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Who should attend Denial Management 101: Surviving ADRs, Denials, & Appeals
Rehab Professionals in every setting – hospitals, nursing homes, outpatient, home health, Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapy Assistants, Speech-Language Pathologists, Nursing Home Administrators, Billing Coordinators, MDS Coordinators, Office Managers
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Rehab Professionals in every setting – hospitals, nursing homes, outpatient, home health, Physical Therapists, Physical Therapist Assistants, Occupational Therapists, Occupational Therapy Assistants, Speech-Language Pathologists, Nursing Home Administrators, Billing Coordinators, MDS Coordinators, Office Managers

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Seminar Summary:

Your documentation has been audited or payment for services provided has been denied or recouped. Now what? Take the stress and guesswork out of tackling ADRs and denials with tools and tips to minimize future denials and maximize reimbursement. (see full course description)

 
 
 

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Training Course Syllabus:


Denial Management 101: Surviving ADRs, Denials, & Appeals 

PROGRAM DESCRIPTION

You've Been Audited. Now What?
Times have changed; therapy is under the microscope by RAC and MAC audits. Don't react like a deer in headlights if an ADR comes across your desk! This course prepares you with the knowledge and tools to respond to ADRs, better interpret why the reviewer denied the claim, write appeals, and ultimately maximize reimbursement.

Be prepared by learning measures to take when confronted with audits and denials, such as exploring Medicare's coverage criteria and documentation requirements. Come away with the dos and don'ts of appeal letter writing as well as the opportunity to practice writing appeal letters. Discuss case scenarios and mock processing of denials through the appeal phases of redetermination, reconsideration, and Administrative Law Judge hearings. By using these tools and resources back in your clinic, you'll gain confidence and skill to tackle ADRs you will eventually face.

WHAT YOU WILL LEARN

• Examine the dos and don'ts of writing an appeal letter
• Accurately complete a critical chart review to determine if you have grounds to appeal a denial
• Interpret and discuss the denial decisions given by RACs and MACs using documentation samples
• Differentiate between a technical denial and an unsupportive documentation denial
• Identify the various audits, including CERT and Z-PIC
• Participate in or observe a mock Administrative Law Judge hearing
 

PRESENTER'S BIO

LAURIE HINDS, OTR/L, is a board-certified licensed Occupational Therapist with more than 30 years of experience working in a variety of settings, primarily specializing in the treatment of neurological disorders in adults. Since 2011, she has worked at SavaSeniorCare Consulting, LLC as a medical review specialist in denials and appeals. Ms. Hinds' success at redetermination and reconsideration is due to her strong knowledge of Medicare documentation requirements and her detail-oriented documentation reviews. She has also represented SavaSeniorCare SNFs during more than 30 Administrative Law Judge hearings for denials of Part A RUG episodes of care and Part B outpatient therapy, where she received partial to fully favorable decisions 91% of the time. Due to the ever-shifting landscape of insurance and Medicare, Ms. Hinds has made it her mission to continually educate other therapists on what to expect in regards to minimizing denials and maximizing reimbursement.

 

WHO SHOULD ATTEND

• Rehab Professionals in every setting – hospitals, nursing homes, outpatient, home health
• Physical Therapists
• Physical Therapist Assistants
• Occupational Therapists
• Occupational Therapy Assistants
• Speech-Language Pathologists
• Nursing Home Administrators
• Billing Coordinators
• MDS Coordinators
• Office Managers
 

CREDITS

The American Occupational Therapy Association, Inc. - 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.

American Speech-Language Hearing Association - 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. This course is offered for .6 ASHA CEUs (Intermediate level; Professional area).

General Statement - 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.

Illinois Physical Therapy Association - This program has been submitted to the Illinois Physical Therapy Association for approval of 6 credit hours. This course content is not intended for use by any participants outside the scope of their license or regulation.

Indiana Professional Licensing Agency, Physical Therapy Committee - This meets the IN-PT approval under 844 IAC 6-8-5 Approved Organizations #9, please contact IN Board or Association if you have questions.

Kentucky Physical Therapy Association - This program has been submitted to the Kentucky Physical Therapy Association for approval of 6 contact hours.

National Association of Long Term Care Administrator Boards - 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.

Ohio Physical Therapy Association - This program has been submitted for 6 CEUs to the Ohio Physical Therapy Association for Physical Therapists and Physical Therapy Assistants.

Professional Association of Health Care Office Management (PAHCOM) - Denial Management 101: Surviving ADRs, Denials, & Appeals has been submitted to the Professional Association of Health Care Office Management for approval of 6 CEUs.
 

SEMINAR CLASS TIME:

Seminar Check-in:  7:30 AM    Seminar Class 8:00 AM - 3:30 PM

Seminar Summary:

Your documentation has been audited or payment for services provided has been denied or recouped. Now what? Take the stress and guesswork out of tackling ADRs and denials with tools and tips to minimize future denials and maximize reimbursement. (see full course description)

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