5 Common Processing Mistakes You Can Check Right Now… PHYSICAL THERAPY PRACTICE TO RETURN $634,837 UPON FAILING AN OIG AUDIT In August 2014, the Office of Inspector General (OIG) released a report of the audit that had been conducted on an Illinois physical therapist. Their review sampled 100 random claims out of the 4,298 Medicare…
In this eighth in our series of Blogs asking the question, “Is your practice ready for a Medicare audit?” We discuss Discharge Notes. Though sometimes overlooked or hurried by clinicians, the Discharge Note is an important part of the overall documentation package. A thoughtfully prepared note can indicate to an auditor that the practice owner…
In this seventh in our series of blogs asking the question “Is your practice ready for a Medicare audit?” we discuss Treatment Notes. “If you did not write it, you did not do it.” This is usually one of the first lessons we learn as clinicians. Simply stated, Treatment Notes are where you write what…
In this sixth in our series of Blogs asking the question “Is your practice ready for a Medicare audit?” we explore specific coverage guidelines and documentation requirements for some of the most common Modalities, Exercises and Activities therapists use in treating their patients. CMS is quite explicit in defining what the clinician is required to…
In this fourth in our series of Blogs asking the question “Is your practice ready for a Medicare audit?” we discuss The Plan of Care and the critical role we have seen it play in provider audits. Therapy services shall be payable when the medical record and the information on the claim consistently and accurately…
Each year the Office of Inspector General releases their action plan for the following 12 months. Â It is the ultimate To Do List; giving us insight into where they will be dedicating resources. Â Not surprisingly, the OIG is looking at areas of high utilization, improper or incomplete documentation, and providers and suppliers billing for services…
MEDICARE THERAPY CAP FOR 2014 On December 26, 2013, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients from taking effect on January 1, 2014. The new law also extends several provisions of…
In this third in our series of Blogs asking the question “Is your practice ready for a Medicare audit?†we continue our discussion of the critical importance of the PT/OT Evaluation. Medicare assigns significant weight to the patient information gathered and presented by the therapist during The Initial Evaluation. The initial evaluation records objective measurable…
In this second in our series of Blogs asking the question “Is your practice ready for a Medicare audit?†we discuss the critical importance of the PT/OT Evaluation. Without question, The Initial Evaluation is your first and best tool in establishing and documenting the medical necessity for skilled therapy services. It is your opportunity to…
It is each Medicare provider’s responsibility to read and fully understand the rules and regulations that have been established for their specialty in Local Coverage Determination (LCD’s) and other official communications. In the event of an audit or other review of your claims, it is prudent for a practice owner to expect that Medicare’s auditors…
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