Course Code: REL-ACU-0-UMTMB
Hours: 1
Type: Online Course
Content Expiration Date: 12/31/2028
Learning Objectives:
Describe coverage, eligibility, and enrollment for the most common Medicare plans.
Differentiate concepts of other Medicare payment plans and notices.
Outline:
Section 1: Medicare Plans, Premiums, and Participation
Introduction
Overview of Medicare
What Is Medicare?
Medicare Part A
Hospital Coverage
Skilled Nursing Facility (SNF) Coverage
Hospice Coverage
Medicare Part B
Overview
Preventive Services Coverage
What Is Not Covered by Medicare Parts A and B?
Medicare Part C
Overview
Medicare Part C and ESRD
Medicare Part D
Plan Information
Coverage Gap
Part D Supplemental Programs
Premiums
Overview
High Income Beneficiaries
Knowledge Check
Key Takeaways
Section 2: Medicare Eligibility and Enrollment
Medicare Eligibility and Enrollment
Overview
Medicare Part A
Medicare Part B
MA Plans
Medicare Part D
Bias Check
Knowledge Check
Key Takeaways
Section 3: Supplemental Plans and Medicare Notices
Medicare Supplemental Insurance
Overview
Medicare Savings Program (MSP)
Outlier Payments
Other Types of Medicare Plans
Cost Plans
Program of All-Inclusive Care for the Elderly (PACE)
Medicare Innovation Projects
Conditions for Coverage (CfCs) and Conditions of Participation (CoPs)
Medicare Notices
Advance Beneficiary Notice of Noncoverage (ABN)
Notice of Discharge and Medicare Appeal Rights (NODMAR)
Home Health Change of Care Notice (HHCCN)
Notice of Medicare Noncoverage (NOMNC)
Other Types of Notices
Knowledge Check
Key Takeaways
Section 4: Conclusion
Course Summary
Course Contributors
Resources
References
Subject Matter Expert: Quierra Rodriguez, MSN-Ed, APRN, WHNP-BC
Quierra Rodriguez, MSN-Ed, APRN, WHNP-BC, has many years of experience as a utilization management nurse. She’s worked for both payers and payees in utilization review and case management. She is passionate about access to care and the appropriate allocation of healthcare resources. Quierra is the owner of The Nurse’s Quill, a written healthcare content company.
Writer: Sooa Devereaux, MSN, RN
Sooa Devereaux, MSN, RN, has a long history of professional development experience within the hospital setting. She has taught in pre-licensure nursing programs and has mentored many nurses, both new graduate and experienced, throughout her career as a nurse educator. Sooa is a Lead SME Writer at Relias and holds an MSN in Nursing Education.
Target Audience:
The target audience for this course is: Care and Case Managers; Nursing Personnel; Social Workers; in the following settings: Ambulatory Care, Hospitals: Acute, Hospitals: Critical Access (CAHs).
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.