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...
Long-term care and therapy: It’s complicated
Sep 09, 2014
There is an option in Facebook to mark your relationship status as, “It’s complicated.” This is a great way to sum up everything, without getting too personal. Even though posting your...
Personal stories every therapist should know
By
Shelly Mesure, MS, OTR/L
Dec 17, 2013
What’s the point of all of our treatment interventions and plans of care if we can’t relate to our patients? If you can put a face and personality behind your justification for therapy services,...
Defining tolerance in therapy
By
Shelly Mesure, MS, OTR/L
Feb 12, 2014
How do you define tolerance? Is tolerance measurable? Is tolerance too subjective? What about activity tolerance? We love to document how patients are improving activity tolerance, but many times that’s...
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...
Palliative possibilities: Therein lies the rub
By
Shelly Mesure, MS, OTR/L
Apr 22, 2014
When a patient is referred to therapy, and they are receiving hospice care, then therapy needs to seek permission from the hospice company to provide any treatment. Hospice is required to reimburse the...
CMS not saying much about a payment deal that could be a game changer
By
John O'Connor
Jul 08, 2013
In recent years, many skilled care operators have nervously watched the Centers for Medicare & Medicaid Services reduce and sometimes eliminate payments for physical, occupational and speech therapy services....
Entitlement or over utilization?
By
Shelly Mesure, MS, OTR/L
Oct 07, 2014
Many of our therapy patients are medically complex and we, unfortunately, are not able to predict the future, as it sometimes seems that regulators want us to do.
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...
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...