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Documentation According to the OIG

July 16, 2013 0 Comments

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 General (OIG) has been auditing physical therapists in private practice as part of its published 2013 Work Plan, and in fact have published a report on their findings of a review of Spectrum Rehabilitation.

This OIG video on the importance of documentation, although not specific to therapy, provides an opportunity to gain insight into the importance of documentation of supporting a claim, as well as protecting the beneficiary as well as the provider.

There are other triggering events in 2013 which may lead to reviews and audits of your therapy documentation and claims by Medicare contractors:

  • Therapy widespread probe reviews by your MAC
  • Provider specific probes
  • ZPIC investigations
  • CERT reviews (Comprehensive Error Rate Testing Program)
  • RAC reviews not associated with the manual medical review program

Grap a cup of coffee, review the Spectrum Report, and get a “to do ” list for auditing your documentation compliance.

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Nancy Beckley

Nancy J. Beckley MS, MBA, CHC: President-Nancy Beckley & Associates LLC. Compliance outsourcing, risk assessment, compliance plans, compliance training, auditing, due diligence, investigation support for therapy providers.

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