Billing for MTM Services in Minnesota

Course Overview

This five part online course provides foundational knowledge for understanding the overall fee-for-service billing landscape for medication therapy management (MTM) in Minnesota. For this course, when we refer to MTM, we specifically mean the comprehensive medication management practice model. It also provides the basics on contracting, provider enrollment and credentialing, service expectations, and claim reconciliation in addition to providing an understanding of the support structures needed to bill for services.

The materials for this course are hosted in Canvas, the University's learning management system, which requires a University of Minnesota account to access. If you have an existing UMN account, you can register for this course using that account; otherwise, you will be directed to create a University of Minnesota Guest Account during registration.

Target Audience

This program is designed for pharmacy technicians and pharmacists who provide MTM services in Minnesota and have a need for improved reimbursement for services, particularly through MN Medicaid programs.

Register Now

 

Once registered

Once  you register for this course, use the login  (your email address) and password used when you registered . This information can also be found in the email you received after registering with the subject line "Your University of Minnesota Guest Account." (Be sure to check your spam and/or junk folders for this email).

In order to access the online learning materials for this course, please log in to the Canvas site specific to this course. Here are directions for logging in:

Open a web browser 

Go to https://canvas.umn.edu/courses/276649 (Bookmark this page so you can easily access it in the future.)

Next, you will be prompted with a window that asks you to type in your Internet ID and password (which you set up when you registered).

Click "Sign In"

You are now in the course Canvas site

 

Learning Objectives

  • Describe payers in Minnesota reimbursing for MTM using fee-for-service mechanisms.
  • Compare the different billing mechanisms that exist, including MTM CPT codes, incident to billing and Medicare Part D
  • Discuss the contracting process in relation to billing and payer credentialing
  • Outline various components of a contract and the considerations needed for each
  • Discuss Enrollment and Credentialing Processes necessary for billing MTM Services.
  • Provide tools for practitioner enrollment  in DHS and PMAP plans.
  • Describe key factors in creating necessary infrastructure to send claims and receive reimbursement for services
  • Evaluate participation in MTM networks specific for your clinical site
  • Review the life cycle of a claim
  • Discuss specific billing requirements for Minnesota Medicaid plans
  • Review how to determine the status of a claim

Instructors

Amanda Brummel, PharmD, BCACP
Vice President, Clinical Ambulatory Services 
Fairview Pharmacy Services
 
Amanda Brummel, PharmD, BCACP, serves as the Vice President of Clinical Ambulatory Pharmacy Services. Dr. Brummel has been employed by Fairview Pharmacy Services since 1999 when she graduated from the University of Minnesota.  While at Fairview, she has built and practiced Medication Therapy Management (MTM) in multiple clinic locations, was the clinical supervisor for the MTM department, the MTM Operations & Program Manager. Currently Dr. Brummel has responsibility for the MTM program, the clinical development and integration of pharmacy services in the Fairview Health Network including our transitions of care approach and our retail clinical services. She works closely with the Fairview Medical Group and the Fairview Network in our population health approach and new payer product development. Dr. Brummel is also an Adjunct Associate Professor at the University of MN. She has published multiple articles on MTM and pharmacy’s role in the care team.   
 
Beth Clarine, CPhT
MTM Coordinator
Fairview Pharmacy Services
 
Beth Clarine became a CPhT in November of 2012 which lead her to join the Medication Therapy Management team in August of 2013. Since then she has been responsible for the Credentialing and Enrollment of all of the Medication Therapy Management Pharmacists for Fairview and HealthEast. Beth also work with the MTM claim reconciliation and billing process for Fairview and HealthEast.
 
Sarah Westberg, PharmD, FCCP, BCPS
Co-Associate Dean for Clinical Affairs
University of Minnesota, College of Pharmacy
 
Dr. Westberg is currently a Co-Associate Dean for Clinical Affairs and a Professor in the College of Pharmacy at the University of Minnesota.  She graduated with her Pharm.D. from Drake University, completed a Pharmaceutical Care Leadership Residency at the University of Minnesota, and then joined the University of Minnesota faculty.  During her career she has provided comprehensive medication management services in family medicine and internal medicine clinics, and is currently caring for patients at the Women’s Health Specialist Clinic. Her areas of interest are in developing and maintaining interprofessional team practices, women’s health, and teaching learners to provide optimal care to patients in an interprofessional environment.
 

Schedule

Billing for MTM Services is a fully online, self-paced course that covers a range of topics and concludes with a cumulative quiz. This course includes five modules. Each module contains a video presentation to help you master these topics and prepare for the final assessment. Participants will be required to pass the 11-question quiz with a score of 70% or better. The learning materials and assessment will be available online 24/7. 

Module 1

Overall Landscape of Payment for MTM Services in Minnesota

Module 2

Contracting

Module 3

Provider Enrollment and Credentialing

Module 4

Implementation of Billing for MTM Services

Module 5

Claim Reconciliation Process for Documentation and Billing

Accreditation

Credit Designation Statement

NCIPE logo
In support of improving patient care, this activity is planned and implemented by The National Center for Interprofessional Practice and Education and the University of Minnesota College of Pharmacy. The National Center for Interprofessional Practice and Education is 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.

This knowledge-based hybrid educational offering and has been approved for 2 contact hours. The Universal Activity Numbers are JA4008105-0000-21-014-H04-T and JA4008105-0000-21-014-H04-P.

Following successful completion of the online activity, and an activity evaluation, participant data will be submitted to The Monitor within 10 days. 

JA logo
 

Registration

Fee: free 

Register Now

 

Once registered

Once  you register for this course, use the login  (your email address) and password used when you registered . This information can also be found in the email you received after registering with the subject line "Your University of Minnesota Guest Account." (Be sure to check your spam and/or junk folders for this email).

In order to access the online learning materials for this course, please log in to the Canvas site specific to this course. Here are directions for logging in:

Open a web browser 

Go to https://canvas.umn.edu/courses/276649 (Bookmark this page so you can easily access it in the future.)

Next, you will be prompted with a window that asks you to type in your Internet ID and password (which you set up when you registered).

Click "Sign In"

You are now in the course Canvas site

 

Contact onlinece@umn.edu with questions.