Medicare Reimbursement University
Practical Reimbursement Scenario Labs
Work through incomplete, de-identified billing situations using documentation review, HCPCS and modifier research, policy verification, denial-risk analysis, and corrective actions.
Modifier Selection Error
A claim edit suggests a modifier conflict.
Missing Order Denial
A claim returns a missing-information denial.
Same or Similar Equipment Denial
A claim returns a same-or-similar equipment signal.
CGM Recurring Supply Claim
A beneficiary is due for recurring CGM supplies.
Hospital Bed Medical Necessity
A beneficiary needs positioning support at home.
Oxygen Qualification Documentation
A beneficiary has an oxygen order.
Power Wheelchair Repair
A power wheelchair requires repair.
Mobility Battery Replacement
A beneficiary reports a failing mobility battery.
CPAP Replacement Supplies
A beneficiary requests recurring PAP supplies.
Initial CPAP Setup
A beneficiary is preparing for an initial PAP setup.
Professional Medical Billing End-to-End Capstone
A de-identified beneficiary received a home-use item after an incomplete intake. A claim was transmitted, accepted, adjudicated, and denied. The account now has a filing and appeal deadline.