Catalog Number : cra1812
Title : CMS 855-B
Speaker : Duane Abbey

Webplay Recording Date : 7-24-2012
Webplay Price : $ 200 for two weeks viewing

Webinar Overview:

What does CMS really want to know about physician practices in order to enroll? Why are provider-based clinics different relative to the CMS 855-B? Come to our Webinar to answer these and many other questions about CMS 855-B.

Target Audience:

• Clinic Managers
• Clinic Administrators
• Hospital Provider-Based Clinic Personnel
• Claim Filing Personnel
• Compliance Personnel
• Financial Personnel
• Accreditation and Licensing Personnel
• Other Personnel Interested in Billing Privileges with the Medicare Program

Webinar Objectives:

• To understand the overall process of obtaining and maintaining billing privileges for Medicare
• To appreciate the CMS Form 855-B and the six different variations of the CMS-855 forms
• To review the data elements and information required for the CMS-855-B
• To appreciate differing requirements for freestanding and provider-based clinics
• To recognize the need for CMS to gather appropriate information concerning ownership, management and operations for billing purposes
• To recognize the need to develop organizational resources to maintain multiple CMS Form 855-B forms
• To understand how the NPIs and other reporting requirements affect the CMS 855-B
• To appreciate the use of PECOS for Internet-based filing of the CMS 855 forms
• To appreciate current and anticipated changes for maintaining billing privileges with Medicare
• To work through several case studies involving different organizational structuring

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

• CMS Billing Privileges
  • Overview of 42 CFR §424
  • CMS Concerns Surrounding Billing Privileges
  • Revalidation Program
  • OIG Investigations Concerning Fraudulent Billing
• CMS Form 855
  • Six Different Forms
  • Use and Relationship of Forms
  • Basic Information Required
• Organizational Structuring for Clinics
  • Different Forms of Business
  • Freestanding vs. Provider-Based Clinics
  • Non-Physician Practitioners and Incident-To Billing
• 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
• Related Issues
  • Ambulatory Surgical Centers (ASCs)
  • Ambulance Services
  • Relationship to 855-I, 855-O and 855-R
  • Verification Processes
  • Common Problem Areas
• Future Requirements for Conditions for Payment
  • 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.