>> The American Speech-Language-Hearing Association is pleased to welcome you to this online education
program entitled "Documentation Essentials For Pediatric SLPs: Articulating the Need
for Skilled Services."
Here with us today is Gennith Johnson, Associate Director of health care services and speech-language
pathology.
Welcome, Gennith.
>> Hi, Jill, thank you.
I would first love to give a warm welcome to Shannon Butkus, our speaker of the hour.
Welcome, Shannon.
>> Thank you.
I'm really excited to be here.
>> Great.
Before we start, Shannon, let's talk a little bit about why we planned this webinar.
I know you have over 15 years of experience as a clinician and over 10 years of experience
as the owner of a private practice.
I also understand you have an in-depth knowledge of how to successfully advocate for patient
benefits and provider reimbursement rates at the state and national level.
Not to mention you also have lots of experience and involvement working with insurance companies
and Government agencies on the development of policies and implementation of Alternative
Payment Models.
So I was really excited to hear that you will be presenting on these topics at the upcoming
ASHA Private Practice Connect Conference in July in Baltimore, Maryland.
Why is this topic so important to you?
And what are today's participants going to walk away with to improve their practice?
>> Well, I'm really passionate about making sure children have coverage for speech therapy
services.
Over the past few years, I've had the opportunity to interact with insurers from across the
country.
Many of them have expressed concerns about the quality of documentation SLPs are submitting
when they request prior authorization.
That motivated me to really start thinking more about documentation and what we could
do as clinicians to make sure our kids got the coverage they needed and deserved.
So my hope today is that participants walk away with ideas that they can immediately
incorporate into their patient reports to not only strengthen their coverage quality
but include the likelihood that services will be approved for coverage.
>> Wonderful.
Well, let's go ahead and get started.
I can't wait to hear more.
And this sounds like a topic that our members will find really, really relevant for their
practice.
>> Perfect.
So today's title "Documentation Essentials for Pediatric SLPs: Articulating the Need
for Skilled Services," I want to briefly start with my disclosures.
I do have financial disclosures.
ASHA is providing me compensation to give this presentation today.
And then I'm also owner of a pediatric speech-language pathology practice as well as co-owner of
a health care consulting company.
Non-financial disclosures, as well.
I'm a member of ASHA's Health Care Economics Committee And I'm also ASHA's Texas State
Advocate for Reimbursement.
So the framework for today's presentation, we're really going to dive into four things.
We're going to do a brief introduction where I'll give you some practical tips.
And then we'll do a description of the disorder that necessitates intervention and an explanation
of how those disorders impact what I call a patient's functional communication in safety.
Then we're going to dive into goal writing and we'll end with discharge criteria.
So let's get started.
Introduction I'm seeing more and more that the trend for short, concise patient reports
is becoming a thing of the past.
As insurers scrutinize the costs they are spending on services, one of the ways they
do that is through a tool called utilization management.
And for us, that means we're going to see prior authorization become more and more common.
Because of that, what we write is very likely going to determine whether our patients' services
are deemed medically necessary.
If they are deemed medically necessary, our patients are going to qualify for services.
And if they are not, then even when our kids may have coverage, if our documentation doesn't
reflect the need for skilled services, an insurance company is likely to deny that.
So it's really important that we think about what we're writing, especially when we know
we have to submit it for prior authorization.
So using the strategies we discuss today, our hope is that we're going to strengthen
the quality of your patient report and improve the chances that your request for speech therapy
interventions are approved.
So I want to start with practical tips.
First and foremost, don't underestimate the importance of formating.
You want to use headings.
You want to organize your information in a logical sequence.
And a you definitely don't want to make your doctors or insurer hunt for your information.
On average, insurers reviewing our requests for speech therapy services may have between
five and seven minutes per case review.
That means they are going through them very quickly.
And they are expecting to see things flow.
If they can't find it quickly, it's really unlikely that they are going to hunt for it.
And this probably seems logical.
But we want to spell and grammar check reports.
I've previously done some co-presentations with insurers who have provided me sample
documentation.
And one of their concerns is, our reports are poorly written.
We're not spell checking them.
We're not doing a grammar check.
And in some instances, we're even using patient names that don't correspond to the patient
that we're actually talking about on any given day.
Other practical tips, we need to work efficiently.
If our patient reports are going to get longer than what we have done in the past and I suspect
they are going to, we have to work smart.
We have to use templates whenever we can.
But I want to stress the importance of not cutting and pasting clinical information.
