Course Code: REL-RCC-OPPS-C02
Hours: 0.5
Type: Online Course
Content Expiration Date: 12/31/2028
Learning Objectives:
Identify services that are reimbursed under the Outpatient Prospective Payment System (OPPS).
Describe the APC system.
Recall what services are paid outside of OPPS.
Identify exclusions from Medicare Part B.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: OPPS Basics
Overview
OPPS Services
Review
Section 3: APCs
OPPS and APCs
Coinsurance
Clinical Example of APC-Covered Services
APC-Paid Laboratory Studies
Pathology Example
Section 4: Excluded and Ancillary Services
Other Outpatient Payment Methods: Physician Payment
Payment for Therapy
Fee Schedule for Laboratory Studies
Exclusions from Coverage
Review
Section 5: Other Services
End-Stage Renal Disease and Outpatient Maintenance Dialysis
Payment for Ambulance Services
Review
Critical-Access Hospitals
Review
Section 6: Conclusion
Course Summary
Course Contributors
Resources
References
Reviewer: Brandi D. Burgett, CCS, CPC
Brandi has over twenty-five years of medical billing and coding experience. Her areas of expertise include beginning-to-end revenue cycle operations, hands-on coding for multiple outpatient specialties, and medical record auditing. Prior to medical coding, Brandi was a Team Lead for a large team of pediatric specialty providers in Virginia.
Target Audience:
The target audience for this course is: Healthcare Billing and Coding; in the following settings: Hospitals: Acute.
Relias Learning will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Relias Learning has a grievance policy in place to facilitate reports of dissatisfaction. Relias Learning will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias Learning at support@reliaslearning.com.
All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.