On Jan. 24 of this year, the Jimmo vs. Sebelius class action lawsuit was settled. This was a significant win for us, the healthcare providers. As we continue to work out the details, I feel now is a good...
No more Rehab Medium RUG defaults
By
Shelly Mesure, MS, OTR/L
Oct 08, 2013
Well, Oct. 1 has passed, and we’re all still hanging in. The biggest changes we saw to rehab were the addition of reporting co-treatment minutes on our billing logs and Section O on the MDS. And,...
Therapy with a twist (of lemon)
By
Tim Mullaney
Oct 01, 2013
As you read this, you might be eyeing the new RAI manual that takes effect today, and are feeling a bit overwhelmed at the sheer number of new pages. So it’s with great regret that I have to add...
What’s on Your PEPPER Report?
By
Shelly Mesure, MS, OTR/L
Sep 10, 2013
Have you received your provider-specific PEPPER report yet? The Program for Evaluating Payment Patterns Electronic Report (PEPPER) were mailed on August 30 and have been slowly arriving at skilled nursing...
Are you prepared? 5 questions you need to know the answers to
By
Shelly Mesure, MS, OTR/L
Aug 27, 2013
With all the recent regulatory changes that have come down the line, or are about to, we developed a simple five-question survey that each provider had to ask every therapy employee. If you can develop...
50 shades of G-coding
By
Shelly Mesure, MS, OTR/L
Jul 02, 2013
Sorry, ladies, I didn’t mean to get your hopes up with that title. But does anyone else feel like there is a lot of ambiguity to the new G-Coding system? Well, it’s a little too early to tell...
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...
Therapy is more than revenue and service
By
Kristy Wikum
May 22, 2013
How do skilled nursing facilities, clinics and hospitals think about therapy? Focusing on patient satisfaction and revenue is a good start, but it is not enough. As therapy continues to be scrutinized...
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...
A study that may never be done — but should
By
James M. Berklan
Mar 28, 2013
Government agencies and lobbyists are famous for conducting studies that prove a point — theirs, namely. That’s why I’ll be very interested to see who will have the courage to conduct one...