If you begin to write the same thing for every patient every time, savvy insurers are going
to notice those patterns.
And they will start to deny your requests.
Not necessarily because your patient doesn't have a need for skilled services.
But because they don't feel it's been individualized to the unique needs of your patient.
Other ways to work efficiently.
It's helpful to develop standardized descriptions for each assessment you use.
Don't reinvent the wheel.
Those are things you can cut and paste in.
A description for a (inaudible) or a PLS 5 doesn't change from patient to patient report.
So grab those and cut those in.
And also, come up with a predesigned table that you can insert your standardized assessment
results into quickly.
Be sure to include your raw scores, your standard scores, your age equivalence, and your percentile
rates.
An insurer may want to see some combination of all of those things when making a determination
of medically necessary speech therapy services.
Then it's also important that we know the requirements of your payer scores.
Typically speaking, Medicare Part B guides documentation.
But every insurer can establish its own documentation requirements.
This is especially true for Medicaid managed care organizations.
Many of us listening today probably have Medicaid managed care organizations that we work with
Some of you may only have one or two that you have to work with.
Others of you may have 10 to 12 or even more.
And every single one of those insurers can come up with unique items that they want you
to discuss in your patient report.
So with that in mind, you need to make sure that your EMR or documentation template has
enough flexibility to meet the individual requirements of your payer.
So my suggestion is that you set up your EMR or your documentation template so that you
document to your most restrictive payer 100% of the time It's better to have extra information
in your patient report than forget to include something.
If you make it a habit of documenting to your most restrictive payer each and every time,
you'll reduce the number of times requests are sent back and forth between you and the
insurer as being incomplete.
Now, those are a few practical tips.
The next thing I want to do is really get into the meat of this, which is report writing,
and discuss what I consider to be three key elements of patient reports
The first is what I call Impact on Functional Communication and Safety And I ask myself
three things: Do my goals aim to improve the care and reduce costs through prevention?
Do my goals increase safety?
And does the intervention increase my client's independence?
If I can answer yes to any or all of those things, then I'm beginning to build a case
that my declined has a medically necessary reason for speech therapy services.
So beyond that, we're going to talk about goal writing.
And I'm going to focus on SMART goals.
Both for long-term goals as well as short-term And then we're going to end with discharge
planning, what's the end goal of treatment?
So let's dive right in.
First and foremost, Impact on Functional Communication and Safety.
The first question I ask is: Do my goals aim to improve care and reduce costs through prevention?
And here is an example: Would improved swallow function reduce the likelihood of hospitalization
or reduce a patient's reliance on a G-tube?
If you can answer yes to that question, then your client qualifies for medically necessary
for speech therapy services.
Your interventions will ultimately result in a cost savings to the insurer.
And your services are not only beneficial to the patient in that instance, but they
are also deemed beneficial to the insurer, because it lowers their overall costs.
Then we want to look at whether the goals increase safety.
For example, would a child have an increased ability to communicate safety information
in the event of an emergency situation?
If you're working with a patient that can't currently express their name, their family's
name, a phone number, or even what's wrong, then there's a need for skilled intervention.
Another thing I think about is whether my patients comprehend the words no and stop.
And if they don't comprehend the words no and stop, it places them at risk.
For example, if you're crossing a street and a patient -- you're holding your son or daughter's
hand and they get separated from you and you yell no and stop, if a child doesn't understand
that and they run into the street, there's a chance that they could be harmed.
And so we want to consider those things.
If they don't understand no and stop, then that's a reason that they may need skilled
intervention.
Another is whether the child's articulation and language delays place them at risk for
social isolation or bullying.
Unfortunately in this day and age, bullying is becoming an increasingly alarming problem.
And if a kid is at risk for bullying because they are being teased or ridiculed or excluded
as a result of their speech and language delay, then there's a skilled need for intervention.
So I think about all of those things when I'm writing my section titled: Functional
communication and safety.
Another thing I think about is independence.
Would my goals support a reduced reliance on a caregiver or other individual?
If what I'm doing during treatment increases their independence so that they can move through
their day with a reduction in support, my patients have a need for medically necessary
speech therapy services.
So let me show you what that looks like.
Here is one example of something we might write: Sam's language delays have a substantial
negative impact on her functional communication and safety.
She is not able to use words to express her wants and needs nor is she able to state the
site of pain or injury.
Additionally, she cannot state when she is not feeling well.
