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

RACs
1/3/2011 5:32:00 PM

Medicare assumes that better patient outcomes are the result of process and measurements.   Are measurements important?  Of course they are.  Measurements can assist with determining our patients’ progress.   However, there are other non- clinical reasons that Medicare is seeking standardization.  A major non-clinical reason for Medicare to emphasize measurements and process is cost control.   Failing to satisfy the changing Medicare demands can have a negative outcome for we therapists.

Many of us are in denial regarding the prospect of a Medicare audit. We at MediGraph have continued to warn of the changing environment, standards and practices surrounding Medicare RAC audits.   We have warned that RAC auditors do not get paid unless they extract a refund from you.  The more a RAC extracts, the more they make.  Because these audits are outsourced, the number of audit contractors (bounty hunters) is increasing the number of audits that can be performed.  

Medicare RACS are looking for specifics, process, and measurements.  Some of the things Medicare wants to know include:

  1. How you make your clinical decisions. (Do you take measurements).
  2. Can you prove there was a functional deficit associated with impairment?
  3. What tests have you performed that demonstrate that your impairments resulted in a functional deficit? 
  4. Did you record your time?
  5. One on one CPT codes.
  6. PTA supervision requirements.
  7. Fifteen minute time codes as the basis for patient encounters
  8. Demonstrating that skilled care was required (establishing a plan of care, progress measurement).
  9. Physician referrals and re-certifications
  10. Time in –time out.

MediGraph provides all the tools that you need to help satisfy these Medicare/RAC demands. To prevent and overcome an audit, employ standardized pre-established measurements (6 Minute Walk, TUG, 9 hole Peg test, etc.) to baseline and demonstrate functional improvement.  ROM and HHD measure impairments that assist to establish the cause of a functional deficit or a disablement.  MediGraph’s easy to read bar charts and tables permit the most untrained RAC auditor to understand your patients’ improvement.  These tools are at your disposal.  There are no additional charges when you employ these testing modules.  We as PTs must behave in a preventive-defensive manner.  The best defense against a RAC audit is to have documentation that deters the RAC contractor.  The tools that help to accomplish this task are at your disposal.  Please consider using them.

Regards,

Tom Kane, PT