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Medicare Coverage, Payment & Denials

Course Overview

Coverage and payment for therapy services are related, but separate terms and are regulated by separate authority. An understanding of the Medicare terminology is essential for therapists to ensure services meet coverage criteria and can be paid. Payment for service is at risk when coverage is not proven in the medical records. This Course explains the differences and also provides proven strategies to respond to ADRs (Additional Development Requests) and TPE (Targeted Probe & Education) reviews.

CEUs Earned

1.0 CEUs


Course Format

Independent online learning

Course Curriculum

Payment Terms

The lingo of Medicare

Understanding Coverage Criteria

Coverage criteria explained in a way that makes sense to therapists including the definitions for skilled, reasonable and necessary care.

CERT Errors

The most common errors by therapists and ways to prevent errors in your records and in your claims.

Course Exam

Final test to show off all you have learned and so that you can earn your Certificate for CEUs.

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