Catalog Number : cra1811
Title : CMS 855 - A&B for Hospitals and Clinics
Speaker : Duane Abbey

Webplay Recording Date : 6-19-2012
Webplay Price : $ 200 for two weeks viewing

Webinar Overview:

What does CMS really want to know? What is the relationship, if any, between the CMS-855-A and CMS-55-B? What kinds of compliance implications are present with the CMS-855 forms? To answer these questions and more, come listen to this informational Webinar.

Webinar Objectives:

• Understand the process of obtaining and maintaining billing privileges for Medicare
• Appreciate the CMS Forms 855-A & B along with the six different variations
• Review the data elements and information requirement for the CMS-855-A and 855-B
• Understand how the CMS 855-A relates to the CMD 855-B
• Appreciate the use of the other CMS-855 forms relative to the CMS-855-A & B
• Recognize the need for CMS to gather appropriate information concerning ownership, management and operations for billing purposes
• Recognize the need to develop organizational resources to maintain multiple CMS Form 855-A along with multiple 855-B forms
• Understand how the NPIs and other reporting requirements affect both the CMS-855-A &B
• Appreciate the use of PECOS for Internet-based filing of the CMS-855 forms
• Appreciate current and anticipated changes for maintaining billing privileges with Medicare

Target Audience:

• Claim Filing Personnel, Coding and Billing Personnel, Compliance Personnel, Financial Personnel, Accreditation and Licensing Personnel, Other Personnel Interested in Billing Privileges with the Medicare Program

The following are a few of the topics to be discussed:

• CMS Billing Privileges
  • Overview of 42 CFR §424
  • CMS Concerns Surrounding Billing Privileges
  • OIG Investigations Concerning Fraudulent Billing
• The CMS Form 855
  • Six Different Forms
  • Use and Relationship of Forms
  • Basic Information Required
• The CMS Form 855-A
  • Hospital Billing Privileges
  • Key Information
    • Type of Entity
    • Ownership
    • Management Control
    • Financial Control
  • Need to File and Maintain Multiple CMS 855 Forms
  • Organizational Structuring to Report Changes and Maintain the CMS-855 Forms
• The CMS Form 855-B
  • Clinic and Group Practice Billing Privileges
  • Key Information
    • Type of Entity
    • Ownership
    • Management Control
    • Financial Control
  • Need to File and Maintain Multiple CMS 855 Forms
  • Organizational Structuring to Report Changes and Maintain the CMS-855 Forms
• NPIs (National Provider Identifiers)
  • Intents and Benefits of the Program
  • Analyzing Business Structures
• Tax Identification Numbers (TINs)
  • Business Structuring o Relationship of TINs
• Related Issues
  • Provider-Based Clinics
  • Ambulatory Surgical Centers
  • Ambulance
  • Verification Processes
  • Common Problem Areas
• Future Requirements for Conditions for Payment
  • Hospital Use of PECOS (Provider Enrollment, Chain and Ownership System)
  • Special Compliance Concerns
• Case Studies and Examples

Contact Hours:

Upon attending this course you will receive  a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

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.