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Rehab Documentation Reviews and RACs: Who Ate My Fax?

July 18, 2013 3 Comments
Rehab Documentation Reviews and RACs: Who Ate My Fax?

Have your faxes not been getting through to the Recovery Auditors (RACs)?  You are in good company, and by the end of this post you’ll have a surefire way to securely get your records to the RAC.  RAC manual medical review of therapy claims over the $3700 thresholds are underway and providers are getting a […]

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Documentation According to the OIG

July 16, 2013 0 Comments
Documentation According to the OIG

Has your therapy documentation been reviewed this year?  If you are participating in Medicare and your patient will exceed the $3700 threshold (PT and SLP combined, and a separate for OT) your documentation will be reviewed under the manual medical review program that is administrated by the Recovery Auditors (RACs).   The Office of the Inspector General […]

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Expedited Review When Therapy Services are Discontinued

July 5, 2013 1 Comment
Expedited Review When Therapy Services are Discontinued

Faced with $1900 therapy caps, and $3700 manual medical review by Recovery Auditors (RACs) therapy providers are cautious about providing therapy services that may not be deemed medically necessary by Medicare contractors.  In light of the change in liability for therapy over the $1900 cap in 2013, therapy providers have a choice of obtaining a […]

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On the Clock: Making Therapy Minutes Count

July 2, 2013 0 Comments
On the Clock:  Making Therapy Minutes Count

It seems that everyone in outpatient therapy knows about the “8-minute” rule with Medicare, right?  Well apparantly not so when you hear of recent provider denials by the Recovery Auditor (RACs) reviews of therapy over the $3700 threshold, or the just released OIG report on Spectrum Rehabilitation LLC.   I will have to chime in also – […]

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Manual Medical Review – The RAC Maze for Outpatient Therapy Claims over $3700 Thresholds

June 25, 2013 2 Comments
Manual Medical Review – The RAC Maze for Outpatient Therapy Claims over $3700 Thresholds

Rehab providers are now receiving ADR (Additional Documentation Requests) from their Medicare MACs for therapy over the $3700 thresholds. ($3700 for physical therapy and speech language pathology; and $3700 for occupational therapy).  The ADR letters provide instructions on how to submit requested documention to the appropriate Recovery Auditor (RAC).  It is a good idea to […]

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Manual Medical Review of Therapy Underway by the Recoverys Auditors (RACs)

June 19, 2013 0 Comments
Manual Medical Review of Therapy Underway by the Recoverys Auditors (RACs)

RAC ‘n Rehab© Series  Providers are receiving the first round of manual medical review results letters from the Recovery Auditors (RACs), and for some the results are a sobbering reality that their Medicare documentation may not be compliant.  For most therapy providers, the manual medical review of therapy claims over the $3700 thresholds is likely […]

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CMS to Therapy Providers: Change to Payment Liability for Therapy Cap Denials

May 24, 2013 4 Comments
CMS to Therapy Providers: Change to Payment Liability for Therapy Cap Denials

Change to Payment Liability for Therapy Cap Denials  In this week’s edition of CMS eNews there was an important update for therapy providers regarding the change of liability for therapy denied as exceeding the therapy caps ($1900 for PT and SLP combined, and a separate $1900 for OT) in 2013.  Currently Remittance Advices (RA) are […]

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CMS Posts FAQ on Manual Medical Review by Recovery Auditors (RACs)

April 18, 2013 2 Comments
CMS Posts FAQ on Manual Medical Review by Recovery Auditors (RACs)

RAC ‘n Rehab© Series CMS, without much fanfare, released a long anticipated Frequently Asked Questions document regarding manual medical review of therapy claims over the $3700 thresholds.  The FAQ is in reponse to the questions posed by the therapy stakeholder group a number of weeks ago prior their meeting with CMS on how the manual medical […]

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CMS Posts Slide Show on RACs and Therapy Manual Medical Review

April 16, 2013 0 Comments
CMS Posts Slide Show on RACs and Therapy Manual Medical Review

RAC ‘n Rehab© Series -CMS has posted updates to their website on manual medical review of therapy over the $3700 thresholds.  A short slide show, containing 8 slides provides little in the way of new information that what has already been communicated to the therapy community.  The presentation is suitable for Recovery Auditor outreach education, and […]

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Connolly Region C RAC Posts OP Therapy Manual Medical Review – Four Issues Posted

April 10, 2013 1 Comment
Connolly Region C RAC Posts OP Therapy Manual Medical Review – Four Issues Posted

RAC ‘n Rehab© Series – RACs and rehab have another new beginning as a result of the CMS decision to have the Recovery Auditors (RACs) take over manual medical review of outpatient therapy claims over the $3700 threshold.  Connolly, the Region C RAC, is the first of the four regional RACs to post issues related […]

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