Skip to main content
 This program is not active.
Not Found
DVD

Rehabilitation Reimbursement & Documentation: Solutions to Avoid Costly Denials, Prove Medical Necessity & Protect YOUR Time


Speaker:
Megan Reavis Nuesch, MBA, BS, COTA/L
Duration:
5 Hours 52 Minutes
Copyright:
Mar 28, 2019
Publisher:
PESI Inc.
Product Code:
RNV063540
Media Type:
DVD


Description

Everything you now are documenting has a time stamp and if it doesn’t add up, it could cost you your job. Mary had seen a patient earlier in the morning and hadn’t completed a daily note while with the patient. At the end of the day, she completed her note, but couldn’t remember the actual time she had spent with her patient. She logged her time with the patient from 11:00 am to 11:45 am and went home for the day.

Mary comes in the next morning and is met by the Rehab Director wanting to know how she saw her patient when the patient wasn’t even in the building. The patient had been taken to the hospital at 10:45, making it impossible for Mary to have seen the patient at the time she had written down. Mary is now under investigation for false documentation because she didn’t take the time to write down her actual time spent and she risks losing her job and her license.

Medical necessity is a big topic in our industry. It is a term that has adopted a variety of definitions and we are looking at an increase in inappropriately billed claims. We now must justify our clinical decisions while capturing treatment accurately and effectively. Audits have become everyday industry concerns as we face the allegations of “inappropriately billed” claims. There is an increased expectation to justify why we are providing services and why our clinical expertise is needed. The standards have changed, the challenges mount and patients still deserve the very best care.

This recording will provide a thorough understanding of medical necessity and a “how-to” guide for effective documentation. Whether you’re a therapist completing evaluations or an assistant completing progress notes, every area of therapy documentation is examined. Computerized documentation or paper versions will never replace the clinical decision making used to determine medical necessity.

Ongoing training and education are our biggest defenses to ensure our claims get paid for the therapy services the patients benefited from. Imagine being able to put your attention back on your patients, without fear of what you are missing in the documentation. Case studies focus on typical, everyday patient situations with opportunity for questions and discussion to enhance the learning experience.

Credit


* Credit Note - **

NOTE: Save time and money off other submission methods – purchase & take the CE test online for $29.99. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). CE certificate may be earned after passing the post-test (80% passing score) and completing the evaluation. Please contact our Customer Service at 1-800-844-8260 for more details. Instructional methods will include PowerPoint, didactic lecture, and others.

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Program content is reviewed periodically per accrediting board rules for currency and appropriateness for credit. Credit approvals are subject to change. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education, as well as which credit types are acceptable for continuing education hours. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact info@pesi.com or 800-844-8260 before purchase.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

For planning committee disclosures, please see the statement above. For speaker disclosures, please see the faculty biography.


Occupational Therapists - Occupational Therapists & Occupational Therapy Assistants

 

PESI, Inc.  is an AOTA Approved Provider of professional development. Approved provider # 3322. This Distance Learning-Independent activity is offered at .6  CEUs Intermediate, OT Service Delivery. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

 


Occupational Therapists - Arizona Occupational Therapists & Occupational Therapy Assistants

CE credit is available. This self-study course consists of 6.0​ continuing education clock hours for Arizona OTs and OTAs. The Arizona Board of Occupational Therapy Examiners (R4-43-203) confirms acceptance of continuing education programs relevant to occupational therapy that are approved by the American Occupational Therapy Association (AOTA).


Occupational Therapists - Florida Occupational Therapists & Occupational Therapy Assistants

PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number #50-399. This course qualifies for 6.0 self-study continuing education credits.

CE Broker


Physical Therapists - California Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 6.0 continuing competency hours.


Physical Therapists - Physical Therapists & Physical Therapist Assistants

This self-study course consists of 6.0 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.


Physical Therapists - Illinois Physical Therapists & Physical Therapist Assistants

PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 6.0 CE credit hours.


Physical Therapists - Kentucky Physical Therapists & Physical Therapist Assistants

CE credit is available. This self-study course consists of 6.0 continuing education credit hours for Kentucky Physical Therapists. The rule under 201 KAR 22:045, Section 2, (2)(a) states that category 1 continued competency credits can be earned from providers approved by another physical therapy licensing agency. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.

 


Physical Therapists - New York Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.2 contact hours.


Physical Therapists - North Carolina Physical Therapists & Physical Therapist Assistants

PESI, Inc. is an approved provider with the Illinois Division of Professional Regulation, Provider Number: 216.000270. This intermediate course is approved by the North Carolina Board of Physical Therapy Examiners by virtue of PESI Inc. approved provider status with the Illinois Division of Professional Regulation. This course qualifies for 6.0 continuing education hours.


Physical Therapists - Pennsylvania Physical Therapists and Assistants

The Pennsylvania State Board of Physical Therapy recognizes approval by all other state boards. This self-study activity consists of 6.0 clock hours of instruction that is applicable for physical therapists.


Physical Therapists - Texas Physical Therapists & Physical Therapist Assistants

This self-study activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2406032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. Instructional Level: Intermediate. This activity will provide 6.0 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.


