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

Proof and Audit Prevention
3/21/2011 10:18:00 PM

At an increasing rate, physical therapists are facing challenges for which they may not be prepared.   One of the biggest challenges we face is producing evidence that our interventions are effective.  Changing standards are being used by Medicare RAC audits and these standards are becoming employed by private insurers as well.  What are these changing standards?   Insurers want proof (measurements) not just words (narratives).  The type of proof will satisfy auditors, both RACs and private auditors, is data.  Recording meaningful data is a boring, cumbersome, and loathsome task; unless you are using MediGraph.  

Two types of proof are essential to overcome audits and objections to payment:

 

  1. Prove that impairments exist by taking measurements.   Effective measurements methods include:

    • Strength deficits are more meaningful when numerical values are employed.  To accomplish this task, many facilities employ Hand Held Dynamo-meters (HHD under Muscular Performance).   A hand held dynamometer is easy to transport, relatively inexpensive, and the numerical values produced  easily reveal an impairment. MediGraph's bar graphs and tables allow a non-therapist (auditor) to easily observe improvement because the bars on the bar graph are getting bigger, and the percentage (%) of limitation displayed in the table  getting smaller.
    • Measure ROM to reveal restrictions.  MediGraph''''s bar graphs and tables allow a non-therapist to observe improvement, because as with HHD all testing,  the bars on the bar graph are getting bigger, and the percentage of limitation displayed on the table are getting smaller
  2. Prove that functional deficits existed and were overcome.  While impairment testing is useful (both clinically and for audit prevention) it is not as important as measuring function.  A person that has overcome their impairments but has not restored function will be worse off than a person that has remaining impairment but has regained function.  The best way to measure functional improvements is with outcome instruments,  72 of which are provided in MediGraqph.  We suggest that at least one, but preferably two of these questionnaires are employed with every patient.  Use a diagnosis specific questionnaire (for example, the Knee Outcome Survey), combined with a generic functional outcome questionnaire.  The most recognized functional outcome instrument is OPTIMAL,  Outpatient Physical Therapy Improvement in Movement Assessment Log developed by the APTA.  Medicare readily recognizes and accepts this outcome questionnaire.  The APTA has granted MediGraph permission to employ OPTIMAL and make it available for our subscribers.  Sadly, many subscribers are not gaining the advantages that the acceptability and recognition that this tool provides.  Why not start today.  If you are ever on the receiving end of a Medicare audit, you will be glad you employed these suggestions.


Regards,
Tom Kane, PT
MediGraph Software