Medicare Basics for Long-Term Care Providers

Live and On-Demand Access

Each session will be recorded and made available on demand. Participants registered prior to each live session will have access to both the live session and the on-demand recording. Participants registered after a live session will have access to the on-demand recording for that session.

Program Description

Medicare rules affect reimbursement, documentation, resident notices, billing and day-to-day operations in skilled nursing and long-term care settings. This three-part Medicare Basics program is designed to give participants a practical, easy-to-follow foundation in Medicare coverage and payment principles, with a focus on how those rules apply in Iowa long-term care facilities.

Across three 90-minute sessions, participants will review Medicare Part A, Part B and Medicare Advantage basics, including coverage requirements, skilled services, documentation expectations, consolidated billing, notices and common operational challenges. The program will also address practical considerations related to the Patient-Driven Payment Model (PDPM), Minimum Data Set (MDS) documentation, denials, prior authorization and appeals so facilities can better protect reimbursement and maintain compliance.

This program is ideal for staff who are new to Medicare as well as experienced team members who would benefit from a structured refresher. The three-part format allows participants to build knowledge over time while still having access to recordings for review or scheduling flexibility.

By the end of this training, participants will be able to:

• Explain key Medicare Part A, Part B and Medicare Advantage coverage concepts that apply to skilled nursing and long-term care settings.
• Identify the documentation needed to support skilled services, medical necessity and payment.
• Recognize how PDPM and MDS documentation affect Medicare reimbursement and compliance risk.
• Apply consolidated billing principles and understand common billing considerations.
• Understand required Medicare notices, including a skilled nursing facility Advanced Beneficiary Notice of Noncoverage (ABN) and a Notice of Medicare Noncoverage (NOMNC).
• Describe common Medicare Advantage challenges, including prior authorization, denials and appeals.

Live Schedule

July 1, July 8 and July 22
10:00 – 11:30 a.m.

Continuing Education Credit

This program is approved for 4.5 contact hours for:

• NF administrators
• Nurses
• Social services

Registration Fees

Members:   $140 per person
Non-members:    $420 per person

Speaker

Jim Wilkes provides consulting and technical reporting services to a large number of Iowa’s providers of skilled nursing and other long-term care services. Throughout his 30+ years in the long-term care sector, he has helped countless facilities establish and maintain Medicare and Medicaid certification. Jim also prepares and consults on Medicare and Medicaid cost reports. Jim is a graduate of Central College in Pella and makes his home in Iowa City.

• Training Hours: 4.50