ACI appreciates that optimizing therapy billing requires an understanding of the regulatory requirements not only of billing, but Medicare credentialing of therapists, physicians and staff. Capturing accurate CPT codes, modifiers, correct place of service and dates of service are critical for proper reimbursement.
Since the mid-2000s Medicare credentialing and documentation requirements have undergone dramatic changes. And, for therapists, it has never been clearer how important it is to properly document the medical necessity for services in the initial Evaluation/Plan of Treatment as well as in the Clinician's Progress Report. Begining in 2009, Medicare began a renewed emphasis on signed physician orders, and what constitutes a "legible signature." Therapists must have solid protocols in place to meet all documentation requirements to be able to successfully respond to a Medical Review request.
It’s clear that the Medicare program is paying more attention to signed, documented physician orders when reviewing claims for physical and occupational therapy services. And, as all government budgets tighten, it should not be surprising that the Medicare program will continue to look for potential overpayments through the audit process. Acevedo Consulting was deeply involved with the Recovery Audit Contractor’s audits during the 3-year Florida demonstration program. Allow our experiences and expertise to aid you in preparing for the inevitable audit.
Whether in private practice or providing therapy services in a physician practice, ACI can help ensure providers meet the Medicare definition of "Qualified Personnel" and that documentation meets payer criteria. Our understanding of and particular expertise in the industry’s nuances is paramount to balancing risk and practicality while optimizing revenue.
|
CONFIDENTIALITY STATEMENT
ACI recognizes that during the review process, our team will have access to patient and proprietary information that needs to be protected from improper disclosure. Many of our projects are conducted under the attorney-client privilege doctrine and we have had the opportunity to work with some of the finest health care law firms in the industry.
In consideration of the trust placed in us, ACI agrees that the firm will not at any time or in any manner, either directly or indirectly, use any information for its own benefit, or divulge, disclose, or communicate in any manner any information to any third party without the prior written consent of the client, except as required by law. ACI will protect your information and treat it as strictly confidential.
|
|
