Source: http://fearonlevine.com/WebinarListing.aspx
Timestamp: 2015-05-26 13:25:12
Document Index: 642404394

Matched Legal Cases: ['art 2', 'art 2', 'art 1', 'art 1', 'art 2', 'art 2', 'art 1', 'art 1', 'art 1']

May 26, 2015 Webinars Fearon & Levine Webinars are 90-minute seminars delivered via the Internet, designed to provide efficient and cost effective educational experiences for you and your staff in the comfort and convenience of your clinic, facility or home. These live, interactive presentations connect professional and administrative staff directly to the nation's leading experts in the areas of documentation, coding, billing, regulatory compliance, and practice management for physical therapy services. Whether one of our regularly scheduled Webinars, published here on our site, or one individualized and privately provided to meet the specific needs of your practice or facility, these presentations allow you to view and learn about critical compliance issues and ask questions and receive accurate, source-verified answers directly from the experts. Please Note: You must subscribe to FearonLevine.com at any level (Free, Basic, or Premier) to register for or purchase a Webinar.
ICD-10 Implementation: Be Ready for the Change: Part 2 To register and purchase access to this webinar please subscribe or log in.
Speakers: Rhea Cohn, PT, DPT
Webinar Date: 6/25/2015
thru 3:30 PM EDT
Recorded On: 6/25/2015 Summary: ICD-10 is scheduled to replace ICD-9 on October 1, 2015. This change will impact providers and payers throughout the industry. The ICD-10 code set is very different than ICD-9 and requires providers to make changes to internal processes including billing and documentation. Advance preparation is needed to educate staff and revise internal practice management processes so that claims submission beginning October 1, 2015 is successful.
[Additional Info About This Webinar]
Summary: This is Part 2 of the webinar "ICD-10 Implementation: Be Ready for the Change" and will include additional case examples of ICD-10 codes that will typically be reported by physical therapists and further guidance on implementation and quality assurance strategies that need to be in place prior to October 1, 2015. Both webinars will include a listing of important resources that can be used by providers for staff education as well as code conversion. The preparation for conversion to ICD-10 is time intensive and starting the process now is highly recommended.
Objectives: Objectives of this two part webinar:Summarize the differences between ICD-9 and ICD-10.Design and implement a plan to successfully transition to ICD-10.Access and utilize available resources for staff training.Successfully apply the ICD-10 codes to claims.Access payer resources pertaining to ICD-10.Implement changes to documentation prior to October 1, 2015. Develop a quality assurance process to monitor revenues after implementation of ICD-10.
[Hide Full Details]
ICD-10 Implementation: Be Ready for the Change: Part 1 To register and purchase access to this webinar please subscribe or log in.
Webinar Date: 5/28/2015
Recorded On: 5/28/2015 Summary: ICD-10 is scheduled to replace ICD-9 on October 1, 2015. This change will impact providers and payers throughout the industry. The ICD-10 code set is very different than ICD-9 and requires providers to make changes to internal processes including billing and documentation. Advance preparation is needed to educate staff and revise internal practice management processes so that claims submission beginning October 1, 2015 is successful.
Summary: This is a two-part webinar. Part 1 will provide an overview of the ICD-10 code set, strategies for successful code selection, case examples of common diagnoses reported by physical therapists, and an introduction to the documentation changes that should be made to align with ICD-10.
Objectives: Objectives of this two part webinar:
Summarize the differences between ICD-9 and ICD-10.
Design and implement a plan to successfully transition to ICD-10.
Access and utilize available resources for staff training.
Successfully apply the ICD-10 codes to claims.
Access payer resources pertaining to ICD-10.
Implement changes to documentation prior to October 1, 2015.
Develop a quality assurance process to monitor revenues after implementation of ICD-10
PQRS 2015: How to Ensure Reporting Success To purchaserecorded webinar subscribe or log in.
