Description
Have you ever listened to a registrar stumble through the Medicare questionnaire? This Medicare Secondary Payer Provisions course will give registrars and those who perform front-end revenue cycle functions, the confidence and knowledge needed to comfortably ask Medicare beneficiaries the right questions while providing a knowledgeable explanation of the reason for doing so.
Objectives:
Lesson 1
- List the ways a beneficiary can be entitled to Medicare
- Identify the reasons MSP provisions were implemented
- Identify the entities and payers with primary payer responsibility
- Explain when the MSPQ must be completed
Lesson 2
- Accurately complete the MSPQ
- Explain the conditions that must be met for Group Health Plan (GHP) coverage to be the primary payer to Medicare
- Explain the proper order in which insurances should be billed
Topics Covered: Medicare Secondary Payer, MSP, Medicare Secondary Payer Questionnaire, MSPQ, secondary payer provisions, Medicare primary payer determination, Medicare secondary payer determination, Medicare entitlement, Medicare eligibility by age, Medicare eligibility by disability, Medicare eligibility for ESRD, Medicare Trust Fund protection, Medicare coordination of benefits, payer responsibility, primary insurance determination, patient access MSPQ workflow, MSPQ completion requirements, inpatient Medicare registration, outpatient Medicare registration, reference laboratory MSPQ exception, recurring services 90-day MSPQ rule, federal programs primary to Medicare, Black Lung Benefits, Department of Veterans Affairs authorization, VA primary payer, government research program coverage, non-group health plan coverage, liability insurance primary to Medicare, no-fault insurance primary to Medicare, workers’ compensation primary to Medicare, work-related injury billing, accident-related Medicare billing, third-party liability coverage, group health plan coverage, GHP primary to Medicare, employer-sponsored health insurance, union health plan coverage, aged Medicare beneficiary GHP rules, disability Medicare beneficiary GHP rules, ESRD Medicare beneficiary GHP rules, current employment status, spouse employer coverage, family member employer coverage, 20-employee rule for aged beneficiaries, 100-employee rule for disabled beneficiaries, ESRD 30-month coordination period, Medicare coverage effective date for ESRD, dually entitled Medicare beneficiaries, ESRD and age entitlement, ESRD and disability entitlement, aged into Medicare, MSPQ Part 1 federal payer screening, MSPQ Part 2 accident injury and work-condition screening, MSPQ Part 3 Medicare entitlement screening, MSPQ Part 4 aged employed and retired beneficiary questions, MSPQ Part 5 disabled beneficiary questions, MSPQ Part 6 ESRD beneficiary questions, retirement date collection, Medicare Part A effective date, payer priority order, insurance billing order, Medicare secondary versus tertiary payer, qualifying group health plan, Aetna and Medicare payer order, Federal BCBS and Medicare payer order, Veterans Administration primary insurance, workers’ compensation Aetna Medicare billing order, Home Depot work injury scenario, forklift injury Medicare scenario, disability and small employer GHP scenario, spouse employer group health coverage, Medicare patient access education, MSPQ registration training, Medicare revenue cycle compliance, coordination of benefits training, patient access payer sequencing, Medicare billing responsibility education
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
Great course.