Physical Therapists - Utah Physical Therapists And Physical Therapist Assistants

This course is designed to meet the Utah DOPL Rule R156-24b-303b.2.c.iv - A commercial continuing education provider providing a course related to the practice of physical therapy. Please retain a copy of the advertising brochure and your certificate of completion to provide to your board should this be requested of you. This self-study activity consists of 6.0 clock hours of continuing education instruction.


Physical Therapists - Vermont Physical Therapists & Physical Therapist Assistants

CE credit is available. This course consists of 6.0 continuing education credit hours for Vermont Physical Therapists. The Board confirms acceptance of continuing education programs that are recognized by other state physical therapy licensing boards. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.


Physical Therapists - Virginia Physical Therapists & Physical Therapy Assistants

CE credit is available. This self-study course consists of 6.0 hours of type 2 continued competency credit for Virginia Physical Therapists and Physical Therapy Assistants. Regulation 18VAC112-20-131, Section B, (2) states that up to ten type 2 continued competency credits can be earned by completing independent study activities related to the clinical practice of physical therapy. 


Speech-Language Pathologists & Audiologists - Speech-Language Pathologists & Audiologists

This course contains 5.5 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.


Speech-Language Pathologists & Audiologists - California Speech-Language Pathologists & Audiologists

PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 5.5 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.


Speech-Language Pathologists & Audiologists - Florida Board of Speech-Language Pathology and Audiology

PESI, Inc. is an approved provider with the Florida Board of Speech-Language Pathology and Audiology. Provider Number: 50-399. This self-study course qualifies for 5.5 continuing education credits. 


Speech-Language Pathologists & Audiologists - Kansas Speech-Language Pathologists

Approved for 7.0 self-study continuing education clock hours for Kansas licensed Speech-Language Pathologists by the Kansas Department for Aging and Disability Services.


Other Professions

This self-study activity qualifies for 6.0 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Handouts/Brochure

Speaker

Megan Reavis Nuesch, MBA, BS, COTA/L Related seminars and products


Megan Reavis, MBA, BS, COTA/L, has worked primarily in the geriatric setting for the past 20 years as a clinician and in management roles, including work as a Rehab Director and Area Director. Megan is a national educator and has written and taught continuing education courses to rehab audiences around the country on a variety of clinical, documentation and reimbursement topics that draw from her areas of expertise. Additionally, Megan has worked as a consultant for Outpatient PT companies and Skilled Nursing Facilities to maximize outcomes and reimbursement, perform auditing and manage denials.


Speaker Disclosures:
Financial: Megan Reavis has employment relationships with MCR Seminars, LLC and LW Consulting. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Megan Reavis has no relevant non-financial relationships.


Additional Info

Access for Self-Study (Non-Interactive)

Access never expires for this product.


Questions?

Visit our FAQ page at www.pesi.com/faq or contact us at www.pesi.com/info


Objectives

  1. Analyze practical application of integrating company policies in accordance with the most recent government regulations.
  2. Maximize time by documenting in a clear and concise manner.
  3. Distinguish the importance of correct supportive documentation as part of the overall claim review.
  4. Complete a case study review to form smart goals and daily notes that capture medical necessity.
  5. Demonstrate a deeper understanding of the various types of definitions in determining skilled therapy services.
  6. Evaluate documentation samples to learn how to minimize denials going forward.

Outline

Documentation And Medical Necessity
  • Medicare A and the upcoming changes around SNFs and home health
  • Medicare B and outpatient reimbursement
  • Managed care
  • ACOs/ bundled payments and the shift therapy deliver
Evaluations, Need & Reimbursement
  • Reasons for evaluation and how to justify medical necessity
  • Prior level of function and what key components to include
  • Co-morbidities/Complexities and how they will impact reimbursement
  • Goal writing and what to add to make it measurable
Critical Terminology: What It Means To Your Documentation
  • Determining medical necessity
  • Rehab terminology that must be included in your daily documentation
  • Skilled vs. unskilled terminology
Supportive Documentation
  • Case study: Break down the components of the treatment plan
  • Pitfalls to avoid
  • Drop-down menus are not your friend
  • If you didn’t write it, it didn’t happen
Coding and Diagnoses
  • CPT codes and what will get you paid
  • Avoiding “Red Flag” codes and why they are denying them
  • Diagnoses that won’t get you paid
Denial Management
  • Understanding RAC, MAC, ADR, denials, and ZPIC audits
  • Reasons for denials: Top 10 reasons we are not getting paid
  • Quality assurance audits used to decrease unpaid claims

Target Audience

  • Occupational Therapists
  • Certified Occupational Therapy Assistants
  • Physical Therapists
  • Physical Therapy Assistants
  • Speech-Language Pathologists
  • Nursing Home Administrators
  • Billing/Finance Department Staff

Reviews

Satisfaction Guarantee
Your satisfaction is our goal and our guarantee. Concerns should be addressed to: PO Box 1000, Eau Claire, WI 54702-1000 or call 1-800-844-8260.

ADA Needs
We would be happy to accommodate your ADA needs; please call our Customer Service Department for more information at 1-800-844-8260.

PESI Mobile App

Access CE trainings on your phone or tablet through our free mobile app. Choose video or audio-only versions of online courses from the world’s best instructors, and complete your CE requirements anywhere, anytime, at your own pace.

https://cdn.pesi23.com/images/android.png     https://cdn.pesi23.com/images/iphone.png

Please wait ...

Back to Top