Why Medical Necessity?
Medical necessity is a big topic in our industry. It is a term that has adopted a variety of definitions and we are looking at an increase in inappropriately billed claims. We are now having to justify our clinical decisions while capturing treatment accurately and effectively. Audits have become an everyday industry concern as we face the allegations of inappropriately billed claims. There is a higher expectation to justify why we are providing services and how our clinical expertise is what is needed. The standards have changed and we need to meet the challenges of fluctuating regulations while complying with the rapid changes in how we are providing patient care. This course also helps develop a thorough understanding of medical necessity and providesa 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 your time 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
Meet The Instructor
For the past 20 years, Megan has worked primarily in the geriatric setting as a clinician and in management including Rehab Director and Area Director. She started MCR Seminars 7 years ago as a platform for educating therapists. She has written and taught continuing education courses including "Creating and Implementing Groups", "Stop Falling! Decreasing Falls in the Elderly"and "Bored?Creative strategies to Maximize Functional Outcomes." Megan has also worked as a consultant for Skilled Nursing Facilities looking at ways to maximize outcomes to provide patient care and managed daily operations. She has also been involved in various projects that have included auditing and denials management for Skilled Nursing and Outpatient Physical Therapy companies. She has been teaching for the past 8 years designing workshops to address the needs of Occupational, Physical, and Speech Therapists in rehab settings focusing on the changing trends of how therapy is being provided in their work and community.