Speakers: Heather Smith, PT, MPH, Program Director of Quality for the American Physical Therapy Association (APTA)
Webinar Date: 2/17/2015
Recorded On: 2/17/2015 Summary: The 2015 Physician Quality Reporting System (PQRS) program includes significant changes to the reporting requirements for physical therapists and occupational therapists. [Additional Info About This Webinar]
Summary: The 2015 Physician Quality Reporting System (PQRS) program includes significant changes to the reporting requirements for physical therapists and occupational therapists. Physical therapists and occupational therapists who bill Medicare for outpatient services in private practice settings (using the 1500 claim form or 837-P) that do not satisfactorily report data on quality measures under PQRS for the January 1, 2015-December 31, 2015 reporting period, will be subject to the 2.0% adjustment in their fee schedule amount in 2017. This webinar is aimed at assisting practice administrators and owners who are looking to stay current with the annual PQRS program changes.
Objectives: Determine which proposed changes will impact your practice most with respect to PQRS in CY2015.
Identify the quality measures for 2015 that apply to physical and occupational therapists in private practice settings.
Determine the changes to practice operations you need to make in order to participate successfully.
Identify the most common pitfalls associated with unsuccessful reporting by physical and occupational therapists.
Knowing Your Cost Per Visit: Financial Essentials for Physical Therapists To purchaserecorded webinar subscribe or log in.
Speakers: Stephen M. Levine, PT, DPT, MSHA, FAPTA
Webinar Date: 10/16/2014
Recorded On: 10/16/2014 Summary: Due to the clinical focus of their professional curriculum, by the time physical therapists have graduated they most likely have had no formal training in financial management related to their professional practice. However, knowing the cost to provide physical therapy care is probably one of the most important pieces of information a therapist can have related to practice management. Knowing your cost per visit (CPV) is vital when determining whether or not to contract with certain health insurance companies, determining your annual budget, negotiating salaries and other forms of compensation with staff, and predicting the opportunity for growth of your practice in the future. In light of the ongoing policy decisions by local payers in Florida, as well as various payment models emerging with national health care reform legislation, it is more important than ever that physical therapists, especially those in private practice or in management positions, know their cost per visit, and us
Summary: This webinar will provide an overview of the basic financial statements necessary for healthy practice management, including the balance sheet, income statement, and statement of cash flows. Additionally, the concepts of fixed, variable, semi-fixed, and semi-variable costs will be reviewed as they relate to determining your clinic/facility cost per visit and the opportunity to predict the financial impact of contracting decisions based not only on the CPV calculation, but on the opportunity and sunk costs that are critical parts of healthy financial decision-making. A commonly accepted method for calculating your CPV will be reviewed, and an opportunity to discuss the use of this calculation in determining contracting decisions will be provided.
Objectives: Be able to describe basic financial statements necessary in physical therapist practice management, including the balance sheet, income statement, and statement of cash flows.
Learn how to calculate your cost per visit using both the "top-down" and "bottom-up" approaches.
Understand the variables necessary in determining the appropriateness of contracting with a health insurer when payment is likely to be less than your cost per visit.
Audit Insurance: How Investing in an Effective Compliance Plan Can Prevent Post-Audit Economic Stress/Destruction for Physical Therapy Practices To purchaserecorded webinar subscribe or log in.
Speakers: Katherine Karker-Jennings JD MS and Stephen Levine PT DPT MSHA FAPTA
Webinar Date: 5/22/2014
Recorded On: 5/22/2014 Summary: CMS has a wide-ranging array of audits available to them, many of which focus on outpatient therapy practices, and these audits can entail pre-payment or post-payment reviews that can be financially toxic for therapy providers. To be effective, Compliance Plans must be tailored to the individual practice, and should provide legal protections that can't be obtained out of a box or from generic Plans available for free on the Internet. An effective Compliance Plan, when drafted by an attorney specializing in Medicare, allows the provider/supplier to rest easier knowing that it will essentially be like buying insurance against a future substantial government determined overpayment.
Summary: Why is this information critical? The Centers for Medicare and Medicaid Services (CMS) has a wide-ranging array of audits available to them, many of which have been focusing on outpatient therapy practices for the past several years. Theses audits can entail pre-payment or post-payment reviews, and can be financially toxic for therapy providers. If the government finds a high error rate, as determined in the sole discretion of the government, than the pre-payment audit will continue indefinitely, and the post-payment audits of a small percentage of claims and documentation can be subject to an extrapolation, which may not be financially survivable. The best way to avoid a bad outcome in both of these settings is by putting in place an effective Compliance Plan.
