There has been a considerable increase in Medicare Part A Additional Documentation requests (ADRs) and denials in skilled nursing facilities. The purpose of medical review is to determine whether the services are reasonable and necessary, delivered in the appropriate setting, and coded correctly, based on appropriate documentation.
Expert speaker Elisa Bovee, MS, OTR/L will begin this session by discussing recent national trends in Medical Review. The presentation will culminate in a review of the keys to responding to a Medicare denied claims with appeal tips and strategies. Additionally, you will be able to summarize goals of Medicare Medical Reviews, identify and articulate examples of the Appeal letter statements, and learn the strategies for interdisciplinary management of Medicare denied claim appeals.
Who should attend
CEOs, CFOs, Administrators, Nursing Management, Nursing Staff, Therapy Management, Occupational Therapists, Physical Therapists, Speech Pathologists and Business Office Managers
- Toni G. Cesta
Elisa Bovee, MS, OTR/L, is the Senior Vice President of Operations for Harmony Healthcare International, a nationally recognized, premier Healthcare Consulting firm specializing in C.A.R.E. (Compliance, Audits and Analysis, Reimbursement and Regulations, Education and Efficiency). In her role, Elisa manages a diversified team of HealthCARE Specialists who have extensive knowledge in the areas of Corporate Compliance, MDS 3.0, RUG-IV, Documentation, Therapy Program development and state-specific Medicaid Case Mix. Elisa...
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