Medicare: Appeals & Penalties
Estimated Time: 3 hours
$69.00
Earn 40 Points for Completing
With our courses, you don’t have to be shackled to failure or pass scores. They are designed to make your recertification experience easy. This interactive course, organized into topic-specific modules, offers learners more familiar with Medicare the information and skills needed to assist Medicare beneficiaries in appealing denials of coverage and navigating issues related to Medicare premium penalties. Throughout four courses, you will learn more about the different types of Medicare appeals and the steps necessary to successfully navigate the appeals process. Includes 21 Supplemental Fact Sheets that provide important information and can be downloaded and kept as a reference. Topic-specific modules include: Module 1 - Original Medicare Appeals, Module 2 - Medicare Advantage Appeals, Module 3 - Part D Appeals, Module 4 - Medicare Late Enrollment Penalties and IRMAA. Worth 7.5 PDCs (SHRM) and 7 CEUs (HRCI General Credits).
Credits
7.5 PDCs
7 CEUs
Learning Objectives
- *Updated in 2020
- Identify when a beneficiary may start an Original Medicare appeal
- Explain the difference between Original Medicare standard and expedited appeals
- Navigate expedited appeals for ending hospital care and ending non-hospital care
- Understand the steps in the different Original Medicare appeal processes
- Identify when a beneficiary may start a Medicare Advantage appeal
- Explain the difference between Medicare Advantage standard and expedited appeals
- Navigate expedited appeals for ending hospital care and ending non-hospital care
- Understand the steps in different Medicare Advantage appeal processes
- Identify when a beneficiary may start a Part D appeal
- Explain the difference between Part D standard and expedited appeals
- Understand the steps in the Part D appeal process
- Explain Medicare late enrollment penalties
- Identify situations when a beneficiary would incur a late enrollment penalty
- Understand how beneficiaries can avoid and eliminate late enrollment penalties
- Talk about Income-Related Monthly Adjustment Amounts, or IRMAA
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SHRM: VTR is recognized by SHRM to offer SHRM-CP or SHRM-SCP professional development credits (PDCs). This program is valid for 7.5 PDCs. For more information about certification or recertification, please visit shrmcertification.org.
HRCI: VTR is a recognized provider of recertification credits. HR Certification Institute® preapproved this program for 7 credits toward aPHR™, PHR™, PHRca™, SPHR™, GPHR™, PHRi™, and SPHRi™ recertification.