With a child in high school and another in middle school, I have for the better part of the last ten years, been fully immersed in sports from youth to high school age. The one thing that becomes more and
Month: March 2013
New Info on Manual Medical Review Process
CMS posted last night with final guidance on the Manual Medical Review for therapy claims above $3,700. Medicare Administrative Contractors (MACs) will conduct prepayment reviews until March 31, 2013 then beginning April 1, 2013 Recovery Audit Contractors (RACs) will conduct all reviews
NON-COMPLIANCE ALERTS – THERAPY FUNCTIONAL REPORTING
Functional Pathways wanted you to be aware that you might receive non-compliance alerts for outpatient therapy functional reporting G-Codes and severity modifiers from your MAC. These alerts do not apply to institutional claims. There will be no alert messaging for institutional
Mandatory Payment Reductions in FFS
In a CMS Medicare FFS Provider e-News bulletin released 3-8-13, the Medicare Learning Network issued the following information about the effect of sequestration on Medicare Fee-For-Service Programs: Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS) Program – “Sequestration” The Budget
Outpatient Therapy Claims Crossover Problem
In the Thursday March 7, 2013 CMS FFS Provider e-News reports problems impacting crossover of Medicare Part B Outpatient Therapy Claims. CMS reports that providers who bill Medicare for outpatient therapy may have recently noticed an increase in the frequency of Health Insurance
Dementia Care Strategies
Caring for residents with dementia in a long term care setting requires an ongoing awareness of both their needs and identification of strategies that will facilitate the resident’s participation in their daily care. Caregivers must avoid offering too much assistance