While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare...
Reviewing the top 10 errors in rehab documentation
By
Shelly Mesure, MS, OTR/L
Apr 23, 2013
As a long-term care therapy consultant, I work on a lot of claim reviews and denials management with my clients. I’ve also read a lot of peer-review research articles related to this subject, and...
Do you know your P’s and Q’s of QAPI?
By
Shelly Mesure, MS, OTR/L
Feb 21, 2013
The Quality Assurance and Performance Improvement system from CMS is on our doorsteps. As facilities have been training and educating themselves, the new QIS (Quality Indicator Surveys) are ready to roll....
OIG? OMG! One lump problem
By
Shelly Mesure, MS, OTR/L
Jan 23, 2013
The Office of the Inspector General’s recent report about what it calls $1.5 billion in inappropriate Medicare payments to skilled nursing facilities should be yet another wake-up call to providers.
Home (safety) for the holidays
By
Shelly Mesure, MS, OTR/L
Dec 21, 2012
It’s hard to believe the holidays are already here. As I have frantically baked cookies, mailed holiday cards and waited in long lines for the perfect gift, I couldn’t help but people-watch....
Beware of hospital observation loopholes
By
Shelly Mesure, MS, OTR/L
Dec 07, 2012
Hospitals have been undergoing more and more restrictions on re-admissions and are now facing financial penalties in some situations. Unfortunately, this has also resulted in more patients not being classified...
The Manual Medical Review mess
By
Shelly Mesure, MS, OTR/L
Oct 29, 2012
What a mess — and that’s probably an understatement! Medicare Part B decided to roll out its new manual medical review process by dividing providers into three phases. If you are unfortunate to...
Are computers overtaking the therapy department?
By
Shelly Mesure, MS, OTR/L
Oct 18, 2012
Are we being replaced by computers? Most likely the answer is no, but … computers have made our jobs more efficient, right? Right?
With new rules, more payment denials expected
By
Shelly Mesure, MS, OTR/L
Oct 02, 2012
Here it comes again! The Oct 1, 2012, federal regulatory changes will not only impact reimbursement but new reporting requirements also will multiply denials for skilled nursing providers across the country.
Grandma has an iPad, what now?
By
Shelly Mesure, MS, OTR/L
Aug 07, 2012
Yes, it’s true: Our seniors are tech-savvy and love their gadgets. But where does this leave us as clinicians and caregivers? Hopefully, not in the dark.