Nursing: Medicare Interactive Pro: Level III

75.00
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About the Course

This interactive course, organized into topic-specific courses, 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 courses include:
  • Course 3.1: Original Medicare Appeals
  • Course 3.2: Medicare Advantage Appeals
  • Course 3.3: Medicare Part D Appeals
  • Course 3.4: Medicare Late Enrollment Penalties and IRMAA

Learning Outcomes:
Upon completion of the course, the learner will be able to:
  • 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.

About the Author:
Medicare Rights Center

The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives. Since 1989, the organization has been helping people with Medicare understand their rights and benefits, navigate the Medicare system and secure the quality health care they deserve. Medicare Rights is the largest and most reliable independent source of Medicare information and assistance in the United States.

About the Nurse Reviewer: 
Susan Sportsman, PhD, RN, ANEF, FAAN

Susan Sportsman, PhD, RN, ANEF, FAAN builds upon 40 years of experience as a clinician, educator, and consultant to provide nursing professionals with expert guidance and consultation in the areas of nursing education, health care policy, and leadership development. Dr. Sportsman has worked as a medical- surgical and psychiatric nurse in hospitals and in the community, has been a teacher and an administrator in both services and education, and has consulted for a broad spectrum of colleges and universities throughout North America. Most recently she served as Director of Consulting Services in Elsevier’s Education Division. Prior to that, she held positions as Dean of the College of Health Science and Human Services at Midwestern State University, Associate Dean of Nursing at Texas Tech University, and Vice President, Mental Health Programs at Harris Methodist Health System.

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