Revenue Cycle Management

Do your employees have a thorough understanding of the patient payment process, regulations, collections and more? We provide 50+ courses and 2 Learning Plans that cover the foundational concepts of the revenue cycle. This is designed for all employees involved in all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue. In other words, all those involved in the entire life of a patient account from creation to payment. We also offer a full complement of mastery skills courses, which will take your students deeper into understanding concepts within the revenue cycle.

Revenue Cycle Learning Plans

The Revenue Cycle 101: Foundational Concepts program provides new employees with an introduction to the basics of the revenue cycle, cutting on-boarding time in half. The content focuses on the skills your employees need to contribute to your financial performance quickly and without taking up the time of senior members for new hire training. Some of the topics include Terminology, How Healthcare is Paid, Payer Verification, and Gathering Visit Information. It will take approximately 14 hours to complete. Recommended roles include Patient Access, Patient Billing, Physician Office Staff, HIM, Financial Counselors, and Customer Service.

  • Introduction to the Revenue Cycle
  • Revenue Cycle Terminology
  • Critical Steps in Payer Identification
  • Computer Software and Generating Bills
  • Introduction to Healthcare Coding Systems
  • Customers and Communication Getting to Know Your Customers
  • Patient Intake Points Within Healthcare
  • Patient Intake Methods
  • Medical Terminology I: Word Building
  • Medical Terminology II: Body Systems
  • Medical Terminology III: Procedures, Symptoms & Acronyms
  • Master Patient Index Search & Assignment
  • Identifying the Patient & Other Key Individuals
  • Patient Interviewing Techniques
  • Getting Correct Information from Patients & Guarantors
  • Why Patient Demographic Data Matters
  • Gathering Essential Visit Information
  • Why Patient Encounter Data Matters
  • Reading an Insurance Card
  • Health Insurance Plans & Participation Basics
  • Introduction to Coordination of Benefits
  • Determining Coordination of Benefits
  • Why Coordination of Benefits Matters
  • Introduction to Medicare Secondary Payer
  • Medicare Secondary Payer Practice Scenarios Introduction to the MSPQ
  • Interpretation of Medicare Secondary Payer MSPQ Practice Scenarios

The Revenue Cycle 201: Developing Skills program helps existing revenue cycle and patient access staff mature into even more productive contributors. These courses are a great way to validate and document their knowledge, as well. Some key topics addressed are Medicare, Patient Registration, Insurance Verification, Coordination of Benefits, and Medicare Secondary Payer (MSP). It will take approximately 19 hours to complete. Recommended roles include Patient Access, Patient Billing, Physician Office Staff, HIM, Financial Counselors, and Customer Service.

  • Understanding How Hospitals Are Paid
  • Components of a Complete Physician Order
  • Components of a Complete Physician Order
  • Your Office in the World of Medicare
  • Introduction to Medicaid
  • Introduction to TRICARE & CHAMPVA
  • Why Accurate Health Insurance Data Matters
  • Introduction to Medicare Advantage Plans
  • Insurance Verification Terminology
  • Insurance Verification Process Step by Step
  • Why Insurance Verification Matters
  • Medical Necessity Concepts & the ABN
  • Explaining the ABN to Medicare Beneficiaries
  • Introduction to Medicare Secondary Payer & Medicaid COB
  • MSP Determination Process
  • MSP Requirements Documentation
  • Workers’ Compensation Assignment
  • Auto Insurance Assignment
  • Residential Accident Assignment
  • Public Location Accident Assignment
  • Entity Request Determination Process
  • Multiple Plan COB DeterminationProcess
  • How Bills are Processed Through theRevenue Cycle
  • Payer Follow-Up Part I
  • Payer Follow-Up Part II

Revenue Cycle 301: Mastery Skills focuses on making sure your organization is capturing the most accurate reimbursement possible. The content focuses on key concepts in Collections, the UB Form, Bill Validation, and Payer Follow-Up. This program consists of 34 courses and will take approximately 19 hours to complete.

  • Patient Intake & the UB-04 Claim Form
  • Introduction to Denial Management
  • Understanding Patient Balances
  • The Collection Flow
  • Payment Options & Solutions
  • Four Steps of Requesting Payments from Patients
  • Managing Patient Balances
  • Why Collecting Patient Balances Matters
  • Identifying UB Data Elements & Form Locators
  • Identifying UB Elements at Patient Intake
  • What a Patient’s UB Data Elements Tell You
  • The Relationship of UB Data Elements & Costs
  • Patients/Payer-Specific UB Data Elements
  • UB Data Elements Relationships
  • Introduction to Validating a Bill
  • Validating a Basic Inpatient Bill
  • Validating an Acute Inpatient Bill
  • Validating a Combined Admit Inpatient Bill
  • Validating a Mental Health Inpatient Bill
  • Validating a Rehabilitation Inpatient Bill
  • Validating Mom & Baby Inpatient Bills
  • Validating a Basic Outpatient Bill
  • Validating an Emergency Outpatient Bill
  • Validating an Observation Outpatient Bill
  • Validating a Surgery/ProcedureOutpatient Bill
  • Validating Other Outpatient Bills
  • Validating a Therapy Outpatient Bill
  • Understanding the Elements ofPayments
  • Following Up on a Medicare Payment
  • The Appeals Process on MedicareDenials
  • Reading the Medicare Remittance Advice
  • General Follow-Up on Blue Cross
  • Following Up with Commercial & OtherPayers
  • Anatomy of a 1500 Claim

Revenue Cycle Annual Compliance provides a review of key regulations for your entire revenue cycle team. It is designed to be taken each year as part of your annual compliance training. This program consists of 8 courses and will take approximately 4 hours to complete.