We cannot stress enough that the Compliance Plan must be effective, the medical and billing records of the physical therapy practice must be reviewed and analyzed by outside expert consultants. A therapy practice cannot police itself; by definition it cannot detect Medicare deficiencies of which it has no knowledge. A Compliance Plan, properly drafted, would enable providers to catch and correct errors prior to any government review and avoid the potential financial destruction that can result from an adverse or extrapolated audit.
So what is a Compliance Plan? A Compliance Plan is a straightforward document which provides a road map for physical therapists to meet the requirements for proper billing under the Medicare Program and to therefore avoid violating the applicable laws, regulations, and policies that govern this heavily regulated industry. However, to be effective, Compliance Plans must be tailored to the individual practice, and should provide legal protections that can't be obtained out of a box or from generic Plans available for free on the Internet.
This critical webinar will teach you the seven fundamental elements required by the Office of the Inspector General (OIG) as necessary for any Compliance Plan. These elements reflect the fact that it is incumbent upon all health care providers to assure that adequate systems are in place to facilitate ethical and legal conduct. It is undisputed that an effective Compliance Plan is a sound financial investment on the part of any Medicare enrolled or certified health care provider, and an effective Compliance Plan, when drafted by an attorney specializing in Medicare, allows the provider/supplier to rest easier knowing that it will essentially be like buying insurance against a future substantial government determined overpayment.
Helene Fearon and Steve Levine are joined by Medicare Health Law expert Katherine Karker-Jennings for this critical topic. Ms. Karker-Jennings is the founding partner of the law firm of Katherine Karker-Jennings, P.A. and is responsible for all aspects of health care law with the firm. She has been a practicing Medicare attorney for over thirty years and is a national speaker covering such topics as Medicare Part A and B appeals, Medicare Part B audits, detecting fraud and abuse, HIPAA compliance, interfacing with government investigatory agencies, analyzing relationships under the Stark Law, and the importance and content of compliance plans for all types of providers and suppliers. She has acted as an expert witness in federal litigation involving Medicare issues, and served as special Medicare counsel in civil and criminal fraud and abuse Medicare trials. Ms. Karker-Jennings is an expert in drafting and implementing Corporate Compliance Plans for hospitals, home health agencies, durable medical equipment suppliers, and all forms of outpatient therapy practices, and represents such providers and suppliers all over the United States. She has also served as the independent reviewer/auditor in Corporate Integrity Agreements.
Objectives: Understand the differences and the synergies between a compliance plan, corrective action plan, and a policy and procedure manual
Learn how a properly drafted Compliance Plan can act as "insurance" against future adverse audits and reduce the risk of resultant financial insolvency
Learn why it is critical to have your Compliance Plan individualized to your practice and drafted by an attorney well versed in this area
Be able to describe the seven elements of a compliance plan that is drafted in such a way as to takes full advantage of the attorney/client privilege
Understand the keys to success in implementation of a compliance plan once developed
PQRS 2014 Updates: How to Ensure Success To purchaserecorded webinar subscribe or log in.
Webinar Date: 3/4/2014
Recorded On: 3/4/2014 Summary: Physical therapists and occupational therapists who bill Medicare for outpatient physical services in private practice settings (using the 1500 claim form or 837-P) can obtain a 0.5% bonus payment in 2014 if they report on quality measures under the Physician Quality Reporting System (PQRS). Eligible professionals, including physical and occupational therapists, that do not satisfactorily report data on quality measures for the January 1, 2014-December 31, 2014 reporting period, will be subject to the 2.0% adjustment in their fee schedule amount in 2016.
Summary: Physical therapists and occupational therapists who bill Medicare for outpatient physical services in private practice settings (using the 1500 claim form or 837-P) can obtain a 0.5% bonus payment in 2014 if they report on quality measures under the Physician Quality Reporting System (PQRS). Eligible professionals, including physical and occupational therapists, that do not satisfactorily report data on quality measures for the January 1, 2014-December 31, 2014 reporting period, will be subject to the 2.0% adjustment in their fee schedule amount in 2016. The 2104 PQRS program includes significant reporting changes to the reporting requirements as well as changes to the reporting mechanism and definitions for some of the most widely used measures by physical therapists and occupational therapists. This two part webinar series is aimed at assisting practice administrators and owners who are looking to stay current with the annual PQRS program changes.
