Coding and Billing Guidelines for FQHCs

Description:

During this Webinar, we will discuss the basics of FQHCs for coding and billing. We will review the Medicare G codes and the qualifying codes/services that correlate with the G codes. We will also outline the FQHC billing requirements for multiple visits on the same date of service. We will discuss when a patient is considered a new patient versus an established patient in an FQHC. The training will also outline which services go on which claim form (i.e., UB versus 1500) for Medicare. This webinar will leave plenty of time for questions to be answered during the training.

Learning Objective:

• The attendees will be able to determine if a CPT/HCPCS code is considered a qualified code for Medicare.
• The attendees will be able to identify when multiple visits are allowed to be billed on the same date of service.
• The attendees will understand when a patient is considered new or established for Medicare in the FQHC setting.
• The attendees will know which claim should be submitted for each CPT/HCPCS code.

Areas Covered in the Session:

• G codes and Qualifying Codes
• Multiple visits on the same date of service
• New vs. Established patients
• Which claim form to submit
• Qualified Provider
• Covered Services
• Coding & Compliance Initiatives – Location
• Coding & Compliance Initiatives – G codes
• Qualifying Codes for G0467 (established patient)
• Qualifying Codes for G0468 (IPPE or AWV)
• Qualifying Codes for G0469 (mental health – new patient)
• Example – New Patient
• Example – Established Patient
• Multiple Visits
• Example – Medical and Mental Health
• Billing Requirements
• Billing Requirements – Multiple Visits
• Claims
• Denial Needed
• Covered or Non-Covered Service
• Four Categories of Items and Services NOT Covered under Medicare
• New Patient – Payment Adjustment
• Electrocardiogram (EKG)
• Ancillary Services
• Laboratory Services
• Technical Component

Suggested Attendees:

• Healthcare Executives
• Physicians
• Nurses
• Coder
• Billing Specialists
• Providers
• Administrators
• Managers
• Claims Adjusters
• Reimbursement Staff

About the Presenter:

Ms. Sulzberger is a Licensed Practical Nurse and a Certified Professional Coder. She received her Bachelor of Science degree in Business Administration from Mid America Nazarene University. Ms. Sulzberger received her nursing license in 1994 and was a practicing clinician at Saint Luke’s Health System for several years before transferring to the internal compliance/audit area. She became credentialed as a Certified Professional Coder in 1996 and assisted the Saint Luke’s Health System with performing medical record chart audits to verify the accuracy of the internal coding and claims processing.

Ms. Sulzberger spent approximately six years as a coding/billing consultant with National accounting and consulting firms (BKD, Grant Thornton) before becoming the President of Coding & Compliance Initiatives, Inc. (CCI) in April 2003. Ms. Sulzberger assists her clients with improving their operational performance in a variety of critical outcome areas, including coding/billing, corporate compliance, charge capture processes, etc. Ms. Sulzberger works with a variety of health care providers including hospitals, physician practices, and rural health clinics in their daily compliance and operational activities.

A substantial amount of Shellie’s time is spent providing education to the physicians and internal coding staff regarding opportunities for the clinic to improve its current documentation and coding practices, which impact both the revenue and compliance risk of the facility.

Shellie works extensively with federally qualified health centers across the country (along with physician practices, rural health clinics, and hospitals) serving as an independent auditor and compliance resource to improve documentation quality, coding accuracy, workflow, and revenue cycle performance. She works collaboratively with the National Association of Community Health Centers (NACHC) and State Primary Care Associations (PCA).

She assists legal counsel with research, investigation, and her expert opinion. She also provides clinical education in the areas of patient management and medical record documentation. She attends many physicians and other staff meetings to offer updates and to act as a liaison for the health care provider.

Ms. Sulzberger presents locally and nationally on coding topics as well as develops specialized training programs to meet the needs of her clients.

Shellie works with the front office and back-office revenue cycle team members, focusing on education regarding E/M and ICD-10 coding and billing guidelines and coding/billing-related processes that improve compliance and cash flow. She emphasizes communication between the billing team and the providers and clinicians about the “downstream” impacts of incorrect coding.

Shellie personally works with 10+ health centers annually regarding documentation, coding, and billing processes and serves as an educational resource for several State PCA’s every year.

Shellie is credentialed through the American Institute of Healthcare Compliance as a Certified ICD-10 Trainer.

Professional Affiliations

• American Academy of Professional Coders (AAPC)
• Greater Kansas City Medical Managers Association (GKCMMA)

System Requirement:

Internet Speed: Preferably above 1 MBPS

Headset: Any decent headset and microphone which can be used to hear clearly.

For more information you can reach out to the below contact: Toll-Free No: 1-302-444-0162 Email: support@skillacquireupdate.com