remaining Days in Benefit Period to Protect Your Bottom Line.

Too often facilities admit a resident to a Medicare Part A stay without knowing that the beneficiary either has no days in their benefit period, or has opted to utilize insurance or a Medicare C plan in lieu of traditional Medicare. In these instances, the provider is liable for all the costs & services provided to the resident.  Knowledge of the beneficiary’s status is critical to the bottom line.

Join this session by expert speaker Marilyn Mines to verify coverage: Medicare A, B, or C and identify the number of days remaining in the benefit period. Other than determining the coverage, you will also understand the differences between various Medicare reimbursement programs. Learn how to utilize the HETS system to verify coverage and investigate techniques to validate inpatient stay in the acute care setting.

Session Highlights:

  • Understand the differences between various Medicare reimbursement programs
  • How to utilize CWF and HETS to verify coverage
  • Investigative techniques to validate inpatient stay in acute care setting
  • Insights on coverage criteria
  • Benefit period verification strategies

Session Snapshots:

  • Components of Medicare – Part A, Part B, Part C and Part D
  • Medicare enrollment statistics
  • Coverage changes
  • Verifying Eligibility
  • Medicare as a secondary payer
  • Medicare advantage
  • Medigap/Supplemental plans
  • CWF & HETS
  • Verification documentation
  • Skilled level of care
  • Level of care requirements
  • Daily skilled services
  • Medical necessity determination
  • Coverage criteria

Who should attend?

  • Admissions
  • Billing
  • MDS/Nursing

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About Our Speaker

Marilyn Mines - Skilled Nursing Coding  Expert

Marilyn Mines RN, BC, RAC-CT, brings over 40 years of experience as a practicing Registered Nurse to her role as Director of Clinical Services for FR&R. While working with clients, she has been instrumental in preparations for JCAHO, Public Health and Public Aid inspections, and promoting confidence in the direct care of patients, as well as managerial staff.

As an educator and advisor, Marilyn...   More Info
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