Objectives: Determine which proposed changes will impact your practice most with respect to PQRS in CY2014.
Identify the quality measures for 2014 that apply to physical and occupational therapists in private practice settings.
Recognize the distinction between reporting the individual measures and the group measures.
Key to Private Practice Success: The Cost of Doing Business - Financial Essentials for Physical Therapists To purchaserecorded webinar subscribe or log in.
Speakers: Hank Balavender PT, CBI and Steve Levine, PT, DPT, MSHA
Webinar Date: 2/11/2014
Recorded On: 2/11/2014 Summary: This webinar provides an overview of the basic financial statements necessary for healthy practice management, and reviews the concepts of fixed, variable, semi-fixed, and semi-variable costs as they relate to determining your clinic/facility cost per visit and the opportunity to predict the financial impact of contracting decisions made by therapists. In addition, the importance of establishing a budget and financial metrics that will enhance practice value and performance will be presented. [Additional Info About This Webinar]
Summary: Due to the clinical focus of their professional curriculum, by the time physical therapists have graduated they most likely have had no formal training in financial management related to their professional practice. However, knowing the cost to provide physical therapy care is probably one of the most important pieces of information a therapist can have related to practice management. Knowing your cost per visit (CPV) is vital when determining whether or not to contract with certain health insurance companies, determining your annual budget, negotiating salaries and other forms of compensation with staff, and predicting the opportunity for growth of your practice in the future. In light of the various payment models emerging with health care reform legislation, it is more important than ever that physical therapists, especially those in private practice or in management positions, know their cost per visit, and use this information in managing their practice. This webinar will provide an overview of the basic financial statements necessary for healthy practice management, including the balance sheet, income statement, and statement of cash flows. Additionally, the concepts of fixed, variable, semi-fixed, and semi-variable costs will be reviewed as they relate to determining your clinic/facility cost per visit and the opportunity to predict the financial impact of contracting decisions based not only on the CPV calculation, but on the opportunity and sunk costs that are critical parts of healthy financial decision-making. A commonly accepted method for calculating your CPV will be reviewed, and an opportunity to discuss the use of this calculation in determining contracting decisions will be provided.
Objectives: Be able to describe basic financial statements necessary in physical therapist practice management, including the balance sheet, income statement, and statement of cash flows
Be able to establish a budget and budgeting process and incorporate financial metrics in the day to day operations of your practice.
Learn how to calculate your cost per visit using both the "top-down" and "bottom-up" approaches
Be able to compare your financial performance to industry "benchmarks"
Speech-Language Pathologists Say Goodbye to CPT 92506 and Hello to 4 New Evaluation Procedure Codes To purchaserecorded webinar subscribe or log in.
Speakers: Dee Adams Nikjeh, Ph.D, CCC-SLP
Webinar Date: 12/9/2013
Recorded On: 12/9/2013 Summary: This webinar presented by Dee Adams Nikjeh, Ph.D, CCC-SLP, will present the history and rationale behind these new procedure codes and will discuss how these codes may be most appropriately used in place of CPT 92506.
Summary: Speech-language pathologists (SLPs) have four new evaluation procedure codes that will appear in the 2014 Medicare Physician Fee Schedule released by the Centers for Medicare and Medicaid Services. Beginning January 1, 2014, Current Procedural Terminology (CPT) Code 92506 (Evaluation of speech, language, voice, communication, and/or auditory processing) will be deleted from the CPT Manual. It will be replaced with four new speech language pathology (SLP) evaluation procedure codes that more accurately and specifically represent evaluation procedures for voice and resonance, speech-sound production, language, and fluency. This webinar, provided by Fearon & Levine and presented by Dee Adams Nikjeh, Ph.D, CCC-SLP, will present the history and rationale behind these new procedure codes and will discuss how these codes may be most appropriately used in place of CPT 92506. All SLP procedure codes that have been revalued over the past several years will be reviewed so that SLPs may see the choices of CPT codes that are available for speech-language pathology. In addition, there will be discussion comparing professional skilled treatment versus unskilled services. Practical coding scenarios will be presented and audience participation is encouraged. Please join Dr. Nikjeh for an information-packed 90 minutes and be prepared with the latest coding information for 2014!
