RHC Billing and Coding Training

CODING AND BILLING CERTIFICATION BOOTCAMP

This special Rural Health Coding & Billing Bootcamp is presented by ARCH Pro Coding on May 22nd and 23rd in Branson, MO. Hosted by the Missouri Rural Health Association and the Missouri Association of Rural Health Clinics, this two-day training is FREE OF CHARGE thanks to grants from the Missouri Department of Health and Senior Services Bureau of Immunizations and Healthy Blue. 

Who Needs Training on RHC documentation, coding, billing, and quality reporting?

• Do you providers, managers, and coding/billing/quality staff have a shared foundation of knowledge?
• Do your clinical providers know the documentation rules related to capturing the valuable services they provide?
• How confident is senior-management that the RHC is not under-valuing their "true costs" on the annual cost report ?How long has it been since they received updates that are relevant to the unique needs of a Rural Health Clinic?
• Does your RHC have a full record of each service provided (CPT/HCPCS-II codes) and why they were done (ICD-10-CM codes)?Are you generating all of the revenue that you are entitled to when billing non-Medicare/Medicaid payers?
• Are you reporting quality measures related to Shared Savings, Risk Adjustment, HCCs, or other Quality Improvement programs?

Who is the class for: This class is specifically designed for clinical personnel (MD, DO, NP, PA, RN), coders, billers, EHR professionals, facility and financial managers that work in RHCs, and look-alikes to encourage building a shared foundation of knowledge. We will provide action Items and how to “get results” by working together through hands-on practice.

Why attend?

• If you aren’t documenting and coding correctly you may not be capturing everything that is done and some revenue may be left on the table! Your cost report is very tied to your professional coding practices – don’t undervalue and underreport what you do.
• With IT finding its way into more areas of medical facilities the difference between clinical documentation, professional coding, and medical billing have never been more important.
• Are you too dependent on IT instead of relying on well-trained and qualified staff? We will focus on the guidelines that appear before and after key coding sections that rarely are accessible to providers and coders/billers in their EHRs and encoder software.
• We will limit the review of codes that will rarely or never be performed in your facility setting – and will focus on primary care visits, behavioral health, and preventive services.
• We will be careful to get hands-on with over a dozen vital resources (including the CMS Benefits and Claims manuals) that outline the unique approach rural health needs to be aware of to stay compliant!
• Recently, RHCs had to start listing all CPT and HCPCS-II codes performed on claims to Medicare for the first time in decades. Many RHCs are still learning to balance its AIR (“per diem”) Medicare system of getting paid with the huge billing variations when billing commercial carriers or Medicaid.

What is Covered

How well do your clinical providers know the rules: Do your clinical providers know the documentation rules related to capturing the valuable services they provide? What type of training do they have on the differences between coding and billing? How long has it been since they received updates?

• Does your facility have a full record of each service provided (CPT/HCPCS-II codes) and why they were done (ICD-10-CM codes) regardless of whether you get paid or not?
• Are you generating all of the revenue that you are entitled to when billing non-Medicare/Medicaid payers?
• Are you reporting quality measures related to Shared Savings, Risk Adjustment, HCCs, or other Quality Improvement programs?

Key Takeaways

• To make sure you are documenting and coding for 100% of what is done based on the CPT, HCPCS-II, and ICD-10-CM guidelines.

• Understand how to bill for per diem and fee-for-service primary care visits, behavioral health, and preventive services to Medicare, Medicaid, and commercial payers.

• Help your facility have a full record of each service you provide and why they were done for your annual cost report regardless of whether you get paid or not.

• To help you generate 100% of the revenue that you are entitled to – but no more than you are allowed.
• Learn to reporting quality measures related to Shared Savings, Risk Adjustment, HCCs, or other Quality Improvement Programs.
• Increase your knowledge of the guidelines that appear before and after key coding sections in the AMA’s CPT that rarely are accessible to providers and coders/billers in their EHRs and encoder software.

Agenda

• Documentation vs. Coding vs. Billing

• Introduction to RHC/FQHCs – What Makes Us Different?

• Key CMS References + Using the CMS 1450/1500 Forms

• Billing for Various Payment Systems (FFS vs. Per Diem)

• Treat and Document Visits – A Focus on E/M

• AMA/CMS Requirements for Documentation in the CPT

• Overview of Preventive Medicine services and CMS-covered Preventive G-codes

• Telehealth versus Virtual Communication Services
• Care Management (i.e., CCM, TCM, PCM, BHI, Psych CoCM)

• Code the Full Encounter for Patients, Cost Reports, and Billing

• Review of the various definitions of the "surgical/global package" – AMA/CMS/commercial

• Documenting for Quality Care Reporting and CPT Category II

• Documenting and Coding for Procedures in the CPT

• Review of the “2024 ICD-10-CM Official Guidelines for Coding and Reporting”

• Z-codes and the Social Determinants of Health

• Free Coding Tools for Billing via RBRVS
• Bundling and Claim Scrubbing via the NCCI

• When do we need to use Modifiers?

Required Class Materials

• CPT manual
• Any publisher’s HCPCS-II manual
• Any publisher’s ICD-10-CM manual
• A pdf of the class slides will be emailed 1-2 days before class

If you need to order books from the ArchProCoding Bookstore, please allow ample shipping time as coding manuals will not be brought by our team for live events and they are required for class when taught live via a live virtual approach.

11 CEUs (Continuing Education Units) approved by ArchProCoding & AAPC.

11 CME (Continuing Medical Education) Credits for MD, DO, NP, PA, RN