Course Type: Audio Course | The Source
Presenter(s): Gwen Simons, PT, Esq, OCS, FAAOMPT, and Carmen Elliott, MS
Price: $99 Member & Members' Office Managers (must be registered by APTA member) | $169 Nonmember (subject to change)
CEU: 0.2 CEUs (2 contact hours)
Description: Are your patients being wrongfully denied medically necessary treatment when they have not met their benefit limit for PT services? Is your care interrupted or delayed by overly burdensome preauthorization requirements every few visits? Did you know there are new federal claims processing and appeals rules under the Affordable Care Act that entitle your patient to internal and external appeals when medically necessary services are denied or even partially denied?
Arm yourself with winning strategies to get visits approved and denials overturned by using the new federal rules for health plans on Internal Claims and Appeals and External Review Processes. Join Gwen Simons, Esq, PT, OCS, FAAOMPT, author of Using the Laws to Get Paid, and Carmen Elliott, MS, director of payment and practice management at the American Physical Therapy Association (APTA) for an eye-opening audio conference that will shed light on how you can easily and successfully set up your appeals procedures to overturn denials (even partial denials) get paid! You’ll learn how to hold payers and utilization review entities accountable for processing your preauthorization and payment requests in accordance with state and federal laws. You'll also learn how to file complaints against payers who violate the laws that protect you and your patients.
Purchase: View full course description at the APTA Learning Center.