Objectives: Learn about the four new speech-language pathology procedure evaluation codes (CPT codes) that take effect on January 1, 2014. Understand how the four new SLP evaluation CPT codes may be best and appropriately used in place of CPT 92506.
Differentiate between professional skilled services and unskilled services
Participate in an active exchange of questions and answers related to coding and reimbursement issues as they relate to speech-language pathology services [Hide Full Details]
HIPAA Compliance: Protecting You and Your Patient To purchaserecorded webinar subscribe or log in.
Speakers: Rhea Cohn, PT, DPT, Helene Fearon, PT, FAPTA and Steve Levine, PT, DPT, MSHA
Webinar Date: 5/14/2013
Recorded On: 5/14/2013 Summary: This webinar will review the important aspects of HIPAA's privacy and security rules and the practice implications pertaining to HIPAA. Practice vulnerabilities will be identified and tips and strategies will be provided so that providers can update their current policies and procedures and internal processes related to HIPAA compliance.
Summary: Providers are increasingly transitioning to electronic medical records and use of mobile devices including laptops, cellphones, and tablets. Consequently, HIPAA compliance pertaining to protection of the patients' protected health information and the security of electronic devices is increasingly important. The government has released new, stricter rules and financial penalties related to HIPAA compliance. This webinar will review the important aspects of HIPAA's privacy and security rules and the practice implications pertaining to HIPAA. Practice vulnerabilities will be identified and tips and strategies will be provided so that providers can update their current policies and procedures and internal processes related to HIPAA compliance.
Objectives: Understand HIPAA's privacy and security rules as they relate to the provision of therapy services.
Execute a review of practice vulnerabilities related to HIPAA compliance.
Implement changes in policies and procedures to decrease financial risk related to HIPAA compliance.
Establish an ongoing methodology to maintain currency with HIPAA regulations.
2013 Medicare Changes for Speech-Language Pathology: Billing, Coding, and Documentation To purchaserecorded webinar subscribe or log in.
Speakers: Dee Adams Nikjeh, Ph.D., CCC-SLP, Helene Fearon, PT, FAPTA, and Steve Levine, PT, DPT, MSHA
Webinar Date: 3/13/2013
Recorded On: 3/13/2013 Summary: The final rule for the 2013 Medicare Physician Fee Schedule (MPFS) released by the Centers for Medicare and Medicaid Services (CMS) contains critical information for speech-language pathologists who provide services to Medicare Part B beneficiaries. This webinar will address key issues as they relate to speech-language pathology.
Summary: The final rule for the 2013 Medicare Physician Fee Schedule (MPFS) released by the Centers for Medicare and Medicaid Services (CMS) contains critical information for speech-language pathologists who provide services to Medicare Part B beneficiaries. This webinar will address key issues as they relate to speech-language pathology. You will receive the latest information on the claims-based data collection requirements for speech therapy services including the newly required G-codes and severity modifiers as well as other changes that will impact your reimbursement such as the therapy cap and exceptions process, new and revised Current Procedure Terminology (CPT) codes and the impact of Multiple Procedure Payment Reductions (MPPR).
These new Medicare requirements impact how you document the services provided, how that documentation must be reflected on your claim form, and ultimately how you are paid for therapy services provided to the Medicare Beneficiary. Join nationally-renowned expert Dee Adams Nikjeh, PhD, CCC-SLP for an information-packed 90 minutes to sort out the policies and rules for engagement as a therapy provider in the Medicare program in 2013.
Objectives: Learn about the 2013 requirements involved in "Claims-based" reporting of the functional status of your Medicare patients
Understand the latest Medicare coding and documentation changes to maximize the potential for success as a Medicare provider
Participate in an active exchange of questions and answers related to coding and reimbursement issues as they relate to speech-language pathology services
Policy Pandemonium: Medicare Part B and Therapy Services Reporting Functional Limitations To purchaserecorded webinar subscribe or log in.
