How to document for rehabilitation work objectively
By
Shelly Mesure, MS, OTR/L
Jun 04, 2013
As the scrutiny continues to increase on rehabilitation documentation, finding ways to document objectively has become a major focus for just about everyone involved.
The G-codes are here for payment claims — ready or not
By
Shelly Mesure, MS, OTR/L
May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers...
Medically Complex Medicare Part B
By
Shelly Mesure, MS, OTR/L
May 08, 2013
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...
Loopholes to help you track Medicare Part B therapy billing
By
Shelly Mesure, MS, OTR/L
Feb 06, 2013
Every time we send our patients to the hospital for rehab-related tests, exams or services, these services are billed to Medicare Part B, and, therefore, reduce our cap allowances. Any small oversights...
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...
Access to healthcare is NOT just an overseas problem
By
Shelly Mesure, MS, OTR/L
Nov 19, 2012
I recently had the opportunity to speak at the China Healthcare Sourcing Summit in Hangzhou, China. It was a remarkable experience and really helped me gain a wider perspective of healthcare delivery around...
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...
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.