On July 13, 2021, 4 Agencies, including the Centers for Medicare and Medicaid Services (CMS), Department of Health and Human Services published an interim final rule titled Requirements Related to Surprise Billing; Part 1 in the Federal Register. On October 7, 2021, 4 Agencies, including CMS published an interim final rule titled Requirements Related to Surprise Billing; Part 2 in the Federal Register. This webinar will teach participants what they need to know regarding Part 149 – Surprise Billing and Transparency Requirements, Subpart G – Protection of Uninsured or Self-Pay Individuals of the No Surprises Act that went into effect on January 1, 2022. Subpart G – Protection of Uninsured or Self-Pay Individuals, does apply to outpatient physical, occupational and speech therapy services provided in all outpatient therapy settings, including private practices and does include cash-based therapy practices as well as out-of-network providers. Essentially, if you provide outpatient physical, occupational and/or speech therapy services, this Good Faith Estimate requirement applies to you.
This 1.5 hour webinar will teach participants what the Good Faith Estimate (GFE) is, to which insurance carriers and patients the GFE applies to, does this apply to cash-based therapy practices, and what are the required elements of a GFE and explain the patient-provider dispute resolution process.
At the conclusion of this webinar presentation, participants will be able to:
- Identify who the Good Faith Estimate requirement applies to
- Understand the various definitions associated with § 149.610 Requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) individuals
- Define who is an uninsured or self-pay individual
- Explain what must be posted on your website and in your office regarding the Good Faith Estimate
- Discuss the timeframes in which a Good Faith Estimate must be provided to an individual
- List the content requirements of what must be included in a Good Faith Estimate
- Understand the requirements for a Good Faith Estimate for recurring outpatient therapy services
- Express how a Good Faith Estimate can be delivered to an uninsured/self-pay individual
- Recite how close the actual patient payment must be when compared to the Good Faith Estimate of expected charges
Rick Gawenda, P.T., graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Mr. Gawenda is currently the President and founder of Gawenda Seminars & Consulting, Inc. and Director of Finances for Kinetix Advanced Physical Therapy Inc., a private practice located in southern California. He has provided valuable education and consulting to hospitals, rehabilitation agencies, private practices, nursing homes, and his peers in the areas of CPT and ICD-10 coding, billing, documentation, reimbursement, and compliance as it pertains to outpatient therapy services as well as denial management and the appeals process for Medicare denied claims. Mr. Gawenda’s website, www.gawendaseminars.com, provides a valuable source of information on rehabilitation rules and regulations, coding, documentation, and reimbursement.
Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is the Past President of the Section on Health Policy & Administration of the APTA as well as Past President of the Michigan Association of Medical Rehabilitation Program Administrators.
Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing For Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes and Modifiers”.
Physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language pathologists, private practice owners and practice administrators, office managers at private practices, as well as directors, managers, supervisors, compliance officers, risk managers, and billers in skilled nursing facilities, hospital outpatient therapy departments, rehabilitation agencies, home health agencies, and comprehensive outpatient rehabilitation facilities.
In addition to the expertise and advice presented during this webinar conference, you’ll also receive a handout (in PDF format) that will include related reference links.
This webinar has not been submitted to any state board or national organization for CEU approval. A certificate of attendance will be available upon completion of the webinar for each participant and may be adequate for credit in some states; you will need to contact your state licensing regulatory body to determine whether or not credit will be granted for this webinar conference. We provide no additional information for CEU approval.
Time: Approximately 1 hour and 21 minutes (including Q&A time recorded)
There are no refunds for no shows or any other reasons once you register and payment is received. We are not responsible for organization firewalls or computer software issues that may interfere and/or prohibit your connection to the webinar portion of the presentation.
Venue system requirements:
- Microsoft Internet Explorer 7+, Mozilla Firefox 2.5+, Safari, or Chrome
- 1024 x 768 screen resolution
- Stable Internet connection, DSL or above
- Wired Internet connection; wireless is not recommended
- Flash Player 9 or higher
- Disable pop-up blockers
- Computer speakers for participants
Note: Android Smart Phones (i.e. iPhone) are not compatible.
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*** This WEBINAR PLAYBACK LINK and HANDOUTS is not to be distributed outside of your organization. If you have a larger organization and have multiple locations, then please contact us here for pricing.
