Protect Your License and Improve Claim Reimbursement
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 gorvernment regulations.
- Define Medical Necessity and other terms important to skilled rehab servics 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.