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1. Analyze practical application of integrating company policies in accordance with the most recent government regulations.
2. Maximize time by documenting in a clear and concise manner.
3. Distinguish the importance of correct supportive documentation as part of the overall claim review.
4. Complete a case study review to form smart goals and daily notes that capture medical necessity.
5. Demonstrate a deeper understanding of the various types of definitions in determining skilled therapy services.
6. Evaluate documentation samples to learn how to minimize denials going forward.

Documentation And Medical Necessity

• Medicare A and the upcoming changes around SNFs and home health
• Medicare B and outpatient reimbursement
• Managed care
• ACOs/ bundled payments and the shift therapy deliver

Evaluations, Need & Reimbursement

• Reasons for evaluation and how to justify medical necessity
• Prior level of function and what key components to include
• Co-morbidities/Complexities and how they will impact reimbursement
• Goal writing and what to add to make it measurable

Critical Terminology: What It Means To Your Documentation

• Determining medical necessity
• Rehab terminology that must be included in your daily documentation
• Skilled vs. unskilled terminology

Supportive Documentation

• Case study: Break down the components of the treatment plan
• Pitfalls to avoid
• Drop-down menus are not your friend
• If you didn’t write it, it didn’t happen

Coding and Diagnoses

• CPT codes and what will get you paid
• Avoiding “Red Flag” codes and why they are denying them
• Diagnoses that won’t get you paid

Denial Management

• Understanding RAC, MAC, ADR, denials, and ZPIC audits
• Reasons for denials: Top 10 reasons we are not getting paid
• Quality assurance audits used to decrease unpaid claims

Megan Reavis, MBA, BS, COTA/L, has worked primarily in the geriatric setting for the past 20 years, as a clinician and in management roles, including work as a Rehab Director and Area Director. Megan is a national educator and has written and taught continuing education courses to rehab audiences around the country on a variety of clinical, documentation and reimbursement topics that draw from her areas of expertise. Additionally, Megan has worked as a consultant for Outpatient PT companies and Skilled Nursing Facilities to maximize outcomes and reimbursement, perform auditing and manage denials.

Speaker Disclosures:
Financial: Megan Reavis has employment relationships with MCR Seminars, LLC and LW Consulting. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Megan Reavis has no relevant non-financial relationships.

Save time and $10 off the price of other submission methods – purchase & take the CE test online for $9.99 USD per participant. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). Please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion are available for email, download and/or printing from your online account immediately following the successful completion of the post-test/evaluation.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Occupational Therapists & Occupational Therapy Assistants


Arizona Occupational Therapists & Occupational Therapy Assistants: CE credit is available. This self-study course consists of 6.0 continuing education clock hours for Arizona OTs and OTAs. The Arizona Board of Occupational Therapy Examiners (R4-43-203) confirms acceptance of continuing education programs relevant to occupational therapy that are approved by the American Occupational Therapy Association (AOTA).

Florida Occupational Therapists & Occupational Therapy Assistants: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 6.0 continuing education credits.

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Physical Therapists & Physical Therapist Assistants
This self-study course consists of 6.0 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.

California Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 6.0 continuing competency hours.

Illinois Physical Therapists & Physical Therapist Assistants: PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 6.0 CE credit hours.

Kentucky Physical Therapists & Physical Therapist Assistants: CE credit is available. This self-study course consists of 6.0 continuing education credit hours for Kentucky Physical Therapists. The rule under 201 KAR 22:045, Section 2, (2)(a) states that category 1 continued competency credits can be earned from providers approved by another physical therapy licensing agency. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.

New York Physical Therapists & Physical Therapist Assistants: PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 7.2 contact hours.

North Carolina Physical Therapists, Physical Therapist Assistants: PESI, Inc. is an approved provider with the Illinois Division of Professional Regulation, Provider Number: 216.000270. This intermediate course is approved by the North Carolina Board of Physical Therapy Examiners by virtue of PESI Inc. approved provider status with the Illinois Division of Professional Regulation. This course qualifies for 6.0 continuing education hours.

Texas Physical Therapists & Physical Therapist Assistants: This self-study activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2406032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. Instructional level: Intermediate. This activity will provide 6.0 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.

Utah Physical Therapists and Physical Therapist Assistants: This course is designed to meet the Utah DOPL Rule R156-24b-303b.2.c.iv - A commercial continuing education provider providing a course related to the practice of physical therapy. Please retain a copy of the advertising brochure and your certificate of completion to provide to your board should this be requested of you. This self-study activity consists of 6.0 clock hours of continuing education instruction.

Vermont Physical Therapists & Physical Therapist Assistants: CE credit is available. This course consists of 6.0 continuing education credit hours for Vermont Physical Therapists. The Board confirms acceptance of continuing education programs that are recognized by other state physical therapy licensing boards. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.

Virginia Physical Therapists & Physical Therapy Assistants: CE credit is available. This course consists of 6.0 hours of type 2 continued competency credit for Virginia Physical Therapists and Physical Therapy Assistants. Regulation 18VAC112-20-131, Section B, (2) states that up to ten type 2 continued competency credits can be earned by completing independent study activities related to the clinical practice of physical therapy.

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Speech-Language Pathologists & Audiologists
This course contains 5.5 hours of self-study continuing education. It was not offered for ASHA CEUs. Please retain your certificate of completion. If audited for ASHA Certification Maintenance, you can submit this certificate of completion at that time. For state licensure, teacher certification renewal, or other credential renewal, contact those agencies for information about your reporting responsibilities and requirements.

California Speech-Language Pathologists/Audiologists: PESI, Inc. is an approved provider with the California Speech-Language Pathology and Audiology Board, #PDP 319. This course meets the qualifications for 5.5 hours of self-study continuing professional development credit for Speech-Language Pathologists or Audiologists, as required by the California Speech-Language Pathology and Audiology Board.

Florida Board of Speech-Language Pathology and Audiology: PESI, Inc. is an approved provider with the Florida Board of Speech-Language Pathology and Audiology. Provider Number: 50-399. This self-study course qualifies for 5.5 continuing education credits.

Kansas Speech-Language Pathologists: Approved for 7.0 self-study continuing education clock hours for Kansas licensed Speech-Language Pathologists by the Kansas Department for Aging and Disability Services.

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Other Professions
This self-study activity qualifies for 6.0 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

• Occupational Therapists
• Certified Occupational Therapy Assistants
• Physical Therapists
• Physical Therapy Assistants
• Speech-Language Pathologists
• Nursing Home Administrators
• Billing/Finance Department Staff