Catalog Number : cca1680
Title : Medicare Secondary Compliance
Speaker : Duane Abbey

Webplay Recording Date : 11-1-2011
Webplay Price : $ 200 for two weeks viewing

Webinar Description:

What is the objective of MSP? What is Medicare Secondary Payer (MSP)? How is MSP supposed to work? To answer these questions and more, come listen to this informational Webinar.

Webinar Objectives:

• Briefly review the fundamentals of the Medicare Secondary Payer program
• Appreciate how the MSP connects with Group Health Insurance
• Appreciate how the MSP is affected by Workers' Compensation payments
• Understand liability insurance coverage in relation to MSP
• Appreciate how provider-based clinics can complicate filing claims for MSP
• Understand what Medicare does and does not pay as a secondary payer
• Appreciate the key form locaters on the UB-04 (electronic 837-I)
• Work through several case studies involving working aged, disability, Workers' Compensation, no-fault liability, and special circumstances
• Review the process of Medicare conditional payment
• Review the impact of MMSEA Section 111 on MSP
• Understand possible audits and recoupments including RAC involvement with MSP

A few of the topics that will be covered:

• Review of the Medicare Secondary Payer Program
   o Basic MSP Processes
   o Coverage Issues for MSP
   o Rules, Regulations and Directives
   o Conditional Payment Process
   o Improper Payments
   o Review of CMS Guidance for MSP
   o Impact of MMSEA Section 111 on MSP
• MSP Relationship to Other Insurance
   o Group Health Plans (GHPs)
   o Workers' Compensation Claims
   o Liability Insurance
   o Special Issues
   o Self-Insured Issues
   o MSP Questionnaire and Data Gathering
• Medicare Payments under MSP
   o Calculating the Amount CMS Pays for MSP Claims
   o Calculating Refunds for MSP
  • Conditional Payments
  • Group Health Coverage Interfaces
  • Deductibles and Coinsurance
   o Interest on MSP Recovery Claims
• Case Studies
  • Billing and Claims Filing
  • Review of Pertinent FLs on UB-04 and Their Values
  • Working Aged
  • No-fault Liability
  • Workers' Compensation
  • Primary Payment in Full or Contracted Amount
  • Provider-Based Clinics - UB-04 and 1500
     o Disability Insurance
     o Public Health Service
• Regulatory Issues
   o COBC - Coordination of Benefits Contractor
   o Waiver of Collection
   o External Audits for MSP Compliance
   o RAC and Recoupment Efforts for MSP
   o Conducting Internal Audits
   o Section 111 MSP Mandatory Reporting
• Sources for Research and Reference

Target Audience:

Patient Financial Services Personnel, Billing Personnel, Claims Transaction Personnel, Compliance Personnel, Utilization Review Personnel, Internal Auditing Staff, Registration Personnel, Clinical Staff, and All Personnel Having Contact with Patients

Attendance Hours:

All participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate for each program.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.