Agenda

• Brief History of Medicare
• Beneficiary eligibility
• Medicare Provider Participation (NPI-Taxonomies)
• Understand Payment Categories
• Medical Necessity per Medicare
• Learn Medicare reimbursement rules (RBRVS-DRG-RUG)
• Advanced Beneficiary Notice (ABN)
• Billing Guidelines
  Timely Filing
  Bundling w/ NCCI
• Appeal Process
• Program Integrity

Instructor: Mary Kustermann BA, RMM, RMC, CPC, COC

Mary’s experience spans 36 years in numerous aspects of physician practices.  After completion of her BA in Health Care Administration, Mary assumed a position as Administrator for a Neurosurgical practice specializing in Neurosurgical surgery and spinal care.

After several years of administration moved to a Health Care consulting position where she started her journey into medical coding.  After securing several coding certifications, Mary traveled extensively in the U.S. educating and providing consulting services to physicians, ancillary providers, hospital systems and medical coders and billers.  Currently,  Mary oversees a team of ten certified coders in a large metropolitan hospital system with oversight of 5 hospital campuses, and multiple specialty groups to include revenue monitoring, provider education and compliance awareness

Mary’s past experience and current day-to-day challenges has confirmed her belief that certification in medical coding and billing is of paramount importance to assure efficiencies in capturing revenue and decreasing compliance concern.  To remain relevant in this industry lifelong learning and continued professional growth is an essential!