  • Red Flag Rule Compliance
  • EMTALA and Patient Intake
  • Annual Revenue Cycle Compliance
  • Understanding Recovery Audit Contractors (RAC)
  • Revenue Cycle Regulations, Compliance & the OIG
  • Revenue Cycle Regulations & Compliance Review
  • The Future of Revenue Cycle Compliance
  • Informed Consent: Demystifying This Important Document

Our revenue cycle management webinar series bring you the education you need from experts you know and trust--all at a great price. The best way to stay current and scratch the cost and inconvenience of the travel-- get the best value education now!

  • IPF PPS - How Do We Get Reimbursed Anyway?
  • The Move from Fee-for-Service to Paying for Qualityand Value
  • Provider-Based Billing and the New Place of Service
  • Medicare Preventive/Screening Services: LostOpportunities
  • Creating an Effective Process to HandleDenials
  • Incident-To, Locum Tenans, ReciprocalBilling
  • Coding and Billing for Foot Care

Medical Collection Skills

Successful medical collections require a staff with the skills to handle difficult situations and negotiations with patients. This training is designed to teach the learner to recognize and overcome common patient payment objections and excuses. Learn best practices in how to collect co-pays, deductibles, and co-insurances at the time of-service. Empower your staff with the skills to successfully collect payments during each face-to-face and phone-based patient interaction.

  • Assumptions, Presumptions and Misconceptions inCollections
  • Triaging for Better Collections
  • Breaking Down Communication Barriers DuringCollection Process
  • Three Keys to Effective Collection Communication
  • Matching Communication Styles forImproved Collections
  • Understanding the Stages of PatientCollections
  • Strategies for Handling Objections toPayment
  • Quality Assurance Methods in theCollection Process

This learning plan is a continuation of the Workplace Communication Skills I learning plan delving deeper into the content covered in part 1 of this topic.

  • Ethics in the Workplace - Houndville Business Animation
  • Reducing Careless Errors - Houndville Business Animation
  • What to Say When: You're Asked to Compromise Your Ethics
  • What to Say When: Someone Disagrees with You
  • What to Say When: You Need to Break a Commitment
  • What to Say When: Someone Breaks a Commitment
  • Everybody Wins: How to Turn Conflict into Collaboration
  • TrainingBytes Achieving Communication Excellence
  • Working Without a Script
  • How to Ask Positive Questions
  • Dealing with Manipulative People
  • Privacy Issues
  • Active Listening
  • How to be a Great Conversationalist

Does your staff understand basic coding, medical necessity and the Advanced Beneficiary Notice, as well as the importance of collecting payment from patients upon every visit? The complexities of teaching patient intake and billing processes is now incredibly easy. This learning plan will benefit all administrative staff. Approximate Completion Time: 5 Hours

  • Introduction to the Revenue Cycle for Practitioner Offices
  • Critical Steps in Payer Identification for Practitioner Offices
  • Determining COB and MSP for Practitioner Offices
  • Introduction to Healthcare Coding Systems for Practitioner Offices
  • Anatomy of a 1500 Claim for Practitioner Offices
  • Understanding the Revenue Cycle at Hospital-Owned Practitioner Offices
  • Medical Necessity Concepts and the ABN for Practitioner Offices
  • Overview of Collecting Patient Balances

MACRA Training

The coding landscape in physician practices is changing rapidly under the new Quality Payment Program (QPP), enacted by the Medicare Access and CHIP Reauthorization Act (MACRA). Coder’s play a key role in the successful transition of physicians and providers to new payment methods. Fundamental concepts in value-based care and quality payment models require Professional fee coders and billers to shift from a procedural focus to a patient outcome focus. This course is designed to provide coders and other interested healthcare professionals with the knowledge required to apply their coding skills in a manner that continues to support changing payment rules.

Essential QPP concepts are presented from the viewpoint of the Centers for Medicare and Medicaid Services (CMS). This course includes detailed information in the reporting and scoring of clinical data as related to physicians’ payments under new payment tracks. Students will gain necessary insight leading to the ability to demonstrate their working knowledge and proficiency with MACRA. This is a self-led micro training course designed to deliver necessary insights in a condensed time frame. In most cases, the course is completed within 6 hours.

LEARNING OBJECTIVES:

  • Upon completing this class, Students will have studied the concepts, skills, knowledge andterminology used within the QPP today.
  • Recognize the political and financial implications associated with Medicare Part B payments.
  • Students will recognize and correctly use coding conventions and guidelines to supportrequirements in 2017 Quality Performance Measure reporting
    • Demonstrate knowledge and competence in the processes of changing requirements forphysician’s payments under:
      • Traditional Payment Models
      • APMs
      • MIPs
      • MIPS APMs
  • Explain the fundamentals of QPP provider eligibility
  • Identify variances in QPP related reporting options
  • Recognize and explain the considerations of privacy and security of medical information.
  • Understand how bonuses are calculated under Advanced APMs
  • Understand how scores are calculated for Performance Measures including Quality, AdvancingCare Information, and Improvement Activities.
  • Understand how the MIPS Final Score is calculated
  • Develop knowledge leading up to the ability to successfully sit for 2017 AAPC MACRA Proficiencytesting.