Authorization denied. Are you tired of having your length of stay or your number of visits dictated by an impersonal algorithm, or an insurance reviewer that does not understand the "case" (person) that you are working with? Do you feel that you have lost control over your professional role and clinical decision-making about prognosis, intensity, and interventions? Are you experiencing burnout because of your battles with peer-to-peer reviews and forms? Finally, do you feel incapable and caught between payers, families, administrations, and policies - leaving you to blame for not advocating effectively enough for the people that you entered your profession to help and defend? Let's talk about how to win these battles, proactively, and restore your agency, trust, and peace.
Course created on June 29, 2022
Course Type: Recorded Webinar, Audio
CEUs/Hours Offered: AK/1.0; AL/1.0; AR/1.0; AZ/1.0; CA/1.0; CO/1.0; CT/1.0; DC/1.0; DE/1.0; FL/1.0; GA/1.0; HI/1.0; IA/1.0; IACET/0.1; ID/1.0; IL/1.0; IN/1.0; KS/1.0; KY/1.0 Category 2; MA/1.0; MD/0.1; ME/1.0; MI/1.0; MN/1.0; MO/1.0; MS/1.0; MT/1.0; NC/1.0; ND/1.0; NE/1.0; NH/1.0; NJ/1.0; NM/1.0; NV/0.1; NY/1.0; OH/1.0; OK/1.0; OR/1.0; PA/1.0; RI/1.0; SC/1.0; SD/1.0; TN/1.0; TX/1.0; UT/1.0; VA/1.0; VT/1.0; WA/1.0; WI/1.0; WY/1.0
- After this course, participants will be able to list three examination strategies to position rehabilitation professionals for proactive insurance authorization.
- After this course, participants will be able to describe two communication strategies that should be used in peer to peer (payer to reviewer) conversations over authorization.
- After this course, participants will be able to describe the clinical decision making processes that govern treatment, patient education, and progress testing while providing care for persons with third party payment that is subject to managed care or utilization review.
|0-5 Minutes||Background, review of learning outcomes|
|5-10 Minutes||Introduction to the trends and emergence of insurance authorization|
|10-20 Minutes||The evolving methods of insurance decision making|
|20-30 Minutes||The initial examination as a proactive tool in authorizations|
|30-40 Minutes||Clinical decision making in treatment, patient education, and progress testing in managed care or utilization review|
|40-55 Minutes||Communicating your case: EMR, verbal, and appeal letters|
|55-60 Minutes||Summary, Q & A|
PT, DPT, MHS, NCS, CEEAA, CWT, CSST, BFPCE, FAPTA
Dr. Studer has been a PT since 1991, and an NCS since 1995. He is co-founder and co-owner of Spark Rehabilitation and Wellness in Bend, where he is an adjunct professor at the OSU DPT program leading the coursework on motor control. Mike was recognized as the 2011 Clinician of the Year in the Neurologic and (in 2014) the Geriatric Academies of the APTA. He received the highest honor available in PT in 2020, being distinguished as a Catherine Worthingham Fellow of the APTA in 2020. Dr. Studer has authored over 35 articles, and six book chapters, and is a consultant to Major League Baseball.
Financial disclosures: Mike Studer received an honorarium for this course.
Non-financial disclosures: Mike Studer has no non-financial disclosures.
Sponsor Disclosure: This Course is presented by PhysicalTherapy.com, a Continued site.
Content Disclosure: This learning event does not focus exclusively on any specific product or service.
Course participation information
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Texas Physical Therapy Association
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