As a result, her family members and caregivers must infer all of her needs, making it difficult
for them to know exactly what is wrong with Sam and when her family should/shouldn't take
her to the doctor.
She is at high risk of injury due to her inability to follow simple commands such as stop, wait,
and don't touch.
Further, her communication delays prevent her from engaging in social and play activities
with same-age peers, causing periods of social isolation.
That brief paragraph, all of four to five sentences, is a clear reflection to the insurer
how the delays I have identified through my testing and evaluation process impact my client.
And when they see a statement like that, it hits home specific reasons why my client needs
speech therapy services.
Here is one more example: Based on the information collected during the assessment, Liam's delays
have a negative impact on his ability to functionally communicate across all environments.
At this time he is not using language to interact with other children his age.
And he prefers to isolate himself rather than play with other kids.
Additionally, reduced speech intelligibility, secondary to difficulty obtaining adequate
airflow to support sustained speech, limits his ability to relate information to others,
including his parents and preschool teachers.
Further, he is not participating in conversational exchanges as would be expected for a child
his age and he often wanders the room rather than engage with other children.
He is at risk of not advancing to his next classroom at a day care due to social communication
delays, which would result in him being placed in a different classroom than his twin sister.
Again, while that paragraph is a bit longer, it provides a clear explanation to the insurer
why I need to provide speech therapy services.
I see these summary paragraphs are very beneficial to an insurer when they are making a determination
either yes, they are going to pay for your speech therapy services, or no, they are not.
And framing it in terms of the impact on your patient's functional communication and safety
really makes it hit home for them.
Now, moving on to goal writing.
I want to really quickly cover the International Classification of Function, Disability and
Health, this is called the ICF.
The ICF is a classification of health and health-related conditions for children and
adults that was developed by the World Health Organization.
The ICF framework is intended to be used in an interprofessional collaborative practice.
And really in person-centered care.
The ICF is endorsed by ASHA as well as APTA and AOTA.
And insurers are actually looking to see if we're writing goals with the ICF in mind.
In this particular example, this is in Texas.
But the Texas Health and Human Services Commission actually released a document stating it was
their expectation that providers write short- and long-term goals using the ICF framework.
So what are the components of the ICF?
There's functioning and disability, which encompasses body functions and structures.
And then activity and participation.
There's also contextual factors.
These are environmental factors, which are factors that are not within the patient's
control, such as family, work, Government agencies, laws and cultural beliefs.
And then there are personal factors, which include things like race, gender, age, and
education level So what does the ICF mean for us?
Short- and long-term goals must focus on function.
Goals should be measurable, developed in conjunction with the patient and family, specific to the
patient's needs.
We can't rely on a preset group of goals that we use for all of our patients.
Again, that's a pattern that our insurers will detect over time.
Our goals have to be specific to the setting where the services are provided.
This is particularly relevant for services in the home and community setting.
More and more in pediatrics when we submit requests for prior authorization I'm seeing
insurers say, if you want to provide services outside of the clinic, then you need to justify
why.
So if you're going to do services in the home or in the community, say a preschool, make
sure you clearly relate your goals back to those settings.
So how do we do this?
We write SMART goals.
SMART goals are specific, they are measurable, they are attainable, they are realistic, and
they are timely.
Another thing insurers look at, if prior authorization is required for continued services, reviewers
will look to see if your patients mastered their goals.
You want to make sure that you set goals that your patients can reasonably accomplish.
If you set lofty goals and your patients come up short of those goals, even though they
may have made wonderful progress, you could see an insurer say to you, well, the patient
failed to master their goals.
It doesn't actually look like the speech therapy services are beneficial So we're not going
to approve the request for continued services.
So make sure that you keep that in mind.
What can your patients reasonably accomplish in the timeframe that you select?
So what are functional goals?
Functional goals represent a series of behaviors or skills that allow a patient to achieve
an outcome relevant to their safety and independence, there are those goals again, safety and independence,
within the context of an everyday environment.
So SMART goals must be specific.
They have to be objectively measured.
And within a given timeframe.
Are you setting goals that you intend to measure within an eight-week period, within a three-month
period, within a six-month period?
That's often going to be determined by your payer source.
So you may have to adjust those from payer source to payer source.
You'll also want to look at what -- how attainable your goals are in relation to your client's
progress and/or developmental delay.
So you really have to think about kids in the absence of a developmental delay may be
able to make progress at a faster pace than our kids who do present with developmental
delays, autism, Down syndrome, cerebral palsy.
So make sure to keep that in mind when you're setting your goals.
