One Denied Therapy Visit Can Cost Your HHA $600

Posted on 28. May, 2009 by seank.

Good care that is poorly documented can lead the feds to suspect fraud.

CMS is concerned that the prospective payment system includes financial incentives to provide more therapy than a patient needs, according to physical therapist Cindy Krafft, Peoria, Ill.-based consultant with Fazzi Associates.

To prevent that result, intermediaries focus intensely on the therapy documentation supporting the need for the visits provided.

Bottom Line: If you’ve provided six visits and the intermediary denies just one of them, your agency has lost $600, Krafft emphasizes. If the agency has already received the money for that episode, it must now return the overpayment. The most common reason for denial is that the visit was not medically necessary or did not require a therapist’s skills.

MO826 – how will it impact your therapy visits? Find out in this AUDIO TRAINING EVENT.

The Heat Is On Therapy Documentation

Unlike the 2008 work plan, the HHS Office of Inspector General’s 2009 work plan does not specifically include a heading for home health therapy. But therapy services scrutiny is continuing and even expanding, says attorney Lucien Bernard with Pearson & Bernard in Covington, Ky. (more…)

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