CMS Resources: Foundational Knowledge for Billing Companies

CMS Resources: Foundational Knowledge for Billing Companies

Presented by Ron DiGiaimo

Wednesday October 29th, 2025
10am PT / 11am MT / 12pm CT / 1pm ET

This program is scheduled for 60 minutes and is valid for 1 CHBME credit.

Member Price: $49.00
Non Member Price: $99.00

Description:

Are you navigating the complex world of medical billing and need a solid foundation in key CMS (Centers for Medicare & Medicaid Services) concepts? Join us for a practical and insightful session designed specifically for HBMA members and revenue cycle professionals.

In this webinar, we will break down essential CMS resources and terminology that directly impact billing companies and their operations. Whether you're new to healthcare business management or looking for a refresher, this session will demystify common but often misunderstood CMS elements, including:

• HOPPS (Hospital Outpatient Prospective Payment System): Understand how outpatient services are reimbursed and the implications for billing accuracy.
• MPFS (Medicare Physician Fee Schedule): Learn how physician services are valued and how to navigate annual changes.
• NCCI (National Correct Coding Initiative): Discover how coding edits impact reimbursement and avoid costly denials.
• RVUs (Relative Value Units): Explore how RVUs drive payment rates and their role in resource-based compensation.
• MACs (Medicare Administrative Contractors): Identify the function of your regional MAC and how their policies shape local billing procedures.
• LCDs (Local Coverage Determinations): Learn how coverage decisions vary by jurisdiction and why understanding them is critical.
• CMS.gov Navigation Tips: Master locating the resources and updates you need most, efficiently and effectively.

Our expert presenter will provide real-world examples and answer your most pressing CMS-related questions. Attendees will leave equipped with the terminology, tools, and confidence needed to support billing operations, compliance, and communication with provider clients.

Learning Objectives:
Course participants will be able to:

• Identify and define key CMS billing and reimbursement terms, including HOPPS, MPFS, NCCI, RVUs, MACs, and LCDs, and explain their relevance to daily billing operations.
• Locate and interpret essential CMS resources on CMS.gov, including fee schedules, coding edits, and coverage policies, to support accurate and compliant billing practices.
• Apply foundational CMS concepts to real-world scenarios in order to improve claim accuracy, reduce denials, and enhance communication with providers and payers.

Speaker Bio:
Ron DiGiaimo is the Chief Executive Officer of R3, the foundation supporting
RCCS, Regents, and RC Billing, leading the organization in delivering strategic
consulting, revenue cycle management, and compliance solutions for healthcare
providers. With extensive expertise in oncology business management,
healthcare finance, and strategic planning, Ron has guided RCCS, Regents, and
RC Billing to become trusted industry leaders in revenue cycle optimization
and strategic consulting. He is recognized nationally as a thought leader and
frequently serves as a consultant for healthcare organizations navigating
complex regulatory environments.

Ron has served as a national government expert witness to the Department
of Justice and the Office of Inspector General (OIG) on oncology fraud and
Medicare spending investigations. He has extensive experience in developing
operational strategies for oncology practices, negotiating payer contracts, and
ensuring regulatory compliance.

Ron has played a pivotal role in shaping oncology business strategies, driving
financial growth, and improving operational efficiencies for healthcare providers.
He has successfully led initiatives in cancer center development, reimbursement
training, and compliance consulting. His contributions continue to influence the
evolution of healthcare finance and revenue cycle management in oncology.