Medicare Basic Training for the NAC and IDT: A Ten-Session On-Demand Workshop

Medicare Basic Training (formerly called Medicare Fundamentals), a ten-part on-demand workshop, is designed to provide the new nurse assessment coordinator (NAC) or IDT member not familiar with Medicare with a strong foundation of knowledge of the basics of Medicare Part A coverage in the skilled nursing facility (SNF). AAPACN nurse expert, Jennifer LaBay, will guide you through the understanding of day-to-day requirements to avoid penalties, including the Medicare benefit period, the key technical and skilled care requirements of Medicare Part A coverage, consolidated billing practices, and the requirements of beneficiary notices to ensure compliance and avoid potential penalties. You will gain an understanding of the medical review process, including responding to medical reviews and appeals.  

Following this workshop, you will be able to:

  • Avoid Medicare noncompliance and penalties seamlessly even when there is staff turnover
  • Understand the technical requirements of Medicare Part A coverage in the SNF, including the qualifying hospital stay, 30-day transfer rule, benefit period, and the physician certification and recertification process
  • Recognize the clinical requirements of Medicare Part A coverage in the SNF including direct skilled nursing, indirect skilled nursing, direct skilled rehabilitation, and the administrative presumption of coverage
  • Explain the documentation requirements of Medicare Part A services
  • Understand the implications of noncompliance with Medicare regulations and how to avoid noncompliance
  • Apply the basics of consolidated billing
  • Identify the key components of Medicare meetings
  • Recognize the required beneficiary notices for Medicare Part A and when and how to fill out the notices and administer them
  • Describe the medical review process, including types of review, possible outcomes, and the appeals process
  • Contains 3 Component(s), Includes Credits

    Part 1 of Medicare Basic Training for the NAC and IDT

    Why Medicare basics? Failure to comply with Medicare requirements results in penalty to the facility that may impact reimbursement or the ability to participate in the Medicare program. Following Medicare Basic Training Part 1: Medicare Basics, you will have a broad overview of the Medicare program’s technical and clinical requirements as well as links to multiple resources to ensure you can locate and follow the required regulations.

    1.0 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 2 of Medicare Basic Training for the NAC and IDT

    Does the facility have a resident who is non-weight bearing on admission and will not need skilled therapy until the 30-day transfer rule has passed? Or perhaps there is a new admission coming in that the team is not quite sure will meet daily skilled clinical requirements. Can these cases be covered under Medicare Part A? During Medicare Basic Training Part 2: Medical Appropriateness Exception and Administrative Presumption, you will take a deeper dive into two frequently misunderstood exceptions to the Medicare program requirements: the Medicare appropriateness exception, which allows skilled Medicare coverage to begin more than 30 days after the qualifying hospital stay; and the administrative presumption of coverage, which is the only guaranteed Medicare Part A coverage available in the SNF. This session will also help you understand when and how these exceptions can be used.

    0.5 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 3 of Medicare Basic Training for the NAC and IDT

    Medicare Part A coverage in the SNF is not unlimited. Beneficiaries are allowed a limited number of days of coverage under the extended care benefit. Following Medicare Basic Training Part 3: Benefit Period, you will understand the number of days available in a benefit period, what starts a benefit period, and what ends a benefit period. This session also includes several examples and popular myths and facts surrounding the benefit period.

    0.5 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 4 of Medicare Basic Training for the NAC and IDT

    The physician certification is a written statement certifying the need for skilled care in the nursing facility. Failure to complete this technical requirement of Medicare Part A coverage per regulations may result in financial penalty. Following Medicare Basic Training Part 4: Physician Certification, you will be able to explain the requirements and timing of physician certifications including who can sign the certifications. This session also includes examples and popular myths and facts surrounding the physician certifications.

