PEPPER stands for Program for Evaluating Payment Patterns Electronic Report and provides an educational tool which helps providers identify Medicare services at risk for improper payments by providing a summary of provider-specific data information. Sharing your PEPPER with your therapy
Category: Compliance
Medical Review of Claims — THE ADR
What is one of the top reasons for therapy claim denials? Poor documentation? Incomplete documentation? Missing documentation? Believe it or not, incomplete submission of necessary documentation when submitting an ADR (Additional Development Request) packet is one of the most common
Security Awareness
Did you know that every 13 seconds a home intrusion is committed? Did you know that 2,500+ cars are stolen per day? That’s almost 2 cars a minute! The next time you leave your car in a parking lot at
Shhhhhhh…..It’s a Secret!!
“We can evade reality but we cannot evade the consequences of evading reality.” –Ayn Rand Technology is the “racecar” for communication these days. All health care settings are becoming more and more dependent on technology when conducting everyday business. Recently,
TIME TO PAUSE?
CMS is in the procurement process for the next round of Recovery Audit (RA) Program contractors and as a result, announced on February 18, 2014, that it will “pause” RA activities. This will allow the RAs time to wind down
Road Block
In the January 2014 publication of McKnight’s, NASL’s, Cynthia Morton reports that a recent survey was conducted regarding claims under manual medical review for those beneficiaries who exceeded the Medicare Part B cap thresholds. This survey revealed a huge amount
FP Compliance Wishes You Happy New Year!
As this year comes to an end, some may wonder where the year has gone!? But others may think back through the year and look at all that was accomplished. We have lived our values, made it through yet more
CMS plans for ICD-10 technical testing
The Affordable Care Act (ACA) requires new standards, operating rules, and identifiers in the upcoming years. ACA also requires health plans to certify compliance with standards and operating rules and that they have completed end-to-end testing. Since all services provided
SPEECH THERAPY EVALUATION CODE CHANGING!!
Effective January 1, 2014 CPT code 92506 will be replaced by four new CPT codes related to evaluation of speech sound production, language, fluency, and voice and resonance disorders. The American Medical Association’s Relative Value Update Committee (RUC) requested to
I AM THANKFUL!
We are fortunate enough to be a member of an outstanding organization for advocacy in the long term care setting. Last week, I had the honor of meeting with members of Congress to discuss the therapy Part B cap