OnDemand Bundles
SNF Billing Summit
What You Will Learn
- Enhance Understanding of the PNM System – Provide billing professionals with the knowledge and tools to effectively navigate Ohio Medicaid’s Provider Network Management (PNM) system, including eligibility checks, claim submissions, and troubleshooting denials.
- Improve Claims Accuracy and Denial Prevention – Educate attendees on common Medicare and Medicaid claim denials, offering strategies for accurate claim submissions, corrections, and compliance with billing regulations.
- Strengthen Compliance and Audit Readiness – Equip billing teams with best practices for maintaining proper documentation, responding to Additional Documentation Requests (ADRs), and preparing for audits to minimize financial risks.
- Optimize Revenue Cycle Management – Introduce innovative technology and AI-powered solutions that streamline revenue cycle processes, improve billing efficiency, and reduce payment delays.
- Clarify CHOP and Regulatory Impacts – Explain the Change of Operator (CHOP) process, its effect on Medicaid and Medicare reimbursement, and necessary steps for compliance and financial stability.
- Foster Expert-Led Learning and Networking – Provide a platform for billers of all experience levels to engage with industry leaders, ask questions, and gain Ohio-specific insights to optimize their billing and revenue cycle strategies
What You Will Learn
- Enhance Understanding of the PNM System – Provide billing professionals with the knowledge and tools to effectively navigate Ohio Medicaid’s Provider Network Management (PNM) system, including eligibility checks, claim submissions, and troubleshooting denials.
- Improve Claims Accuracy and Denial Prevention – Educate attendees on common Medicare and Medicaid claim denials, offering strategies for accurate claim submissions, corrections, and compliance with billing regulations.
- Strengthen Compliance and Audit Readiness – Equip billing teams with best practices for maintaining proper documentation, responding to Additional Documentation Requests (ADRs), and preparing for audits to minimize financial risks.
- Optimize Revenue Cycle Management – Introduce innovative technology and AI-powered solutions that streamline revenue cycle processes, improve billing efficiency, and reduce payment delays.
- Clarify CHOP and Regulatory Impacts – Explain the Change of Operator (CHOP) process, its effect on Medicaid and Medicare reimbursement, and necessary steps for compliance and financial stability.
- Foster Expert-Led Learning and Networking – Provide a platform for billers of all experience levels to engage with industry leaders, ask questions, and gain Ohio-specific insights to optimize their billing and revenue cycle strategies
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LoginPrice
$125
for Member
$250
for Non-member
Publisher
Ohio Health Care Association
Questions
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Summary
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Programs Included in this Bundle
PNM Basics
Date Published: February 5, 2025
Learning Objectives:
- 1. Understand how to create a new OH|ID and connect it to a facility.
- 2. Learn the process of Medicaid revalidation for provider compliance.
- 3. Identify where to locate and access financial documents, including cost reports and rate-setting sheets.
- 4. Gain proficiency in running member eligibility checks and saving the information properly.
- 5. Learn best practices for correcting claims and troubleshooting denials.
- 6. Optimize the use of Provider Network Management (PNM) for efficient Medicaid billing and management.
Summary
Presenters
Credit
This program has not been submitted for credit in any jurisdiction.
Advanced Claims Troubleshooting in PNM
Date Published: February 4, 2025
Learning Objectives:
- Understand how to identify and resolve patient eligibility issues affecting claims processing.
- Learn the proper procedures for troubleshooting and correcting claim denials in PNM.
- Gain insight into handling non-covered days and patient liability issues.
- Explore methods for making necessary corrections within PNM, such as revenue codes, attending physician details, and value codes.
- Learn how to enter and process Medicare coinsurance claims.
- Understand best practices for submitting claims adjustments and managing attachments like ODM 6653.
Summary
Presenters
Credit
This program has not been submitted for credit in any jurisdiction.
Top Medicare Denials for Ohio SNFs and TPE Updates
Date Published: February 4, 2025
Learning Objectives:
- Understand the Targeted Probe and Educate (TPE) program and its impact on Skilled Nursing Facility (SNF) claims.
- Learn the SNF 5-Claim Probe and Educate process, including selection criteria and documentation requirements.
- Identify common Medicare claim denials for Ohio SNFs and strategies to prevent them.
- Gain insight into the review process for Medicare claims, including Additional Documentation Requests (ADR) and submission guidelines.
- Explore best practices for responding to ADRs, avoiding claim denials, and ensuring compliance with Medicare billing regulations.
- Understand available resources and educational opportunities to improve claim accuracy and reduce error rates.
Summary
Credit
This program has not been submitted for credit in any jurisdiction.
Navigating CHOPs for Ohio Medicaid
Date Published: February 4, 2025
Learning Objectives:
- Understand the differences between Change of Operator (CHOP) and Change of Ownership (CHOW) and their impact on Medicaid and Medicare reimbursement.
- Learn about the historical and current Medicaid reimbursement processes following a CHOP.
- Examine the effects of CHOP on quality incentive payments and regulatory restrictions in Ohio.
- Understand the steps involved in the CHOP process, including transparency requirements and regulatory scrutiny.
- Identify the impact of CHOP on various Medicaid rates, such as ventilator rates, private room add-ons, and hospice rates.
- Explore the billing considerations for Medicare and Medicaid following a CHOP, including provider numbers, contracts, and claim submissions.
Summary
Presenters
Credit
This program has not been submitted for credit in any jurisdiction.
Leveraging Technology to Optimize Your Revenue Cycle
Date Published: February 4, 2025
Learning Objectives:
- Understand how AI-powered workflow solutions can enhance revenue cycle management in long-term and post-acute care settings.
- Learn how to optimize the admissions process using automated financial and clinical reviews to reduce write-off risks.
- Explore the benefits of integrating technology with EHR and state Medicaid systems (PNM and HENS) to improve billing accuracy.
- Identify common billing errors and strategies to minimize claim denials and payment delays
- Gain insight into how automated tracking and compliance monitoring can improve efficiency and financial performance.
- Learn about CoreCare’s solutions, including Pre-Admit, Admit, and Revenue, and their impact on revenue optimization.
Summary
Presenters
Credit
This program has not been submitted for credit in any jurisdiction.
Winning the Game of Medical Reviews
Date Published: February 4, 2025
Learning Objectives:
- Understand the basic payer systems and processes related to post-payment clinical care audits.
- Review key skilled nursing facility (SNF) charting and documentation guidelines necessary for successful medical reviews
- Identify best practices for accessing and organizing medical records across facilities and rehabilitation services.
- Recognize common audit trends, including GG charting, therapy documentation, and proper medical record submission.
- Learn strategies for ensuring compliance in documentation to prevent claim downgrades and denials.
- Explore methods for efficient record storage, collaboration among healthcare teams, and maintaining audit-ready documentation.
Summary
Presenters
Credit
This program has not been submitted for credit in any jurisdiction.
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