And then relevant to the client and family.
Although I don't cover it in this workshop, one of the things that we do include in our
patient report is a statement of the family goals.
And then as we develop our own goals, we make sure that those goals tie directly back to
the client and family's goals Chances are if you write goals without input from the
client and the family, and they don't happen to be important to them, you're not going
to have a lot of family support.
And in the absence of family support, your patient's rate of progress may slow.
And if their rate of progress may slow, then it may be harder over time to get continued
services, even if your patient needs those services.
And then your goals also have to be based on medical need.
Again, think what is the impact on their functional communication and safety.
Again, more and more insurers are paying attention to goals that are medical in nature versus
goals that are academic in nature.
And if you write goals that are academic in nature, while your kids may have a need for
speech therapy services, an insurer could look at those goals and say, those appear
to be goals that could be accomplished in an academic setting and they might deny them.
Now, thinking to recertification requests, you're always going to want to include your
previous authorization period's goals and provide an update on progress.
And I'm going to cover an example of that here in a few slides.
But let's talk now about long-term goals.
Long-term goals should reflect the highest level of desired function anticipated upon
discharge.
I always suggest to individuals that they think hierarchically.
What's the most complex skill you're trying to achieve within your designated timeframe?
Identify this and then designate that as your long-term goal.
Here is an example of what we shouldn't write when we're thinking about long-term goals.
Patients will develop age-appropriate articulation skills.
Or patients will develop age-appropriate receptive and express language skills.
That's a very generic goal that doesn't really tell the insurer why the speech therapy services
are important.
So instead of that goal, we might want to write something that's more specific.
Within 6 months, the patient will demonstrate the ability to participate in conversational
exchanges for up to 8 volleys in order to maintain conversations with peers and relate
critical medical and safety information to adults.
That goal is time bound, within 6 months.
It's specific.
It's measurable.
And I also state why the goal is important, which is a key for insurers.
In terms of short-term goals, we want to state why we're working on the particular skill.
I think of these as the building blocks required to master a long-term goal.
I always have my therapists write short-term goals framed around these key statements.
The patient will XYZ in order to.
Or the patient will blank so that.
And then to reduce.
To prevent.
To increase.
To decrease.
When you add the second component of these statements, you automatically tie your goal
to a function.
And you provide the reason.
And that's what our insurers are looking to see.
So if you can write your short-term goals in this type of pattern, you'll increase the
likelihood that a reviewer will look at these and say, these are medically necessary goals.
So here is an example of what we should not write.
Sam will increase her knowledge of object-functions from 35 objects to greater than 50 objects.
It's not necessarily a bad goal.
But it's not time bound.
And it doesn't state why the goal is important.
Instead, we could reframe that goal so that it said, within 3 months, Sam will increase
her knowledge of object-functions from 35 objects to greater than 50 objects in order
to carry out at least 10 activities of daily living in her home environment.
Now that I've couched that goal in this manner, same goal, but I've made it time bound.
And I've stated the reason why the goal is needed.
In this particular instance, this patient needs to increase their ability to complete
activities of daily living.
An insurer is going to look at that and say, this goal makes sense to me.
I understand why there's a need to work on it.
Here is another example, within 6 months, Sam will follow 1-step directions to increase
-- there is one of my key phrases -- her independence during the completion of at least 5 home routines
And here is my example, it's time to brush your teeth.
Go get your toothbrush.
Writing the goal in this manner makes it very relatable to the insurer.
Now, some practical tips.
Make sure that you select goals that are consistent with the information provided in your patient
report.
Does the information about the Impact on Functional Communication and Safety relate to the goals
you've written?
And is the information regarding the impact on the patient's functional communication
and safety consistent with the areas of weakness you identified?
You want to make sure that all of those things cohesively work together.
If you comment on impact and functional communication and safety related to a child's feeding and
swallowing but then turn around and write a goal for a pragmatic, an insurer is probably
going to touch that and say, where did this come from?
It doesn't make sense to me.
So make sure all of that information cohesively works together.
Now, other practical tips.
If you're going to continue a goal from one plan of care to the next, which does happen
from time to time, be sure that you don't write the goal verbatim.
You want to update the goal to reflect what the patient has achieved so far.
And where you hope to get them during the next certification period.
And here is an example.
If the original goal was that the patient will produce the phoneme /s/ in all positions
of words with greater than 80% accuracy and they have achieved 40% proficiency you can
write a subsequent goal that says, the patient will increase their ability to produce the
phoneme /s/ in all positions of words from 40% accuracy to greater than 80% accuracy
in order to -- and then you could continue on with that to tie it back to the specific
reason you're working on the goal.
