Credit Hours
1.25 Business Credits
Learning Objectives
- Define defensible documentation in O&P and identify key elements required to meet medical necessity and policy coverage.
- Describe contemporary denial trends (including S&S, RAC, MAP) and how to address them in documentation and claims proactively.
- Apply strategies to anticipate and manage potential denials, including prior authorization and post-payment audits.
- Explain how outcomes data can support reimbursement efforts, including NOC coding for innovative technologies.
- Implement practical revenue cycle management approaches to “Get Paid, Stay Paid” in today’s reimbursement environment.
Course Description
Presidential Academy Think Tank Roundtable - Real World Reimbursement in O&P (PresAcadRT-2025-S4)Join Academy President Gerald Stark, PhD, MSEM, CPOL, FAAOP(D) for an insightful on-demand roundtable exploring critical reimbursement issues in orthotics and prosthetics. This session examines the meaning of defensible documentation, including how to meet medical necessity, align with coverage policies, and anticipate potential denials both before and after payment.
Learners will review current denial trends, the role of Recovery Audit Contractors (RAC), and the increasing influence of Medicare Advantage Programs (MAP). The course also highlights how outcomes data supports reimbursement strategy, particularly in validating NOC coding for emerging technologies.
By the end of the session, you will better understand how to develop documentation and claims that withstand payer scrutiny and support sustainable reimbursement in today’s evolving landscape.
Event Presenter(s)
Presenter Name(s)
• Gerald Stark, PhD, MSEM, CPOL, FAAOP(D)
• Michelle Wullstein
• Curt Bertram, CPO, FAAOP
DISCLAIMER
The user acknowledges that the workshops, handouts, and related course materials contained therein are intended for educational purposes only, and should not be considered to be legal advice or a substitute for legal or clinical consultation. These presentations address issues that are multi-faceted, and the user should not assume that the courses discuss every law, regulation, or ethical code that may be relevant to the subject matter. Legal and ethical standards are subject to change and it is always prudent to check to see whether a particular law, regulation, or ethical standard may have changed.
Refunds/Cancellations: AAOP does not offer refunds for On-Demand Library purchases.