General

Documentation Changes Everything: Strategies to Enhance Reimbursement for Pediatric Rehabilitation Services

Friday, November 9
2:15 PM - 4:45 PM
Location: Ballroom J - Convention Center

Pediatric physical therapists often express frustration with documentation requirements and payment for rehabilitation services. This course will examine the contemporary reimbursement climate, with a focus on utilization management. Participants will gain insights into utilization management procedures, including authorizations and rationales for the determination of medical necessity for pediatric rehabilitative care. Defensible documentation for pediatric physical therapy services over an entire episode of care will be covered, with techniques for coding and billing to maximize payment. Participants will have the opportunity to critique and create sample documentation based on a case scenario. Strategies for responding to denials for care will be presented. Internal peer review and other mechanisms to strengthen documentation and improve reimbursement will also be explored. Billing for school-based services under Medicaid will be included in the discussion, as will insurance billing for early intervention services. The content will be aligned with the APTA Code of Ethics and Guide to Professional Conduct, APTA Defensible Documentation, the Center for Medicare and Medicaid Services guidance, and current published evidence.


 

Learning Objectives:

Michele Wiley, PT DPT PCS

Assistant Professor
Shenandoah University

Michele Wiley PT, DPT, PCS received a Bachelor’s of Science in Physical Therapy from Temple University, a post-professional Doctor of Physical Therapy degree from Drexel University, and is currently a Doctor of Health Science in Rehabilitation Science candidate at Drexel University. She is an Assistant Professor at Shenandoah University and teaches documentation, ethics, and billing. Dr. Wiley was supervisor of related services for Loudoun County Public Schools, and served as the vice president of the Virginia Physical Therapy Association Pediatric Special Interest Group. She also works as a school based physical therapist and a peer reviewer for the insurance industry.

Presentation(s):

Send Email for Michele Wiley


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