Despite the multiple resources and complex electronic software systems to guide us through the required screens and dropdowns, it can still be quite diﬃcult to keep up with the required components to assure reimbursement for covered therapy services for the diﬀerent payor sources. Rules and policies may frequently be changing, which might then result in a therapist’s services not being reimbursed.
This course will update therapists on healthcare documentation requirements, to begin with the most recently updated edits to the Medicare Beneﬁt Policy Manual, since many other payer sources initiate their own documentation guidelines from this resource. Then examples will be provided regarding what payors often expect as they are determining whether therapy documentation meets their deﬁnitions of “skilled” services. Medicaid documentation requirements will then be reviewed, to include examples of what state policies may often require. And ﬁnally Alternative Payment Models will be explained, to support the subsequent rationales for what therapy documentation may need to include for this value based system.
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- Introduction: Understanding the different payor sources and the goals of documentation
- Current Medicare Guidelines and Policies
- Differentiate the Requirement to document "skilled" versus "unskilled" therapy services
- Common documentation policies cited by state Medicaid policies
- Concepts to consider for assuring documentation with the Alternative Payment Models
Course Goals & Objectives:
This course is intended to instruct the professional on tools and resources to competently assure all documentation requirements for services in the healthcare setting.
- Identify the rules of medical necessity, per the Medicare Coverage Benefit Policies.
- Recognize the required skilled care components to be included in documentation
- List the required documentation components for Medicare documentation
- Identify documentation examples for skilled and unskilled therapy services
- List examples for denials based on missed documentation requirements
- List example policies for required Medicaid documentation
- Recognize how documentation must support episodes of care for alternative payment models (APMs)
"Seminar-On-Demand" course are streamed on your web browser if the online version if purchased. Our SODs are optimized for the most current versions of Safari, Google Chrome or Mozilla Firefox. A current version of Adobe Flashplayer is also required when viewing on a desktop or laptop computer. All SOD courses are mobile ready.
Contact Hours: 2 contact hours in length (check your state’s approval status in the state specific course catalog for your profession).
Target Audience: Physical Therapist, Physical Therapist Assistant, Occupational Therapist, Occupational Therapist Assistant, Speech Language Pathologist
Instructional Level: Intermediate
Criteria for Completion: Criteria for Completion: A score of 70% or more is considered passing. Scores of less than 70% indicate a failure to understand the material and the test will need to be taken again until a passing score has been achieved
This course is offered for 0.20 ASHA CEUs (Intermediate level, Professional area).
Financial – Lisa Milliken is employed by Select Rehabilitation and receives a salary. She receives payment from HomeCEU for the presentation of this course.
Nonfinancial - no relevant nonfinancial relationship exists.
Content Disclosure: This course does not focus solely on any specific product or service
Cancellation Policy: For activity cancellation, returns, or complaint resolution, please contact Anne Osborn by email Anne@HomeCEU or by phone at 1.800.55.4CEUS (2387). We have a 100% satisfaction guarantee. Refunds will be issued for courses that have not been completed (exam not taken), or for any course that has been rejected by your board of approval. Webinar attendance must be canceled 24 hours before the scheduled start time.