In my role as a consultant, speaker and presenter, one of my responsibilities is to provide my clients and participants with the correct information with references, when applicable, to successfully run their therapy practice or department while remaining compliant with Medicare and private insurance carrier rules and regulations. Over my past 19 years in my current role, I have received many “urban legend myth” questions that have been passed down that people think are true. The goal of this webinar is to dispel some of those myths. Some of the 20 or more myths that will be addressed in this webinar include:
- Therapy students can’t treat Medicare outpatients
- You can’t double book Medicare patient’s
- You can’t bill 2 CPT codes during the same 15-minute period
- You can’t bill more than 4 units per hour
- The definition of “requires direct one-on-one contact” applies only to Medicare
- Medicare requires an order to begin outpatient therapy services
- Medicare requires a re-evaluation every 10 visits
- Medicare doesn’t pay for maintenance therapy
- You must issue an ABN when a Medicare beneficiary exceeds the therapy threshold
- I can collect cash from a Medicare patient for covered therapy services
- Medicare Advantage plans follow Medicare rules and regulations
- Medicare does not pay for reevaluations same day you provide treatment
At the conclusion of this webinar presentation, participants will be able to:
- Identify the supervision requirements of a student treating a Medicare outpatient
- Describe how you can schedule Medicare and non-Medicare patient’s
- Recite what you can and can’t bill together during the same 15-minute time period
- Describe how you can bill more than 4 time-based units in an hour
- Define what the Medicare program does require for payment (order or plan of care)
- Identify the criteria for a re-evaluation to be billed to Medicare and private insurance carriers
- Recite when maintenance therapy is covered under the Medicare program
- List what services you can collect cash for from a Medicare beneficiary
- Understand the difference between traditional Medicare and Medicare Advantage plans
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. 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, billing companies, office managers at private practices, as well as compliance officers, risk managers, directors, managers, supervisors, and billers in skilled nursing facilities, hospital outpatient therapy departments, rehabilitation agencies, home health agencies, comprehensive outpatient rehabilitation facilities, and billing companies.
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 references.
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 18 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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