Protect Your License and Improve Claim
Medical necessity is a fast-growing industry term that has adopted a variety of
definitions. In today's current climate, rehab professionals must document to
justify their clinical decisions. RAC audits, MAC audits, ADR reviews, Denials,
and Z-Pic audits have become everyday industry concerns as we face the
allegations of "inappropriately billed" claims. The face and expectations of the
current documentation standards have changed substantially in the last two,
five, and ten years. Yesterday's methods are no longer able to meet today's
standards. This course equips health care professionals with the tools necessary
to master the challenges of fluctuating regulations while continuing to meet
company policy and procedure requirements.
This course also helps develop a thorough understanding of medical necessity and
provides a "how-to" guide for strong documentation. Whether you're a therapist
completing evaluations or an assistant completing progress notes, every area of
rehab 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 deserved. Case scenarios
focus on typical, everyday occurrences with an open format to promote group
discussion and enhance the learning experience. Resource tools and reference
materials are provided to promote continued learning beyond the classroom.
WHAT YOU WILL LEARN
- Examine practical application of integrating
company policies in accordance with the most recent government regulations
- Define Medical Necessity and other terms
important to skilled rehab services vs. unskilled
- Maximize productivity by documenting in a
clear and concise manner with every aspect of documentation
- Discuss the importance of correctly
documenting supportive documentation as part of the overall claim review
- Complete an audit through better understanding
of chart documentation and knowing the "RIGHT" questions to ask
SHELLY A. MESURE, MS, OTR/L, is a
nationally recognized industry expert and speaker specializing in training and
seminars throughout the United States on translating government regulations to
everyday clinical practice. She is also the SVP of Orchestrall Rehab Solutions,
providing on and off-site consulting services throughout the US and China. In
2012, Ms. Mesure was a featured speaker on rehabilitation at the China Sourcing
Summit in Hangzhou, China. In addition to authoring the blog Rehab Realities
through McKnights.com, Ms. Mesure has also developed various workshops and
educational programs, including webinars and six-hour live seminars for
continuing education. In 2011, she was featured in News-Line for Occupational
Therapy for her efforts in continuing education and consulting work.
Ms. Mesure received a bachelor's degree in Rehabilitation Services with a minor
in Gerontology from The Pennsylvania State University and a master's degree in
Occupational Therapy from Rush University in Chicago.
Financial – No relevant financial relationship exists
Nonfinancial – No relevant nonfinancial relationship exists
Excellent job relaying clinical relevance to all
disciplines. Marilyn Creech, PT Mullins, SC
Wonderful information. Opened my eyes to new ways to provide my LTC patients the
best care possible that they deserve. Refreshed my spark to serve my patients.
Holly Dula, OT Conover, NC
WHO SHOULD ATTEND
• Rehab professionals in every setting—pediatrics,
hospitals, nursing homes, outpatient, home health
• Physical Therapists
• Physical Therapist Assistants
• Occupational Therapists
• Certified Occupational Therapy Assistants
• Speech-Language Pathologists
• Nursing Home Administrators
• Directors of Nursing
• Billing and Coding Coordinators
• MDS Coordinators
• Rehab Nurses
Cross Country Education, LLC is approved by the Continuing Education Board of
the American Speech-Language-Hearing Association (ASHA) to provide continuing
education activities in speech-language pathology and audiology. See course
information for number of ASHA CEUs, instructional level and content area. ASHA
CE Provider approval does not imply endorsement of course content, specific
products or clinical procedures.
course is offered for up to .6 ASHA CEUs (Intermediate level; Related area).
Cross Country Education, LLC is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center's Commission on
This course is offered for 6 contact hours.
Cross Country Education is an AOTA Approved Provider of continuing education.
This course is offered for .6 AOTA CEUs. The assignment of AOTA CEUs does not
imply endorsement of specific course content, products, or clinical procedures
by AOTA. AOTA Educational level Introductory, Category 3: Professional Issues.
Cross Country Education is approved by the California Board of Registered
Nursing, Provider #CEP 13345, for 7.2 contact hours.
Cross Country Education is an approved provider by the Florida Board of Nursing,
provider #50-466. This course is offered for 6.0 contact hours.
This educational offering qualifies for 6 continuing education hours as required
by many national, state and local licensing boards and professional
organizations. Save your course outline and certificate of completion, and
contact your own board or organization for specific filing requirements.
Cross Country Education is an approved provider with the Iowa Board Of Nursing,
approved provider #328. This course is offered for 7.2 contact hours.
Cross Country Education is a Certified Sponsor of professional continuing
education with the National Association of Long Term Care Administrator Boards
(NAB) and has submitted this program for the number of clock hours listed under
their sponsor agreement with NAB/NCERS. State licensure boards, however, have
final authority on the acceptance of individual courses.
This program has been submitted to the Illinois Physical Therapy Association for
approval of 6 credit hours.
SEMINAR CLASS TIME:
Seminar Check-in: 7:30 AM Seminar Class 8:00 AM - 3:30 PM