Description
Medical necessity audits can be time-consuming, expensive, and frustrating for providers. This session will examine the expectations of the Centers for Medicare & Medicaid Services (CMS) regarding effective documentation as well as the most common reasons for claim denials. Skilled services are frequently denied due to insufficient documentation supporting medical necessity. This session teaches participants how to document effectively and accurately. It also teaches them to identify reasonable criteria for skilled therapy services and develop and write functional-based goals. Additionally, the speaker will review the regulatory requirements for medical necessity, common mistakes, and how to skillfully paint a picture of their current functional abilities. This session is intended for occupational, physical, and speech therapists, quality improvement personnel, and administrators/managers responsible for agency success.
Objectives
The following are some examples of learning objectives to be covered:
- Identify the most common reasons for medical review denials.
- Identify common mistakes made in documentation and how to avoid.
- Understand the concept of medical necessity and how to meet CMS requirements of reasonable and necessary.
- Review requirements for evaluations and reassessments.
- Review components needed for goals to meet the requirements of functional and measurable.
- Demonstrate and implement effective documentation to support skilled services were provided.
Certificate
By completing/passing this course, you will attain the certificate HCAF Course Certificate
Learning credits
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