Speakers: Helene Fearon, PT, FAPTA and Steve Levine, PT, DPT, MSHA
Webinar Date: 12/18/2012
Recorded On: 12/18/2012 Summary: On November 1, 2012, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule to inform providers regarding the 2013 Fee Schedule. This webinar will provide an overview of the key elements of the Final Rule and their impact on the provision, documentation, claims submission, and payment for therapy services under Medicare in 2013.
Summary: The Final Rule contains critical information on the Sustainable Growth Rate (SGR) update and other changes impacting payment, the therapy cap and exceptions process, claims based data collection of information regarding function - including new G codes that must be submitted, and updates to the Physician Quality Reporting System (PQRS).
Next year's Medicare Fee Schedule and associated payment policies continue to be under debate. These ongoing policy discussions will provide for an outcome one way or the other by January 1, 2013, and will directly impact payment of outpatient therapy provided to the Medicare beneficiary in all settings. Regardless of further refinement, new Medicare requirements affecting the therapy benefit for 2013 will impact how you document, how that documentation must be reflected on your claim form, and ultimately how you are paid for therapy services provided to the Medicare Beneficiary.
In this critical webinar, Fearon & Levine will provide information on these and other changes under Medicare beginning January 1, 2013, how to best prepare, and what to continue to watch for as policies are considered during the last couple weeks of this year.
Join Helene Fearon and Steve Levine for an information packed 90 minutes sorting out the policies and rules for engagement as a therapy provider in the Medicare program in 2013.
Learn about the impact on the fee schedule of the continued flaws in the formula to determine payment, as well as the potential scenarios related to the therapy cap as we head into 2013
Provide an understanding of changes to be implemented January 1, 2013 to maximize the potential for success as a Medicare provider
Part 2: Making PQRS Work Effectively For Your Private Practice: Beyond Implementation To purchaserecorded webinar subscribe or log in.
Webinar Date: 11/6/2012
Recorded On: 11/6/2012 Summary: Part 2 in this webinar series will discuss important process considerations beyond the basics of participation, including the importance of auditing your success and accessing, understanding, and interpreting your annual feedback reports. Helpful tips including the most common provider pitfalls in failure to achieve reporting success will be provided, and the proposed changes to the PQRS system for CY2013 will be discussed.
Summary: Physical therapists and occupational therapists who bill Medicare for outpatient therapy services in private practice settings (using the 1500 claim form or 837-P) can obtain a 0.5% bonus payment in 2012 if they report on quality measures under the Physician Quality Reporting System. The Affordable Care Act made a number of changes to the Physician Quality Reporting System, including authorizing incentive payments through 2014 and requiring payment adjustments beginning in 2015 for professionals who do not satisfactorily report. Last year, the Centers for Medicare and Medicaid Services finalized the use of the calendar year 2013 reporting period to inform the 2015 payment adjustment. Eligible professionals, including physical and occupational therapists, that do not satisfactorily report data on quality measures for the January 1, 2013-December 31, 2013 reporting period, will be subject to the negative 1.5% adjustment in their fee schedule amount in 2015. This two part webinar series is aimed at assisting practice administrators and owners who are new to the PQRS as well as those who are looking to refine their reporting process and stay current with the annual PQRS program changes. This Webinar has been approved by the Florida Physical Therapy Association for 1.5 continuing education hours.
Objectives: Recognize the importance of auditing your practices performance in this reporting program. Understand how to access and interpret the data provided in the standard annual feedback reports that are provided by Quality Net (the PQRS program administrator). Appreciate the importance of the Physician Compare Website and public reporting of the PQRS data to your practice and your clients. Identify the most common pitfalls associated with unsuccessful reporting by physical and occupational therapists. Determine which proposed changes will impact your practice most with respect to PQRS in CY2013. [Hide Full Details]
Part 1: Making PQRS Work Effectively For Your Private Practice: Getting Started To purchaserecorded webinar subscribe or log in.
