2025 Coding and Billing Certification Bootcamp
About this Event

Day 1: Feb 26, 2025: 9:00am to 4:30pm

Day 2: Feb 27, 2025: 9:00am to 12:30pm

*Breaks will be given in the morning, lunchtime, and afternoon.

2025 Coding and Billing Certification Bootcamp

INSTRUCTIONS TO ACCESS THIS TRAINING WILL BE SENT OUT THE (business) DAY BEFORE ON 2/25/2025

Overview and Purpose - 2025 updates will be reviewed

This 2-day bootcamp focuses on clinical documentation, coding, & billing for Rural Health Clinics (RHC) and Federally Qualified Health Centers/Community Health Centers (aka FQHCs) and allows attendees to optionally earn the nation’s only RHC/FQHC-specific coding and billing credentials.

Why Should Facility Leaders Also Attend?

Those clinical and business staff members who have worked in traditional medical offices in the past, and have recently joined a RHC/FQHC, notice that there are unique CMS billing rules that differ from Part B fee-for-service payment documentation and payment rules.

· Coordinate effective revenue cycle workflows to stay compliant and to facilitate the submission of a cost report that shows our true costs via consistent professional coding.

· Gain knowledge of how the insurance participation agreements we are bound to by Medicare/Medicaid/commercial insurance companies requires differing billing approaches and claim forms.

Why Should Clinical Providers Also Attend?

This course is approved for 11 CMEs for providers as described more fully below. We respectfully urge key clinical personnel (MD, NP, PA, RN) to attend as well since the clinical documentation they enter into the medical record is the foundation for all professional coding and medical billing.

· Learn the guidelines from key source materials (ex., CPT and ICD-10-CM) instead of EHR/IT short-cuts in order to distinguish the differences between coding and billing activities.

· Identify their responsibilities in how information moves from their mind to the medical record – how those services are subsequently coded to generate public health data and information for our cost report – and finally, how some codes may have to change (ex. 99214>G2025) to meet various insurance company billing requirements.

Key Takeaways

· To make sure you are documenting and coding for 100% of what is done based on the CPT, HCPCS-II, and ICD-10-CM guidelines.

· Understand how to bill for per diem and fee-for-service primary care visits, behavioral health, and preventive services to Medicare, Medicaid, and commercial payers.

· Help your facility have a full record of each service you provide (via CPT/HCPCS-II codes) and why they were done (via ICD-10-CM codes) for your annual cost report regardless of whether you get paid or not.

· To help you generate 100% of the revenue that you are entitled to – but no more than you are allowed.

· Learn to report quality measures related to Shared Savings, Risk Adjustment, HCCs, or other Quality Improvement Programs.

· Increase your knowledge of the guidelines that appear before and after key coding sections in the AMA’s CPT that rarely are accessible to providers and coders/billers in their EHRs and encoder software.

Basic Agenda

· Documentation vs. Coding vs. Billing

· Introduction to RHC/FQHCs – What Makes Us Different?

· Key CMS References + Using the CMS 1450/1500 Forms

· Billing for Various Payment Systems (FFS vs. Per Diem)

· Treat and Document Visits – A Focus on E/M

· AMA/CMS Requirements for Documentation in the CPT

· Overview of Preventive Medicine services and CMS-covered Preventive G-codes

· Telehealth versus Virtual Communication Services

· Care Management (i.e., CCM, TCM, PCM, BHI, Psych CoCM)

· Code the Full Encounter for Patients, Cost Reports, and Billing

· Review of the various definitions of the "surgical/global package" – AMA/CMS/commercial