Description
Explore Haugen Academy’s Medicare Plans course. Medicare is the largest payer for health care services in the U.S. Understanding and differentiating among Traditional Medicare, Medicare Advantage, and Medicare Supplement (Medigap) plans allows you to accurately register Medicare beneficiaries. Accurate registration is the foundation for an accurate claim and timely payment for services provided.
Objectives:
Lesson 1
- Demonstrate understanding of the parts of Medicare
- Recognize and use common Medicare terms
- Understand and explain patient financial responsibility with Original Medicare
Lesson 2
- Identify the differences between Medicare, Medicare Advantage Plans, and Medicare Supplement Plans
- List the open enrollment period for Medicare Advantage Plans
- Explain the difference in benefits between Original Medicare and a Part C Medicare Advantage Plan
Topics Covered: Medicare basics, understanding Medicare, Medicare eligibility, Original Medicare, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Advantage, Medicare Advantage Plans, MAP plans, Medicare Replacement Plans, Medicare HMO, Medicare PPO, Medicare Choice, Medigap, Medicare Supplement Insurance, Medicare beneficiary, Medicare Beneficiary Identifier, MBI, Medicare ID card, Railroad Medicare, Medicare entitlement, Medicare effective dates, Medicare enrollment, Medicare open enrollment, Medicare Advantage open enrollment, January 1 plan effective date, Medicare eligibility by age, Medicare eligibility by disability, Medicare eligibility for ESRD, Medicare eligibility for ALS, Lou Gehrig’s disease Medicare coverage, dual Medicare entitlement, Medicare Part A benefits, inpatient hospital coverage, skilled nursing facility coverage, hospice coverage, home health coverage, nursing home non-custodial care, Medicare Part A deductible, Medicare benefit period, 60-day benefit period rule, Medicare Part A coinsurance, Medicare lifetime reserve days, 60 lifetime reserve days, Medicare Part B benefits, physician services, outpatient hospital services, observation stay coverage, ambulance services, durable medical equipment, DME, Medicare Part B deductible, Medicare Part B coinsurance, 80/20 Medicare coverage, Medicare Part B out-of-pocket maximum, clinical diagnostic laboratory tests, initial wellness visit, outpatient therapy benefit limits, Medicare Part A only registration, Medicare Part B only registration, Medicare outpatient coverage, Medicare inpatient coverage, Medicare plan selection, Medicare insurance plan ID, Medicare subscriber name matching, Medicare name discrepancy, Social Security Administration name correction, Medigap policy eligibility, Original Medicare with Medigap, Medigap as secondary payer, Medicare supplement plan types, Medigap standardized plans, Medigap and Part B deductible rules, Medicare Advantage versus Medigap, Medicare Advantage versus Original Medicare, Medicare Advantage plan restrictions, Medicare Advantage network requirements, Medicare Advantage referrals, Medicare Advantage authorizations, Medicare Advantage out-of-network coverage, Medicare Advantage HMO out-of-network benefits, Medicare Advantage plan identification, Medicare Advantage insurance cards, Medigap insurance cards, Medicare Advantage plan IDs, Medicare Advantage mnemonics, insurance master setup, Aetna Medicare registration, Medicare and Medicare Advantage account rules, either Medicare or Medicare Advantage coverage, Medicare Secondary Payer Questionnaire, MSPQ, Medicare primary payer determination, Medicare secondary payer determination, Medicare Advantage primary payer determination, Advanced Beneficiary Notice, ABN, ABN for Original Medicare, ABN not required for Medicare Advantage, Important Message from Medicare, inpatient Medicare discharge appeal rights, Important Message for Medicare Advantage inpatients, patient access Medicare workflows, Medicare registration training, Medicare eligibility verification, Medicare patient responsibility, Medicare deductibles and coinsurance, Medicare coverage education, Medicare revenue cycle training, patient access Medicare course content.
AHIMA This program has been approved for 1 continuing education unit for use in fulfilling the continued education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
- Domain: Revenue Cycle Management
The question about “beneficiary may become entitled to Medicare” was a little confusing because the lesson mentions the Railroad exception (retirement) so got it wrong on the first try in the assessment.
There is a lot to learn with Medicare and course length is definitely more than an hour.
Lots of codes!
Response from Haugen Consulting Group
PASCORE02_MCR
The sample cards were a bit hard to read. Maybe adding a hover feature that enlarges the cards would help.