How to Win Authorization and Influence Reviewers: The Battle for More Visits
Course: #4417Level: Advanced 1 Hour 1330 Reviews
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.
On Demand
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; NY/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
Course Preview
Watch the first six minutes of the course. Register for immediate access to the full course, which will also appear on your Pending Courses page.
Learning Outcomes
- 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.
Course created on June 29, 2022
Agenda
| 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 |
Reviews
1330 ReviewsPresented By
Mike Studer
PT, DPT, MHS, NCS, CEEAA, CWT, CSST, BFPCE, FAPTA
Dr. Studer, a Physical Therapist (PT) since 1991 and a Board-Certified Clinical Specialist in Neurologic Physical Therapy since 1995, co-founded and co-owns Spark Rehabilitation and Wellness in Bend, Oregon. Additionally, he serves as an adjunct professor at Touro University and is an instructor at UNLV. Actively engaged as a practicing clinician, researcher, author, and presenter in DPT programs and continuing education, Mike was honored as the 2011 Clinician of the Year in the Neurologic Academy and, in 2014, in the Geriatric Academy of the APTA.
Dr. Studer has presented invited lectures in all 50 states and 12 countries across four continents. In 2020, he received the highest honor in PT, being distinguished as a Catherine Worthingham Fellow of the APTA. Over his 33-year career, Mike has authored over 35 articles and six book chapters and is a consultant to Major League Baseball.
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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.
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California
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The District of Columbia Board of Physical Therapy (Board) has established that PhysicalTherapy.com is an approved continuing education provider for DC physical therapists and physical therapist assistants. Licensees must adhere to all other continuing education regulations of the Board, including those related to online courses and content.
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IL Physical Therapy Continuing Education Sponsor
PhysicalTherapy.com is approved by the Illinois Department of Professional Regulation as a sponsor of continuing education for PTs/PTAs (Sponsor License #216000252). This course is offered for 1.0 hours (Advanced level).
KPTA
This course is offered for 1.0 hours (Advanced level, Category 2) by the Kentucky Physical Therapy Association (Provider #CS80-2024-APTAKY).
Maryland
This course has been approved by the Maryland State Board of Physical Therapy Examiners for 0.1 CEUs.
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Oklahoma
PhysicalTherapy.com is an Approved Provider by the Oklahoma State Board of Medical Licensure & Supervision for Physical Therapists, PT CE Provider BAP202310006. This course is offered for 1 hours of continuing education for Oklahoma PTs/PTAs.
Texas Physical Therapy Association
This course is offered for 1.0 hours (Advanced level) by the Texas Physical Therapy Association. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. The Texas Physical Therapy Association (TPTA) administers the CCAP on behalf of the Texas Board of Physical Therapy Examiners (Provider #2706033TX).
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