Let's Help Each Other

Physical therapy is changing rapidly. As a PT with more than thirty years of experience, the changes observed in the last ten years triple those of the first twenty years. The pace of change is not slowing down. The Medigraph Blog will serve as a forum that will enable us to exchange ideas and assist each other. This blog will be used to share billing, documentation, and any other ideas to improve any aspects of our profession. If we share what we have learned, we can develop a resource that enables our collective understanding to advance our careers.

As profit margins grow smaller and expenses grow larger, we need to assist each other to survive and prosper. If we share our experiences we can help each other to grow professionally, administratively, and financially. Our professional lives, our livelihood, and our personal lives are intertwined. Our resources individually are limited. Together we can accomplish more than we can individually. Let's help each other

Regards,

Tom Kane, PT
MediGraph Software

Second Quarter RACs Capture $592.5 million
7/18/2011 6:13:00 PM
The June report from The Centers for Medicare & Medicaid Services (CMS) has been released.  In the first half of 2011 RAC audits have captured $592. 5 million in refunds from medical providers.   At this pace , RACs will collect $1,850 billion in refunds for 2011.   Realisitcally, the $1.850 billion is a low estimate because RACS are gaining efficiency from their experience.  The greater efficiencies have resulted in a steady increase in refunds.  In each quarter reported, the RACs collect more than the prior quarter. The most problematic area for providers remains proving medical necessity for the treatment rendered (http://www.cms.gov/Recovery-Audit-Program/Downloads/FFSUpdate.pdf).
 
Throughout the MediGraph blog and in occasional emails, we have continued to emphasize the importance of establishing the medical necessity of treatment.   We have stressed the importance of using the impairment model of physical therapy to support the disablement model.  The impairment model (ROM, strength, pain, etc.) will not stand alone as justification for intervention.   The disablement model must demonstrate that the patient has a functional loss that is verified by objective assessments (functional tests like the 6 Minute Walk, Timed Up and Go, and peer reviewed outcome questionnaires such as OPTIMAL, Lysholm Knee Index, etc.).   All of the tools that you need to prevent a RAC from picking your pocket are contained in MediGraph.  These procedures consume time but they are not difficult to perform.  If you are not using these tools, start today.  If you need assistance or would like to discuss this matter, please call.  
 
Regards,
Tom Kane, PT
MediGraph Software