Description

Inpatient rehabilitation facilities (IRFs) are experiencing a large number of denials for authorization for IRF admissions, continued stays, and for subsequent subacute rehabilitation for patients requiring care at these facilities. Many of these denials are overturned on appeal. This session will highlight case presentations by members of the Inpatient Rehabilitation and Inpatient Consultant communities in which the physiatrist was successful in obtaining insurance authorization after an initial denial. They will discuss why they felt the care was necessary in each case and what talking points they used to convince the physician reviewer. This session will incorporate audience polling features, chat, and Q&A functions to facilitate audience participation.

Learning Objectives
1. Discuss trends in insurance authorization practices as they pertain to inpatient rehab 
2. Better identify cases likely to be denied prior authorization on the first attempt 
3. Describe strategies for getting insurance decisions overturned on appeal 


Member Community
Inpatient Rehabilitation & Inpatient Consultants

Accreditation Statement
The American Academy of Physical Medicine and Rehabilitation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation of Credit
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.  

Financial Disclosures
AAPM&R requires all individuals who are in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest, which is any entity producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. Disclosures are made in written form prior to the start of the educational activity and any potential conflicts of interest that exist are resolved prior to the start of the activity through AAPM&R’s Conflict of Interest Disclosure and Resolution Policy Process. Individuals in a position to control content and their disclosed financial relationships are listed below.

Faculty
Lauren Shapiro, MD: Disclosed no relevant financial relationships.
David Steinberg, MD: Disclosed no relevant financial relationships.
Matthew Rider, MD: Disclosed no relevant financial relationships.
Adriana Valbuena, MD: Disclosed no relevant financial relationships.
Matthew Dawson, MD: Disclosed no relevant financial relationships.
Jamieson Haak, DO: Disclosed no relevant financial relationships.
Vishwa Raj, MD: Disclosed no relevant financial relationships.

AAPM&R Medical Education Committee
John C. Cianca, MD: Ownership or partnership with Musculoskeletal Ultrasound Consultants, LLC.
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Rachel A. Brakke Holman, MD: Disclosed no relevant financial relationships.
Joseph E. Burris, MD: Serves on the Speakers Bureau for, and received clinical research grants from Allergan.
David S. Cheng, MD: Disclosed no relevant financial relationships.
Theresa A. Gillis, MD: Disclosed no relevant financial relationships.
Kevin N. Hakimi, MD: Disclosed no relevant financial relationships.
Matthew T. Haas, MD: Disclosed no relevant financial relationships.
R.Samuel Mayer, MD: Royalties from Demos Medical Publishing.
Ameet S. Nagpal, MD MS MEd: Disclosed no relevant financial relationships.
Sunil Sabharwal, MD: Royalities from Demos Publishing; board member, American Board of Physical Medicine and Rehabilitation.
Sarah M. Smith, MD: Disclosed no relevant financial relationships.
Stephanie Tow, MD: Disclosed no relevant financial relationships.
Kevin R. VIncent, MD, PhD: Disclosed no relevant financial relationships.

AAPM&R CME Committee
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Cherry C. Junn, MD: Disclosed no relevant financial relationships.
Sheryl R. Levin, MD: Disclosed no relevant financial relationships.
Kentaro Onishi, DO: Disclosed no relevant financial relationships.
Evan R. Peck, MD: Disclosed no relevant financial relationships.
Cynthia G. Pineda, MD: Disclosed no relevant financial relationships.
Patricia T. Tan, MD: Disclosed no relevant financial relationships.
Brionn K. Tonkin, MD: Disclosed no relevant financial relationships.
Kristin A. Wong, MD: Disclosed no relevant financial relationships.

No other planners, faculty or other individuals in control of content disclosed any relevant financial relationships.

FDA Disclosures
All faculty members for this activity have disclosed they do not intend to discuss or demonstrate any pharmaceutical or medical device for which FDA clearance has not been approved.