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Overview
The goal of this course is to equip nurses and social workers with knowledge of utilization management as it applies to Medicare beneficiaries in acute care.Goals and Learning Outcomes
Medicare is the largest health insurance provider in the U.S. with more than 62 million people enrolled (Centers for Medicare and Medicaid Services [CMS], 2022b). Medicare offers four primary plans and multiple forms of supplemental or other insurance coverage for people who meet specific eligibility criteria. Some forms of Medicare must be paid, while some people are able to enroll in premium-free coverage plans. To ensure adequate coverage, anyone interested in Medicare services should discuss eligibility requirements, enrollment dates, and covered services with a knowledgeable professional. This course will describe the four parts of Medicare, including coverage, eligibility, and enrollment, and allows the learner to identify eligible Medicare participants.
The goal of this course is to equip nurses and social workers with knowledge of utilization management as it applies to Medicare beneficiaries in the acute care setting.
- Describe coverage, eligibility, and enrollment for the most common Medicare plans.
- Differentiate concepts of other Medicare payment plans and notices.
Course Details
Course Originally Released on : 12/1/2022
REL-ACU-0-UMMB
Course Author
MSN, RN, NE-BC
RN
Accreditations
NURSES
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Provider approved by the California Board of Registered Nursing, CEP#13791
Disclaimer: Not all courses will provide California Board of Registered Nursing approval. Per California Assembly Bill No. 241, continuing education courses related to direct patient care shall address at least one or a combination of the following:(1) Examples of how implicit bias affects perceptions and treatment decisions of licensees, leading to disparities in health outcomes; or (2) Strategies to address how unintended biases in decision-making may contribute to health care disparities by shaping behavior and producing differences in medical treatment along lines of race, ethnicity, gender identity, sexual orientation, age, socioeconomic status, or other characteristics.
CEBroker
Relias LLC reports to CEBroker for the following boards (Provider # 50-1489): Arkansas State Board Of Nursing, District Of Columbia Board Of Nursing, Florida Board Of Nursing, Georgia Board Of Nursing, New Mexico Board Of Nursing, South Carolina Board Of Nursing and West Virginia Board Of Examiners For Registered Professional Nurses
Please check the licenses/certifications section under my account (after logging in) to make sure you have entered a valid license number. This information is required for correct reporting of your course completions to CE Broker.
Disclosures
None of the planners/faculty, unless otherwise noted, for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
This program has been pre-approved by The Commission for Case Manager Certification to provide continuing education credit to CCM® board certified case managers. The course is approved for 1.00 CE contact hour(s).