Medicare: Appeals & Penalties

$69
Est. Study Time: 5 hours
7.5 PDCs
7 CEUs

Synopsis

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).
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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

How do I earn credits with VTR Learning?

Earning credits with VTR Learning is easy. Simply purchase one of our self-paced courses and complete it within a year. Afterward, you will be given a certificate of completion, which contains a code to submit to your certifying organization.

Can I earn free credits?

Yes, you can! For each organization we serve, we offer at least one free course, which can be found at the top of the Shop page. Once you have completed a course, whether free or paid, your certificate of completion will be available under “My Courses”.

How quickly do I receive my credits after completing a course?

Immediately! Once you have completed a course, you will have access to your certificate of completion/activity ID to submit to your organization to redeem your credits.

How long do I have to complete my course?

You have one year after beginning your course to complete it. After that year, your course will close automatically and no progress will be permitted.

What happens if I fail my course?

Your course will reset and you will be allowed to retake the course until you have met the passing requirements.

Do I earn a certificate of completion?

If you are looking to recertify with HRCI, SHRM, APA, and NASBA/AICPA, we offer a certificate of completion that can be used to redeem continuing education credit with these organizations. However, our courses are not accredited stand-alone and are not a certification in any way.

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.