This course is an introduction to the Medicare Appeal process for part B therapy services. The learner will be presented with case studies to better understand both Medicare requirements and reasons for denial. Also in this presentation, the learner will understand how to defend denied cases up to the Administrative Law Judge level.
Course created on June 13, 2019
Course Type: Video, Audio
CEUs/Hours Offered: AOTA/0.15 Intermediate, Category 3: Professional Issues - Legal & Legislative;Regulatory & Reimbursement Issues; CE Broker/1.5 Home Study, General (FL), Management (AL), General Continuing Education (GA), Professional/Health Care Related (SC), CE Broker #20-726700; IACET/0.2; NBCOT PDUs/1.88 Intermediate, Admin And Management
- After this course, participants will be able to describe the Medicare appeals process.
- After this course, participants will be able to define RACs, MACs, QICs, ALJs.
- After this course, participants will be able to apply strategies to therapy documentation that will meet Medicare requirements per the Medicare Manual in Chapter 15.
|5-30 Minutes||Medicare Appeals process|
|30-40 Minutes||Case Study #1|
|40-70 Minutes||Medicare Benefit Policy Manual Chapter 15|
|70-80 Minutes||Case Study #2|
|80-90 Minutes||Summary, Q & A|
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Kathleen Dwyer, OTR/L, CHT
Kathleen Dwyer is an Occupational Therapist with over 20 years of experience in the health care industry, which includes professional leadership in the corporate setting. Following her graduation from Eastern Michigan University, she focused on earning her certification in hand therapy and also specialized in aquatic therapy.
Her experience in therapy management began as the Director of Rehabilitation for a vast campus which included a Skilled Nursing Facility, a Long-Term Acute Care Hospital and an Outpatient Therapy Center. Kathleen has also served as the Director of Operations for a chain of 56 skilled nursing facilities. She is certified in Healthcare Compliance and has also earned the RAC-CT, which designates her as an expert in skilled nursing facility prospective payment system and the minimum data set assessment. She is currently working as the Executive Vice President for JMD Healthcare Solutions.
Sponsor Disclosure: This Course is presented by OccupationalTherapy.com.
Content Disclosure: This learning event does not focus exclusively on any specific product or service.
Course participation information
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American Occupational Therapy Association
OccupationalTherapy.com is an AOTA Approved Provider of professional development, #7659. This distance learning - independent course is offered at 0.15 CEUs (Intermediate level, Category 3: Professional Issues - Legal & Legislative;Regulatory & Reimbursement Issues Area). The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.
OccupationalTherapy.com is an approved provider for CE Broker, provider #50-14558. This course is offered for 1.5 hours, Home Study, General (FL), Management (AL), General Continuing Education (GA), Professional/Health care related (SC) category/categories. If you are an OT/OTA in Alabama, Florida, Georgia, or South Carolina, CE Broker may be of interest to you.
International Association for Continuing Education and Training
continued, LLC, DBA OccupationalTherapy.com, is accredited by the International Association for Continuing Education and Training (IACET). continued complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, continued is authorized to issue the IACET CEU. continued, LLC, is authorized by IACET to offer 0.2 CEUs for this program.
National Board for Certification in Occupational Therapy
OccupationalTherapy.com is a NBCOT® Professional Development Provider. This course is offered for 1.88 NBCOT PDUs (Intermediate level, Admin and Management Area). NBCOT® is a registered trademark of The National Board for Certification in Occupational Therapy, Inc.