    0.5 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 5 of Medicare Basic Training for the NAC and IDT

    SNF staff have the ultimate responsibility of determining skilled Medicare Part A coverage at the time of the delivery of care. No outside entity reviews the records and makes this decision during a beneficiary’s stay. SNF staff must understand what the Medicare Administrative Contractor will be looking for in the documentation to support why those skilled services were provided. Following Medicare Basic Training Part 5: Skilled Nursing Requirements, you will be able to recognize the requirements that qualify as skilled nursing care under Medicare Part A, as well as to recognize the difference between direct and indirect skilled nursing services.

    0.5 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 6 of Medicare Basic Training for the NAC and IDT

    SNF staff have the ultimate responsibility of determining skilled coverage at the time of the delivery of care. No outside entity reviews the records and makes this decision during a beneficiary’s stay. SNF staff must understand what the Medicare Administrative Contractor will be looking for in the documentation to support those skilled services were provided. Following Medicare Basic Training Part 6: Skilled Rehabilitation Requirements, you will be able to recognize the requirements that qualify as skilled rehabilitation care under Medicare Part A, as well as the documentation requirements of therapy under Medicare Part A in the SNF.

    0.75 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 7 of Medicare Basic Training for the NAC and IDT

    The goal of SNF documentation is to ensure that residents receive proper care to promote the highest practicable level of well-being through clear written communication, to validate a facility’s decisions for or against care and treatment, to prove the need for daily skilled care to support claims and to comply with federal regulatory requirements. Following Medicare Basic Training Part 7: Skilled Medicare Documentation, you will understand both basic and skilled documentation requirements. This session also includes examples of notes that reflect skilled care versus task completion, as well as the supportive documentation of other members of the IDT.

    0.75 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 8 of Medicare Basic Training for the NAC and IDT

    Is the facility paying for services that they are not responsible for? Is it unclear why the facility is getting a bill for certain services from the physician? Under Medicare Part A, facilities are paid a daily rate calculated from the MDS. Out of this daily rate, the SNF is required to pay for all the goods and services provided to the beneficiary while they are a resident in the SNF under a Medicare Part A paid stay, a consolidated bill. There are some items that are excluded from this consolidated bill, meaning these are services that are typically outside the scope of services provided in a SNF and are not the responsibility of the SNF. Following Medicare Basic Training Part 8: Consolidated Billing and Essential Medicare Meetings, you will be able to apply the basics of consolidated billing including how to determine if a service is not the responsibility of the facility. In addition, this session will provide examples of several beneficial facility meetings that could be conducted to ensure Medicare coverage guidelines are met including the daily PPS meeting, the weekly Medicare meeting, and the monthly triple check meeting.

    1.0 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 9 of Medicare Basic Training for the NAC and IDT

    Medicare beneficiaries have protections related to financial liability and appeal rights. A beneficiary notice is a required CMS form that notifies the beneficiary or their representative that the facility believes Medicare will no longer pay for the services and that financial liability will be transferred to beneficiary and provides details on how to appeal this decision. Following Medicare Basic Training Part 9: Beneficiary Notices Initiative, you will be able to explain the reasons to end Medicare coverage and to identify what required documents must be delivered to the resident and when. This session includes step-by-step instruction on completion of the required forms, as well as examples and popular myths and facts surrounding the beneficiary notices initiative.

    1.0 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.

  • Contains 3 Component(s), Includes Credits

    Part 10 of Medicare Basic Training for the NAC and IDT

    The SNF Medicare claims processing system is based largely on the honor system. A claim is submitted to the Medicare Administrative Contractor and is paid without the SNF first being asked for evidence that items on the bill occurred or met Medicare requirements for billing. Medical review is the process of reviewing a portion of claims to determine whether services provided were medically reasonable and necessary, as well as to follow up on the effectiveness of previous corrective actions. Following Medicare Basic Training Part 10: Medical Review and Appeals, you will be able to describe the medical review process including what to do when a request for medical records comes in and how to proceed if the decision is not in the facility’s favor.

    0.5 contact hour will be awarded for this continuing nursing education activity. Learners must view at least 80% of the entire video and complete the associated evaluation to receive the contact hours. No partial credit will be awarded. Contact hours will be awarded for this activity until February 3, 2026.