In this module students will learn about the life cycle of the claim from the time it is submitted to the time it is paid. Learn the differences between electronic and paper claims submission. Explore the various billing software including the Direct Data Entry (DDE) and MAC portals. Will look at the eligibility requirements and different OASIS’s types. Students will get an understanding of the 60-day episode life cycle, 30 day periods, form CMS-485, Face to Face requirements, and the free software Haven and Pro-32 which are provided by Center for Medicare and Medicaid Services (CMS). Students will learn which documents and clinical documentation are needed before billing can be submitted. Discuss how clinical and billing interact and take a look at verbal orders. Students will explore the diagnosis codes, revenue codes, HCPCS codes, G codes, Q codes and other billing codes as well as the billing process.
Registered students are to log into PMBI’s education portal online with their unique credentials that will be given to them once they have completed registration and payment requirements.
Students must watch each online recorded session, in it’s entirety, in sequential order. Students must pass the required quiz with a score of 70%.