Webinar Date: 9/25/2012
Recorded On: 9/25/2012 Summary: Part 1 of this series reviews the basics of the PQRS program, including the program's history and current reporting requirements, detailed review of the measure specifications and the current list of measures available to physical and occupational therapists, case studies will be utilized to provide examples to guide providers in reporting under this program.
Summary: Physical therapists and occupational therapists who bill Medicare for outpatient therapy services in private practice settings (using the 1500 claim form or 837-P) can obtain a 0.5% bonus payment in 2012 if they report on quality measures under the Physician Quality Reporting System. The Affordable Care Act made a number of changes to the Physician Quality Reporting System, including authorizing incentive payments through 2014 and requiring payment adjustments beginning in 2015 for professionals who do not satisfactorily report. Last year, the Centers for Medicare and Medicaid Services finalized the use of the calendar year 2013 reporting period to inform the 2015 payment adjustment. Eligible professionals, including physical and occupational therapists, that do not satisfactorily report data on quality measures for the January 1, 2013-December 31, 2013 reporting period, will be subject to the negative 1.5% adjustment in their fee schedule amount in 2015. This two part webinar series is aimed at assisting practice administrators and owners who are new to the PQRS as well as those who are looking to refine their reporting process and stay current with the annual PQRS program changes. Initially, participation in the PQRS program can be daunting. Part 1 of this series reviews the basics of the PQRS program, including the program's history and current reporting requirements. Detailed review of the measure specifications and the current list of measures available to physical and occupational therapists will assist providers in understanding the specific reporting requirements for each measure. In addition, case studies will be utilized to provide examples to guide providers in reporting under this program. Lastly, implementation considerations will be discussed to assist administrators and clinicians in choosing or modifying the measures utilized in their practices. This Webinar has been approved by the Florida Physical Therapy Association for 1.5 continuing education hours. Objectives: Decide when your private practice should begin participation in the program.
Identify the quality measures for 2012 and 2013 that apply to physical and occupational therapists in private practice settings.
Determine the changes to practice operations you need to make in order to participate successfully. Modify your billing to report the quality measurement codes successfully.
A Bold Change: An Alternative Payment System for Therapy Services To purchaserecorded webinar subscribe or log in.
Speakers: Helene M. Fearon, PT, and Steve Levine, PT, DPT, MSHA
Webinar Date: 3/1/2012
Recorded On: 3/1/2012 Summary: Learn how the environment has necessitated a transition from the current procedural and time-based codes to a one in which the clinical judgment and decision-making of the
physical therapists is reflected in a coding structure, the current options being discussed and developed related to payment for the future,
and how a transition to a new payment system will likely impact your practice.
Summary: Since adoption of the Balanced Budget Act in 1997, The Centers for Medicare and Medicaid Services (CMS) has been engaged in reports and projects in an attempt to develop a new payment system for therapy services. These CMS contractor reports have generated significant data and will likely serve as a basis for new models of payment, but have not yet resulted in the implementation of a new payment system that would serve as an alternative to the present procedure-based fee schedule system and arbitrary therapy caps. Recent policy changes, including the multiple procedure payment reductions (MPPR) and continued regulations that inhibit the delivery of cost-effective and efficient physical therapist care, have created not only the opportunity, but the necessity to make bold moves forward with an alternative payment model for physical therapists.APTA has also been developing a conceptual framework for a new payment system for a number of years. This concept is now moving to the next steps of modeling and implementation. Some of the key concepts that would be the basis for change include having at its core the clinical expertise and judgment of the physical therapist, reducing the oppressive administrative burdens, and dramatically changing the manner in which physical therapists services are communicated to third parties - specifically moving away from procedural, time-based coding. The desired impact of these and other characteristics of an alternative payment system would include: An improved reflection of the provision of consistent, quality, evidence-based care,The reduction of unwarranted variations in practice resulting in decreasing benefits and payment for physical therapy, andA manner in which to demonstrate value for physical therapists as key collaborators in the changing healthcare environment. As APTA's advisors to the AMA's CPT Editorial Panel, where new codes will be developed reflecting the alternative payment system, and the Relative Value Update Committee (RUC), where the values for new codes that translate into payment are determined, Helene Fearon, PT and Steve Levine, PT, DPT, MSHA, have been involved in the discussions and development of the conceptual model and continue to work with APTA and other consultants to bring the model through the next phases of development and implementation as an alternative system to the current inadequate and burdensome methodology. Join these recognized experts to understand the environment that has necessitated a transition from the current procedural and time-based codes to a one in which the clinical judgment and decision-making of the physical therapists is reflected in a coding structure, the current options being discussed and developed related to payment for the future, and how a transition to a new payment system will likely impact your practice.
