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Front Office Courses
This presentation provides information on how to determine if a given service is typically covered under the Medicare program, how to submit a claim for reimbursement, and how to deal with claim denials. If you are primarily interested in getting an overview and understanding how government payment systems work, we may suggest the presentation entitled “Understanding Government Payment Systems” which provides a fuller and more detailed description of those policies. The primary goal of this presentation is to provide more of a nuts and bolts description of determining how and why a service is considered covered and the indications necessary for reimbursement. We explain how to properly code a service, submit a claim, and what to do if the claim is denied. Because of the variations in the regulations depending on the type of provider and where you live, we include a lot of information on where to find the specific rules you will need to bill correctly in this complex arena.
- Learn where to find everything you need to know
- Gain a basic understanding of coding and billing for services
- Know where to find out what constitutes medical necessity for a given service
- Learn how to code a procedure properly
- Determine what system Medicare uses for payment for a given procedure
- Learn how to deal with a denial for coverage for medical necessity
Estimated time for Course Completion: 85" CME: 1.5 hours
This program is intended for physicians, sonographers, or other allied health professionals. There was no commercial support for this educational product and the author and planning committee have nothing to disclose pertinent to this presentation. After viewing this video presentation covering this topic, the participant will be directed to take a quiz testing the knowledge gained. Successful completion with a score of 70% or greater allows access to a course evaluation and finally claiming Continuing Medical Education credit for this activity. Physicians should only claim credit commensurate with the extent of their participation however each activity must be completed to allow navigation to the next stage.
Original Date of Release: August 1, 2015 Reviewed: August 1, 2017 Termination Date for Completion of CME Credit: September 1, 2018
System Requirements: In order to view this program, you must have a recent internet browser and a video player capable of viewing industry standard MP-4 video. High speed internet connection is recommended. You will also need the ability to view and print PDF files in order to obtain your CME certificate.