Another practical tip.
As silly as this might seem, make sure that you report progress so that it matches how
the goal is written.
If you write a goal that your criteria is for 80% mastery be sure to report progress
as 7 out of 10 trials.
I think we're all thinking here that that ought to be easy enough for an insurer to
understand, don't assume that they will make that conversion for you.
Just instead of 7 out of 10 trials, write the 70% of trials.
I have actually heard of some instances where reports were sent back for additional information
because there was a mismatch in how the progress was reported.
Another practical tip.
Some of your insurers will require that you report the baseline level of performance,
especially in instances where your patient hasn't mastered the goal.
So if you have a goal within 3 months, the patient will label a minimum of 25 objects
in order to communicate their wants and needs to primary caregivers, you could document
as follows: The patient's ability to label objects and make requests increased from 3
objects to 15 objects.
The patient is consistently using 10 words to make requests.
Alternatively, you could do it as follows: The patient is labeling 15 objects and is
consistently using 10 words to make requests.
And then you'll see I clearly designate baseline, the patient demonstrated the ability to label
3 objects at the start of this plan of care.
You can report that in either way.
Just be sure to report it.
Again, I know of instances where insurers will send requests back if clinicians have
failed to include the baseline level of performance.
Now, manufacturing on to the last area, discharge planning.
And this might seem to some of you like a silly one to include.
Why is my discharge planning that important?
Again, as prior authorization becomes a more common strategy and insurers are thinking
more and more about the cost of care, they want to understand that you have a discharge
plan.
And that you don't intend to keep your patient on services indefinitely.
You know, in the model of the past, it has not necessarily been uncommon that we bring
a kiddo on for speech therapy services at the age of 2 or 3 and that they are continued
on with services at the age of 5, 6, 8, 10 years of age And we're moving beyond that
model.
And insurers want to understand and see that you're thinking about that.
So this means we have to think about what the beginning, the middle, and the end of
treatment is from the day we bring that child onto services.
Treatment in this instance then becomes something that is not lifelong.
We need to be identifying what family community resources may be available to support the
patient.
And we need to think about how we can transition our clients from our setting to those settings
as soon as it's feasible.
But I will add, without compromising the quality of care our patients are receiving.
So when we identify discharge criteria, we need to use the information generated when
discussing that Impact on Functional Communication and Safety And again, I've taken what I consider
that key section.
And I'm tying it now to my discharge plan.
I want to talk about a document quickly that was developed by ASHA.
It's called the Admission/Discharge Criteria in Speech-Language Pathology Ad Hoc Committee
on Admission and Discharge.
It was created by members of ASHA that were speech-language pathologists.
This document becomes important not only because it gives us suggestions on when we should
consider discharge for our patients, but also because insurers, during the audit process,
are using it to determine whether we have discharged our patients at an appropriate
time.
And I have seen some instances in reports produced by the Office of Inspector General
where they have found that speech-language pathologists potentially didn't discharge
their patients when it was appropriate.
And so per this document, patient and client discharge from treatment ideally occurs when
the individual family or designated guardian, as well as the speech-language pathologist,
conclude that the communication or feeding and swallowing disorder a remediated or when
compensatory strategies are successfully established.
And then they give multiple suggestions.
And I'm not going to read them all to you.
Because you'll have this as a reference But one is that the speech, language, communication,
or feeding and swallowing disorder is now defined within normal limits or is consistent
with the individual's pre-morbid status.
That's probably one of the ones we're most familiar with.
Another is that the goals of treatment have been met and the patient can functionally
communicate.
Another includes that the individual's speech and language communication or swallowing skills
no longer adversely affect their individual's educational, social, emotional, or vocational
performance.
So here we're not necessarily saying that their scores are all within the average range.
But we are saying the patient can functionally communicate to navigate through their environment.
And that's what an insurer is looking to see Now, there may be other instances where discharge
is warranted prior to mastery of treatment goals.
That could include an instance where you have an unwilling patient, where treatment attendance
has been inconsistent or poor, and where you've taken efforts to address those items.
But you don't have family support in return.
You may have a family that requests to be discharged to move to another service provider
or you could have a family that is not in your service area.
And in that instance, if that occurs, then we really have a responsibility to help that
family try to locate a provider within their new home territory.
