Reimbursement Master Program: Self-paced, hands-on billing curriculum for HME

Posted on in Billing/Reimbursement, Education/Training

reimbursement-master-program-image-600x226           By: Dorothy de Souza Guedes, VGM Education Frustration over constantly changing Medicare policies or audited claims likely have you yearning for in-depth billing education for your staff. But ever feel your employees are simply too busy to attend an in-person seminar or course? Would you like to ensure billing education is up-to-date and answers questions specific to your business? You’re in luck: the two-level Reimbursement Master Program provides VGM and U.S. Rehab® members with self-paced, hands-on, interactive online billing instruction for all levels of HME employees. The program, a collaboration of U.S. Rehab and VGM Education, is further divided into rehab and respiratory tracks. [caption id="attachment_4018" align="alignleft" width="133"]ronda-buhrmester Ronda Buhrmester, reimbursement specialist, U.S. Rehab[/caption] As every HME knows, Centers for Medicare & Medicaid Services has been increasing the number of audits to deal with over- expenditures within Medicare trust funds. When CMS began enforcing, over time, its policies and requirements for equipment claims, member/suppliers didn't understand the policies and requirements, said Ronda Buhrmester, reimbursement specialist, VGM & Associates. "It can be confusing because Medicare doesn't always leave it in black and white; they tend to have gray areas," Buhrmester said. And not knowing how to handle those gray areas can lead to costly reimbursement delays or time-consuming audits. [caption id="attachment_4019" align="alignright" width="172"]michael-bender Michael Bender, owner, Therapeutic Specialties, Inc.[/caption] For member Michael Bender, owner of Therapeutic Specialties, Inc., a complex rehab wheelchair provider in the St. Louis area, the timing of program’s release in March could not have been more perfect. "This is ongoing and it's relevant and current. All the rules change with Medicare frequently so it's important to stay up to date," said Bender. Although the Reimbursement Team members – Buhrmester and Dan Fedor – are available to answer member questions about billing, claims review, reimbursement and audits, the Reimbursement Master Program provides an opportunity to go beyond answers to specific claims questions and dig deeper into better understanding of billing and the HME industry. VGMU-interfaceThe program’s curriculum has been designed for anyone working in HME, Buhrmester said. The Basic Level is for all HME staff, including delivery technicians, clinicians, billing staff, customer service and intake staff. The Basic Level covers what an employee needs to know in the HME world and Medicare world, and what’s expected, Buhrmester said. The Advanced Level content includes billing of repairs, working audits, handling denials and more for billers, auditors and compliance staff. "I would also make my intake people do the Advanced Level," Buhrmester said. Intake staff are the ones receiving that referral so they need to know what that policy requires, she explained. Billers use that intake information and if mistakes are found too late, it’s a challenge to get the problem resolved before it’s billed, she said. This level also includes one-on-one assistance from the Reimbursement Team, which is always available to members, and case studies only available in the program. There are advantages to taking the online program rather than an in-person seminar:

  • Self-paced. Work-at-your-own-pace learning helps all levels of staff, and all types of learners, work through the material with less frustration – and as their work duties allow.
  • Interactive. The program forces the learner to do things to challenge them and retain more information. The idea is to use interactive slides to engage the learner; to get them to stop, think – and understand it before they take the test. Engagement within a course is proven to help learners more readily recall information they need to use later on the job.
  • Assessment. There are tests and quizzes that the course-taker must pass before moving through the content. Learners can’t simply click through slides to get to a test and be done with it.
  • Case studies. Advanced Level case studies are real member claims – minus the protected health information – audited by Medicare. Case studies show an organization's audited claim would look like start to finish. The student acts as a Medicare reviewer, answering specific questions to see if they would pay the claim.
[caption id="attachment_4021" align="alignleft" width="118"]jill-blaser Jill Blaser, design and development manager, VGM Education[/caption] "The case studies are awesome, said Jill Blaser, VGM Education design and development manager. “That’s one of the things we’ve gotten the most positive feedback about.” In addition to selecting HME and billing content most useful to members, education theory and e-learning course design are factored into the program’s development. The courses included are not as passively designed as many online courses. It’s not just about telling the learner something, it’s also about showing them, Blaser said. There's a lot of interaction in the billing courses," Blaser said. "The person taking a course has to engage to gain the information." Courses are learner-centric, that is, designed with the learner in mind. Course content uses less technical jargon so all levels of billers/employees can understand. There's no point over-complicating the content. A glossary of terms a biller should know is included. When it comes to specific questions from course takers, Buhrmester does DME and respiratory and Fedor handles complex rehab and PMDs. Content is updated as Medicare changes or updates policies, Buhrmester said. That’s one of the reasons Bender plans to have all of his employees take the courses. He also likes that the Advanced Level includes course content specific to complex rehab wheelchairs. “It’s a very complicated business,” Bender said. Taking the program helps employees get the basics down and do what needs to be done, not what they think they need to do. “That way there’s consistency,” Bender said. “Even if they aren’t doing customer service, they need to understand the process we’re going through. The biggest thing this [program] has done is it’s helped everyone to connect the dots to see the big picture rather than just the slice of what they’re doing,” he said. It’s difficult to train employees, other than hands-on, he said. The first Therapeutics Specialties employee to complete the Basic Level used that course as a refresher, then quickly moved on to the Advanced Level, he said. Employees in the Reimbursement Master Program often refer back to course material, rather than asking Bender questions. “It’s freeing up more of my time because they’re becoming more independent and learning more specifics of the industry,” Bender said. It’s becoming increasingly difficult to hire experienced employees because the shrinking number of employers in his line of business mean fewer trained applicants. And even if someone is experienced “it doesn’t mean they’re doing it right,” Bender said. Even long-time employees can benefit from the course. “You never know if there’s something they think that can’t be done that can be done,” Bender said. “You might have a person who knows what they’re doing but there’s a whole lot of stuff we’ve got to know.” And if there’s something course takers feel they need to know that isn’t included in the content, that’s something that can be changed. Blaser stressed that suggestions from members and course-takers are not only welcome but are a valuable part of the program’s process. “Our goal is to ensure that the courses in the Reimbursement Master Program continue to meet the needs of member billing employees,” Blaser said. Discounts are available for VGM and U.S. Rehab members. Call 866-227-8171 to receive your discount code, learn more about the curriculum and purchase the program.