AUDIOCONFERENCE ON TAPE OR CD
Sponsored by Briefings on Outpatient Rehab Reimbursement and Regulations
presented on August 29, 2006
Avoid the common pitfalls of proving medical necessity and prevent denials!
CMS is scrutinizing rehab providers' claims now more than ever before. The chances of a carrier or fiscal intermediary reviewing one of your claims is increasingly high, making the ability to prove that your services were medically necessary crucial. If you can't provide sufficient proof, you will be denied payment and lose money.
Listen to this 90-minute audioconference and hear how to prevent Medicare from denying claims based on medical necessity and recoup appropriate reimbursement. During Proving Medical Necessity in the Outpatient Rehab Setting: Best Practices for Reducing Denials, expert Nancy Beckley, MS, MBA, will provide an overview of the problem, including how much it costs rehab providers in reimbursement each year. You'll also benefit from documentation tips, learn how to appeal denials based on medical necessity, and find out what all rehab providers should have in a patient's medical record to back up therapy claims.
AGENDA
- What is medical necessity: do you know it when you see it?
- Dangers of not proving medical necessity
- How has the therapy cap changed things?
- The treacherous road of automatic exceptions (are they really a guarantee?)
- Safety in manual exceptions!
- Five steps to proving medical necessity
- Payor's chart review: in the eyes of the beholder
- All is not lost: handling denials based on medical necessity
- Q&A
LEARNING OBJECTIVES
At the end of this program, participants will be able to:
- Construct a practical process to reduce denials
- Understand the total chart as proof of medical necessity
- Identify the language of medical necessity
- Explain utilization review: how it can save you from financial ruin
ABOUT THE SPEAKER
Nancy Beckley, MS, MBA, president of Bloomingdale Consulting Group in Brandon, FL, consults in the area of outpatient rehab. She has worked with rehab therapy clinics and hospitals in the areas of Medicare program development, survey & certification, managed care and marketing, and has served on Medicare's Professional Technical Expert Panel on Comprehensive Outpatient Rehabilitation Facilities (CORF), as well as serving as a program advisor to Easter Seals’ rehab outpatient programs nationally. She has also conducted mandatory training programs for facilities following compliance issues. She has over 20 years of inpatient and outpatient rehab experience as a clinician, manager and administrator.
She is a consultant, speaker and trainer with a focus on programs targeted to the rehab audience on managed care, corporate compliance, documentation, and marketing. Ms. Beckley has a B.S. from the University of Wisconsin, M.S. from the University of Illinois, and an MBA from the University of South Florida.
WHO SHOULD LISTEN:
Rehab directors and administrators, physical therapists, OTs, SLPs, rehab billers, financial managers in rehab settings
BONUS TOOLS INCLUDED IN YOUR MATERIALS PACKET:
In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and tools including:
- A breakdown of a recent OIG report on medical necessity
- Documentation forms
- Samples of documentation
- Policies from carriers/intermediaries
Program materials will be provided with PDF links.
Save money when you purchase multiple copies! Ask your customer service representative about money-saving
discounts and bulk orders. Call toll free 800-650-6787 or e-mail
customerservice@hcpro.com.