There may be an additional reason for discharge that's appropriate, including if your treatment
no longer results in measurable benefit.
So here we're not saying that the patient has mastered their goals.
But we are saying the patient's progress has plateaued.
And if you have reached a point where your patient's progress has plateaued, even if
they haven't met all of their goals, it's time to consider whether discharge is appropriate.
And if discharge would be appropriate, then we need to discharge the patient, even if
we're in the middle of an authorization period.
And referencing back to the Office of Inspector General, this is where they cited concern.
They were reviewing treatment notes.
They saw clinicians were documenting essentially the same level of performance and progress
from treatment session to treatment session, from week to week to week to week.
And rather than discontinuing those services, say after a four- to six-week period, or having
a conversation with the family if there was an adjustment that needed to be made in their
plan of care, they stayed the course to the end of the authorization period and didn't
discharge the client.
And that was concerning to the auditor.
Another reason it might be appropriate to discharge is because the patient has a serious
medical, psychological, or other condition, or if you experience behaviors with your client
that are interfering with their improvement in participation.
And in those instances, it may be need to take a break from services, help them case
manage their needs with other service providers, and then readmit them to your practice at
the point in time in which they are stable to continue and make progress towards goals.
Thinking these things through will really help you be successful in writing your patient
reports.
So a few practical tips with respect to discharge planning.
You want to avoid these statements, don't write something that says, when maximum potential
is met.
Or when functional potential is met Those statements will probably be flagged by your
insurer and sent back to you for more information because they are really not specific.
They don't demonstrate to the insurer anything about the beginning, the middle, and the end
of treatment So here is an example, discharge is not expected
within the next 6 months due to the severity of Sam's delays and the complexity of the
goals established.
Discharge will be considered when Sam can successfully: Follow directions to assist
in the completion of activities of daily living.
Use words/approximations to state her wants and needs to her primary caregivers.
And when Sam can state the site of injury or illness to assist in her medical care.
I based my discharge criteria on the things I wrote in my section titled Impact on Functional
Communication and Safety.
So I've essentially written that section I've now written goals that are consistent with
that section.
And here my discharge planning is consistent with my goals and consistent with my section
titled Impact on Functional Communication and Safety.
When I have information that's that seamless, it shows to the insurer I have a plan.
And again, that plan increases the likelihood of coverage.
Here is a second example.
Discharge is not expected over the next 6 months as Sam has a number of skills he needs
to acquire before achieving the ability to functionally communicate.
Long term, the SLP anticipates discharge when Sam can complete the following tasks: Transition
through his day with a minimal number of protest behaviors.
Initiate and maintain social relationships with peers.
Use short sentences to comment on activities and express his wants and needs.
And ask and answer questions in a conversation at format to provide critical personal and
safety information.
Again, I'm telling that seamless story.
And I'm showing to the insurer from Day 1 I'm thinking about discharge.
Therefore, I'm increasing the likelihood of coverage
So a few concluding thoughts.
When we're documenting medical necessity, your client's coverage and your ability to
seek reimbursement through an insurer is dependent on the quality of your documentation.
Unfortunately, as insurance requirements increase, the length of our reports are likely to increase.
So you want to make sure that you plan accordingly and make sure you give yourself and your staff
adequate time to write your patient reports.
In my practice, we used to be able to write a patient report in an hour to an hour and
a half.
I live in a state where we have seen some pretty significant increases in expectations
relating to our documentation and evaluation reports.
Because of that, I now have to a lot two to two and a half hours for my SLPs to write
patient reports.
But because we're willing to spend the time upfront and make sure we get the patient report
right and correct, we have better than a 98% approval rating.
And we have really almost eliminated the time we have to spend during the appeals process
in fighting for coverage.
And for us, that extra time upfront makes it more than worth it.
So make a goal.
Now that we're at the end of this workshop, let's think about one thing you can implement
from this course in the next week or month.
One item, if you don't already have it, might be to build in that section titled Impact
on Functional Communication and Safety.
And really spend the next month integrating those into your patient reports.
You would want to set a calendar reminder to check your progress.
And when you do, share your experience on social media so we all know how it's working.
Thanks so much for joining us today.
It's been a pleasure to give this workshop.
>> Thank you so much, Shannon, for sharing so much helpful information.
I'm really looking forward to hearing more at the upcoming ASHA Private Practice Connect
Conference in Baltimore this July.
Thank you, again, to all of our participants.
And we hope to see you at another webinar soon.
Goodbye for now from the ASHA National Office.
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