[3444] Clearing the Path to Pediatric Reimbursement
Hear strategies on how to avoid claims recoupment from clinical record audits to improve audit outcomes from pediatric payors.
Presentation Info:
- TAHC&H Virtual Event | 51st Annual Meeting & Conference | Recorded for On-Demand Access
- Presentation Date | September 3, 2020
Education-Training Credits:
- TX HCSSA Administrator/Alternate Continuing Education
CE Approval Statements:
· This program meets continuing education requirements
for Administrators and Alternates under Texas HCSSA licensing regulations.
1
HCSSA Topic(s) Addressed:
- §558.259[d][4]agency responsibilities
- §558.260[a][3]basic principles of management in a licensed health-related setting
- §558.260[a][5]quality improvement
- §558.260[a][7]financial management
Program Description: All too often professional staff submit a Plan of Care (POC) anticipating Payor approval, yet later
hear their POC was denied due to missing payor specific documentation requirements. In this presentation, Beverly Sepulveda will highlight the specific documentation you
will need to decrease your denials and improve payor approval. This will include critical elements that must be included in the Plan of Care, treatment notes and
telehealth notes. Hear strategies on how to avoid claims recoupment from clinical record audits to improve audit outcomes from pediatric payors.
TAHC&H Faculty/Presenter(s): Beverly Sepulveda, MBA, BSN, RN, SynerImages Healthcare Consulting
About the Presenter(s):
Beverly Sepulveda is the founder, CEO, and Principle consultant for SynerImages Healthcare Consulting,
a national healthcare and regulatory consulting firm in operation for over 23 years. She holds a Master's in Business Administration and a Bachelor of Science in Nursing.
Her nursing specialization is in quality assurance and accreditation compliance. Ms. Sepulveda's consulting expertise covers a broad array of areas including Home Health Agencies,
Therapy clinics, ORFs, CORFs, Hospitals and the MCO industry. Ms. Sepulveda's company specializes in start-up healthcare business seeking state and federal licensure, cloud-based
policies and procedures, on-going regulatory compliance services and insurance contracting assistance. In addition to offering home health startup and compliance services, her
firm also facilitates other business needs such coordinating medical equipment inspections, application management services, educational conferences/webinars and other business operations assistance.
[3444] Clearing the Path to Pediatric Reimbursement
