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OIG Upcoming Changes
OIG Tips Series ~ OIG upcoming changes in CMP and Exclusions were highlighted by Inspector General Dan Levinson at HCCA’s Compliance Institute this past spring. In continuing his use of colorful...
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Therapy Groups
The question of therapy groups always seems to come up for therapy providers after a staff member has attended a CEU course, or perhaps sought out advice via an online message board or list serve....
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Medicare Audits
Have you had a Medicare audit? Medicare has a number of program integrity contractors that can pry into your records, while you are sleeping, as well as during the day for an onsite “surprise ” visit....
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Medicare Signature Requirements
When is a signature, not a signature? Did you know that Medicare has signature requirements? Judging from the number of emails that I have received from the MACs over the past few weeks, it would...
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Three Tips When Converting to A Therapy EMR
Are you in the process of converting to a therapy electronic medical record (EMR)? Or perhaps you are still considering which EMR program you will select? Regardless of where you are in the process,...
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Top 3 Essential Compliance Components
Do you have the top 3 essential compliance components in your therapy program or practice? You may have a compliance plan that you wrote, or purchased a compliance program off the shelf, or maybe...
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CMS to Restart Some RAC Reviews
CMS announced today that it is initiating contract modification with the current Recovery Auditors in Regions A, B, C and D to restart reviews of a limited number of issues. While CMS had previously...
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RAC Restart Facts…(Not Rumors)..So Far
The therapy community is abuzz with all the rumors and misinformation on the RAC restart facts. So far there are a few things that we do know. We know that CMS wrote letters to members of Congress on...
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Keep Using 59 Modifier
CMS issued MM 8863 on Modifiers for Distinct Procedural Services in August leaving the therapy community wondering how to best use the new subset of the 59 modifier. The subset, referred to as...
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2015 Therapy Cap Values
CMS has announced the 2015 Therapy Cap values for 2015 for physical therapy and speech-language pathology combined and occupational therapy. The therapy caps were initiated under the Balanced...
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Medicare Signature Requirements – Update
Medicare recently updated signature requirements in Transmittal 604 to the Medicare Program Integrity Manual. The updates include the inclusion of the Supplemental Medical Review Contractor (SMRC)...
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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...
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New Rules for Therapy Appeals
CMS has issued guidance for reviews at the redetermination and reconsideration levels resulting in new rules applicable for therapy appeals. Given that providers are now receiving the results of...
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Compliance Plan Seven Elements
A compliance plan should address seven elements that are based upon the Federal Sentencing Guidelines. TheOffice of Inspector General has developed numerous compliance guidances over the past 17...
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Physical Therapy Locum Tenens
Physical therapy locum tenens is once again on the on the legislative “must do” list in 2015. First, you may be wondering what does physical therapy locum tenens mean? In short, if you are a physical...
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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...
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What is A Rehab Agency?
I get calls and inquiries asking “what is a rehab agency”. Generally people have heard that a rehab agency may be a more profitable outpatient model than private practice, or that supervision rules...
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Does Medicare Cover Ionto?
Therapists always seem to ask “does Medicare cover ionto?” There is a bit of urban legend that Medicare does not cover this constant attendance modality, where in fact there is not a National Coverage...
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2016 PQRS Measures for Physical Therapy
Time to get started to with 2016 PQRS measures for physical therapy! As the new year begins physical therapists may find themselves in one of three situations regarding PQRS reporting: 1) Successful...
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2016 PQRS Measures for Occupational Therapy
There is no change in 2016 PQRS measures reporting for occupational therapy for claims based reporting. As the new year begins occupational therapists, much like physical therapists, may find...
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