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Digital Seminar

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


Faculty:
Megan Reavis
Duration:
5 Hours 53 Minutes
Format:
Audio and Video
Copyright :
Mar 28, 2019
Product Code:
POS063540
Media Type:
Digital Seminar


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.

Credits


**

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing and passing the on-line post-test evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. 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 cepesi@pesi.com or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals.  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 professions standards


Occupational Therapists & Occupational Therapy Assistants

AOTA

PESI, Inc. is an AOTA Approved Provider of continuing education. Provider #: 3322. This self-study course qualifies for 6.0 self-study contact hours or .6 CEUs in the Category of Domain of OT and Occupational Therapy Process. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA. Course Level: Intermediate. Expires: 03/28/2022.


Florida Occupational Therapists & Occupational Therapy Assistants

CE Broker

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.


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.


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.


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.


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.


Texas Physical Therapists & Physical Therapist Assistants

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2106032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. 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.


Speech-Language Pathologists & Audiologists

ASHA

This course is offered for .55 ASHA CEUs (Intermediate level, Related area).

** ASHA Self Study CEUs are available on this course from 06/01/2019 to 05/31/2024. PESI, Inc. will submit ASHA CEU Requests to the ASHA CE Registry on a monthly basis; ASHA CEU Requests received before 06/01/2019 or after 05/31/2024 cannot be reported.

** Please note that Speech-Language Pathologists & Audiologists who participate in the self-study (Digital Seminar or Online Course) will be required to complete additional steps if they want their participation submitted to the ASHA CE Registry. Detailed instructions will be provided under the Handouts section of the online program.


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 6.0 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.


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

Faculty

Megan Reavis Related seminars and products: 1

MBA, BS, COTA/L,


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 an employment relationship with Orchestrall, Inc. She receives a speaking honorarium from PESI, Inc.

Non-financial: Megan Reavis has no relevant non-financial relationship to disclose.

 


Additional Info

Program Information

CD/DVD

Click here to purchase the DVD or CD recording from our product store.


Additional Resources

To order the book, 2018 ICD-10-CM Annual Version, please visit our product store.

To order the book, Treating Chronic Pain, please visit our product store.


Access for Self-Study (Non-Interactive)

Access never expires for this product.


Objectives

  1. Examine 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

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Overall:     3.6

Total Reviews: 13

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