Can anyone guess what the title to this blog is stating? In the current culture of text messaging and abbreviations for everything, it can be a danger zone for medical documentation. Unfortunately, I have...
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...
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?
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...
Paying it forward
By
Shelly Mesure, MS, OTR/L
Dec 02, 2014
‘Tis the season to be giving. My cousin shared with me recently that she had her coffee paid for twice in the past week when going through the drive-thru at a Starbucks. I feel that we could all...
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...
Pay for performance, medical necessity and Jimmo
By
Shelly Mesure, MS, OTR/L
Jun 04, 2014
Why would anyone mention value-based reimbursement, medical necessity and the Jimmo lawsuit in the same sentence? I feel they are all related, but it will be difficult to find the perfect balancing act...
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.
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...
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...