Objectives: Overview of Content:
Review of why the current procedural based reporting and payment system is an unsustainable model in the third party pay environment.
Objective:Gain an understanding of the critical timing of this effort Describe the key components of the alternative payment system including the way in which clinical judgment and decision-making will be a prominent feature of its application to physical therapist practice.
Objective: Learn how this model will require physical therapists use of a common nomenclature in describing patients presentation as well as the clinical services they deliver. Outline of the timeline for further development, physical therapy professions feedback and external stakeholder communications and third party pay implications.
Objective: Plan for participation in the review, and the provision of critical feedback as well as learn how to advocate for change as the process moves forward. [Hide Full Details]
Protecting Against Audits: Defending Medical Necessity for Physical Therapy To purchaserecorded webinar subscribe or log in.
Speakers: Rhea Cohn, PT, DPT and Steve Levine, PT, DPT, MSHA
Webinar Date: 1/31/2012
Recorded On: 1/31/2012 Summary: This webinar provides critical information to help you assess whether you are appropriately justifying medical necessity in your documentation, the steps to take in the event of an audit, and the importance of developing
a corrective action plan to address any insufficiencies that may be identified through a self-assessment process.
Summary: There is no single industry-wide standard definition of "medical necessity", particularly as used by third-party payers for payment determinations, and yet the lack of medical necessity continues to be the most significant reason for denial of claims on review of documentation. The American Physical Therapy Association has adopted the position "Defining Medically Necessary Physical Therapy Services". This definition is intended to be utilized by physical therapists and payers in their ongoing efforts to find consensus related to medically necessary services. The definition was modeled after the "Model Contractual Language for Medical Necessity", developed by the Center for Health Policy at Stanford University. The key pillars of the concept presented in this model are authority, purpose, scope, evidence, and value. The definition makes a clear statement that physical therapists are professionals and must be responsible for the clinical decisions they make.The rate of audits and reviews of physical therapy services is skyrocketing, driven by multiple factors, including the OIG identifying outpatient physical therapy services as a key area of audit for the past 3 years. As a result, the number of physical therapy providers that have been targeted for medical necessity audits has begun to rise rapidly. New predictive modeling audits have generally focused on 3 key areas that can be identified on claim forms: use of the KX modifier, amount of billing under a single provider number, and number of time-based units billed per date of service. Typically, these audits happen without warning, and result in 100% prepayment review prior to any claims being approved for payment. Once documentation is submitted, denial rates are maintained due to determination of a lack of medical necessity supported in the documentation. The anxiety produced as a result of these audits, as well as the lack of cash flow resulting from this process, can be crippling to a practice. It is critical that therapy providers understand how medical necessity is defined by Medicare and other third party payers, become familiar with how it is described by the professional association representing physical therapy, learn how to effectively communicate medical necessity in clinical documentation, and understand how to respond in the event of a negative or punitive audit. Join experts Helene Fearon, PT , Steve Levine, PT, DPT, MSHA, and Rhea Cohn, PT, DPT, as they provide critical information to help you assess whether you are appropriately justifying medical necessity in your documentation, the steps to take in the event of an audit, and the importance of developing a corrective action plan to address any insufficiencies that may be identified through a self-assessment process. Don't miss this important information!
Objectives: Learn the profession's adopted definition of medical necessityLearn how Medicare defines medically necessary services for the purpose of payment of claimsUnderstand the importance of justifying medical necessity in your documentation and how the federal False Claims Act may be used against you in an audit.Understand the requirements of skilled care under Medicare and ensure you have the information to justify compliance with these requirements.Learn what steps to take should you be audited or receive an Additional Documentation Request (ADR) [Hide Full Details]
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