2806 – Documentation and Reimbursement

Intermediate / Symposium 2-hour Lecture

Sanibel, FL / Wednesday, June 30, 2010 – 9:40 am-12:00 pm – 2.0 credit hours equal to 2.0 CECs/.2 CEUs

(Classroom: 9:40 am-12:00 pm)

Faculty: Brenda Klass, PhD, MFT, DACFE

COURSE DESCRIPTION:

Accurately processing health insurance claims has become more exacting at the same time health insurance plan options have rapidly expanded. These changes, combined with modifications in state and federal regulations, affect the health insurance industry and are a constant challenge to individuals providing the service. Those responsible for processing health insurance claims require thorough instruction in all aspects of medical insurance including plan options, carrier requirements, state and federal regulations, abstracting relevant information from source documents, accurately completing claims forms, and coding diagnoses and procedures.

Proper documentation is vital to reimbursement and patient care in the therapy setting. Improper documentation can lead to a host of problems including denials, decreased reimbursement and lawsuits. Unfortunately, therapists don't receive formal training on documentation and are often left to decipher the confusing requirements set forth by Medicare, Medicaid, and managed care companies, alone.

With the release of the 2009 National Patient Safety Goals (NPSG) came some cumbersome documentation requirements. Find out how to navigate your way through all the paperwork.

COURSE OBJECTIVES:

1) Introduce information about major insurance programs and federal health care legislation.

2) Provide a basic knowledge of national diagnosis and procedure coding.

3) Simplify the process of completing claims forms.

4) Determine helpful words and specific sentences that are good to use in documentation so there is no more guesswork involved.

FACULTY: Brenda M. Klass PhD, MFT, DACFE, Care Center Rehabilitation and Pain Management, has been involved in patient care and practice management for over 30 years. She is a licensed health care professional, a certified medical practice manager, certified in medical reimbursement, and certified in California workers compensation bill review. She founded Care Center Rehabilitation and Pain Management over 25 years ago and has taken the Center thru Medicare Certification. Prior to the Center, she was hospital based and involved with JACHO certification and establishment of the hospital billing departments relative to functional restoration. She has been heavily involved in the education of professionals, functional restoration, as well as education of individuals who are involved with legal and billing aspect of various therapies. She works closely with a health care attorney and stays on top of all new legislation coming down the pipeline, which could affect professionals treating injured individuals. Currently, she is involved in establishing contractual agreements with payers for functional restoration treatment and training of its staff in the coding and reimbursement of these services.