
Administrative Law Judge Trial -- Simulation Proceedings
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INTRODUCTION The denial of a prior authorization directly delays the ability to provide medically necessary care to a patient. The ability to navigate the appeal process in an effective, efficient and timely manner not only benefits the ability to provide clinical care but also has an immediate and direct impact on productivity and profitability to the facility.
Learning Objective:
- This presentation will provide a simulation of an ALJ trial, the 3rd and for all intents and purposes, the last effective stage within the Medicare System of appeals.
- The trial simulation will identify key elements of the process and procedure of an ALJ setting, from the viewpoints of the plaintiff (prosthetic provider), defendant (Medicare) and the Adjudication Law Judge.
- Focus will be on identifying the most common prior errors, omissions, and misconceptions of the ALJ to provide real life examples of effective trial procedures to implement and which ones to avoid.

Dale Berry, CP, FAAOP, LP
Owner
Prosthetic Xpert Consultation
Dale Berry, CP, FAAOP, LP is the owner of Prosthetic Xpert Consultation, LLC, and is licensed in Texas, Minnesota and Illinois and a Fellow of the American Association of Orthotists and Prosthetists. With over 40-years of clinical care experience Dale consults with national organizations with a focus on Clinical Operations, Regulatory Standards and Compliance.

Mitchell Dobson, CPO, FAAOP
SVP, Chief Compliance Officer
Hanger, Inc.

Lesleigh Sisson, CFo, CFm
Founder
O&P Insight
