A SNFs Guide to Appealing Medicare Contractor Denied Claims

Event Information
Product Format
Prerecorded Event
Elisa Bovee, MS, OTR/L
Conference Date
Tue, Mar 24, 2015
60 minutes
Product Description

Get a Deeper Understanding of the Medicare Reimbursement System in a SNF

Skilled Nursing Facilities have seen a significant increase in Medicare Part A, Additional Documentation requests (ADRs) and denials in this area. The objective of medical review is to establish whether the services are necessary, delivered in the proper setting, and coded correctly, based on appropriate documentation.

This program with expert speaker Elisa Bovee, MS, OTR/L, will allow rehabilitation professionals to provide quality healthcare through an understanding of the Medicare Reimbursement System in a skilled nursing facility.

Session Highlights:

  • Discussion on the recent national trends in Medical Review
  • Find out the keys to responding to a medical record request and appeal tips and strategies
  • Learn about the specific denial trends associated Medicare Part A Skilled Nursing Facility claims following hospitalization for a psychiatric diagnosis.
  • Summarize goals of Medicare Medical Review related to a Skilled Nursing Facility stay after an acute psychiatric stay
  • Insights on strategies for interdisciplinary management of Medicare documentation requests and appeals

The following will be referenced and reviewed:

  • Medicare documentation review trends related to Skilled Nursing Facility (SNF) stays after an acute psychiatric stay
  • Discussion on Medicare benefit policy manual coverage of extended care Skilled Nursing Facility (SNF) services
  • Clinical denial reasons and trends
  • Additional Documentation Response (ADR)
  • Appeal rights and process
  • Keys to success

Who should attend
Nursing Management, Administrators, MDS Coordinators and Business Office Managers, Rehabilitation Managers, Therapy Professionals


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About Our Speaker

Elisa Bovee - Medicare Billing Expert

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...   More Info
More Events By The Speaker

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