"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Wednesday, December 19, 2007

You’re Crazy if You’re Not Paranoid

I just sent a note to my staff therapists.

We’re making a Medicare abbreviation list as a reference for anyone who needs to read our charts: therapists, case managers, back office staff or auditors.

The note said the following:

Please include any abbreviations you typically use in your charts for a list for when the Medicare auditors come


Not if, but when.

Because Medicare audits can be random or targeted and because physical therapists don’t fully understand the criteria for targeted audits.

That’s when it’s good to be paranoid.

When Medicare is concerned, it’s good to be paranoid.

Click here for the OIG Compliance Program for Individual and Small Group Physician Practices.

This document will describe the optimal compliance program for small private practice physical therapists.

I did get a little teasing from my peers for my choice of wording in the note.

The teasing was good-natured and the point was taken. Nevertheless, my recommendation is to design your Medicare compliance program with the end firmly in mind.

Design your compliance program as if you anticipate the worst.

At night I sleep well because in the daytime, at work, I’m paranoid.

Paranoia is a disturbed thought process characterized by excessive anxiety or fear, often to the point of irrationality and delusion. (Wikipedia, Web Accessed 11/30/07)

While these personality qualities are dysfunctional when applied to social relationships they are essential when applied to the mindset of your corporate Medicare compliance officer.

Create an abbreviation list. Mine is posted on this blog as 'Abbreviation List'.

Find other, creative ways to make your organization Medicare compliant. Make it easy for the Medicare auditor to give you a passing grade.

A little paranoia won’t destroy you.

It might save you.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"


Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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