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Guided Pathways to the Medicare Program There are three products that make up the Guided Pathways curricula; they are: - Guided Pathways Basic Curriculum for all Medicare Fee-for-Service (FFS) Health Care Professionals, Suppliers, and Providers
- Guided Pathways to Medicare Resources Intermediate Curriculum (Part B) for FFS Health Care Professionals and Suppliers who enroll in Medicare using the 855 B, I or S forms
- Guided Pathways to Medicare Resources Intermediate Curriculum (Part A) for Medicare FFS Health Care Providers who enroll in Medicare using the 855 A form
DESCRIPTION: The Guided Pathways curricula consist of three booklets which are resources and descriptions listed by heading and subheading. Please find a more detailed description of each product listed below. The products were designed to allow learners to easily scan the resources and click on only topics of interest to them, instead of proceeding line-by-line. 1. Guided Pathways Basic Curriculum for all Medicare FFS Health Care Professionals, Suppliers, and Providers This basic curriculum takes you on a tour of Medicare resources and provides a fundamental overview of Medicare knowledge. You are encouraged to travel further down the path of Medicare knowledge by also visiting one or both of the intermediate curricula which take you to more detailed Medicare Fee-for-Service (FFS) policies and requirements. AUDIENCE: All Medicare Providers. RESOURCES INCLUDE: - Information about the Centers for Medicare & Medicaid Services (CMS)
- Basics of the Medicare program
- Becoming a Medicare provider
- Medicare Reimbursement
- Protecting the Medicare Trust Fund
- Appeals
- Overpayments
- Medicare services such as kidney dialysis and transplant services, long term care hospital prospective payment system (LTCH PPS), preventive services information, rural health services, provider specific web pages and clinical laboratories.
Please scroll to the Downloads Section below to access the Guided Pathways. 2. Guided Pathways to Medicare Resources Intermediate Curriculum (Part B) for Medicare Fee-for-Service (FFS) Health Care Professionals and Suppliers who enroll in Medicare using the 855 B, I or S forms AUDIENCE: Health care practitioners/suppliers who bill carriers/Medicare Administrative Contractors (MAC): - Physicians
- Non-physician Practitioners
- Other Part B Practitioners
- Suppliers Who Enroll with Carriers/MACs
The information is also helpful for suppliers of Durable Medical Equipment Prosthetics, Orthotics and Medical Supplies (DMEPOS) that bill DME MACs for: - Nonimplantable durable medical equipment, prosthetics, orthotics, and supplies (including home use)
- Enteral and parenteral products (other than to inpatients covered under Part A)
- Oral drugs covered by Part B and billed by pharmacies
- Method II home dialysis
In addition, this information is helpful to institutional providers who bill certain Part B services to the Fiscal Intermediary (FI)/MAC or hospitals that may bill for Medicare Part B practitioner services. RESOURCES INCLUDE: - Medicare Professional/Practitioner/Supplier Requirements
- Medicare Coverage and Reimbursement (General Intermediate Level)
- Medicare Coverage and Reimbursement (By Practitioner Type)
- Services by Other Practitioners
- Medicare Coverage and Reimbursement (By Type of Service)
- Services by Suppliers
- Coding
- Billing and Reimbursement
- DMEPOS (Independent Diagnostic Testing Facility)
- Quality, including; Medicare approved facilities, Medicare health support, PQRI, QIO and quality initiatives
Please scroll to the Downloads Section below to access the Guided Pathways. 3. Guided Pathways to Medicare Resources Intermediate Curriculum (Part A) for Medicare FFS Health Care Providers who enroll in Medicare using the 855 A form AUDIENCE: - Community Mental Health Center
- Comprehensive Outpatient Rehabilitation Facility
- Critical Access Hospital
- End Stage Renal Disease Facility
- Federally Qualified Health Center
- Home Health Agency
- Hospice
- Hospital
- Indian Health Services Facility
- Outpatient Physical Therapy / Occupational Therapy / Speech Pathology Services
- Religious Non-Medical Health Care Institution
- Rural Health Clinic
- Skilled Nursing Facility
RESOURCES INCLUDE: - Medicare Institutional Requirements
- Medicare Reimbursement and Coverage
- Improving Patient Quality
- Medicare Services such as; clinical trials, health care cost report information, MedPAC, Medicare approved facilities, demonstrations, enrollment reports, Fee-For-Service statistics, the Medicare-Medicaid relationship, program rates and statistics, sustainable growth rates & conversion factors and telehealth.
Please scroll to the Downloads Section below to access the Guided Pathways.
Page Last Modified: 12/18/2008 12:25:47 PM
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