Do you every have a therapy patient no show at your outpatient clinic? The patient that is schedule for an initial evaluation, or a follow up visit? For a new evaluation you have likely blocked off the time of a physical or occupational therapist on the schedule, and if the patient does not show up for the evaluation the time slot … Read More
Private Practice
Medicare Targeted Probe and Educate
Have you been “welcomed” by your Medicare Administrative Contractor (MAC) into the CMS Targeted Probe and Educate Program (TPE) ? CMS rolled out the TPE program October 1, 2018 in order help providers and suppliers reduce claims denials and appeals through one-on-one help. … Read More
Therapy Supervision
Therapy supervision rules differ by venue in terms of Medicare, and may differ by state jurisdiction for Medicaid. Tricare does not have therapist supervision rules for private practice, as therapy assistants are not allowed by Tricare Military policy. Medicare, Medicaid and Tricare supervision rules are payor rules. There are also practice rules for supervision noted in your physical therapy, occupational therapy or speech-language pathology practice act which should be referenced in… Read More
Aquatic Therapy Compliance
Does your facility offer aquatic therapy? If so do you have aquatic therapy compliance addressed to ensure compliance with Medicare requirements for your type of Medicare enrollment? Aquatic therapy may be offered at your facility, next door at the health club or a community pool such as the local YMCA. Look to your Medicare Administrative Contractor’s (MAC) Local Coverage Determination (LCD) for requirements on the use aquatic therapy as well as suggested documentation … Read More
Therapy Direct Access and Medicare
How does therapy direct access and Medicare get along? Therapists with direct access are often discouraged to learn that the freedom to practice without physician referral may come at a cost of insurance reimbursement, including Medicare. Does a Medicare beneficiary need a physician referral for physical or occupational therapy? … Read More
Physical Therapy OIG 2015 Work Plan
Physical therapy in the Office of Inspector General (OIG) 2015 Work Plan should be no surprise. Physical therapists in private practice have been in the cross hairs in the OIG’s annual Work Plan for the past four years. The OIG has issued several reports under Office of Audit Services #W-00-11-33220 including Spectrum Rehabilitation, LLC, Claimed Unallowable Medicare Part B Reimbursement for Outpatient Therapy Services … Read More
Compliance Consulting
TwitterFacebookLinkedin