"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

Thursday, November 5, 2009

Private Practice Physical Therapists will get RAC data from Belinda Holmes

Belinda Homes of Kerkering BarberioBelinda Holmes, BS, CPC, CCP-P will share her physical therapy RAC 'war stories' and tips to protect yourself from physical therapy automated claims review for 'untimed codes' in 2010.

Belinda will present
"Medicare Defense Strategies"
in Palmetto at Medical Arts Rehabilitation, Inc from 9am to 3pm - Belinda's part begins at 10:30am -11:30am on Saturday, November 7th, 2009.

Belinda works for Kerkering Barberio, a large Sarasota accounting firm with expertise in defending physical therapy clinic owners from Medicare audits.

Belinda is usually called in after the audit letter is received by the physical therapist and by then her job is usually 'damage control'.

At her seminar, Belinda would like to share with you ways to prevent that audit letter from ever reaching you.

Belinda's talk will focus on real-world, 'boots-on-the-ground' tactics you can use in your daily practice to prevent and defend your notes and charts from a Medicare audit.
  1. RACs: What are they and how to avoid them
  2. OIG 2010 Work Plan
  3. Real life accounts of physical therapy audits
  4. The new focus on medical necessity
Recent RAC missteps

RACs have not been putting up the kind of stellar numbers recently that earned their Demonstration Project permanent status in 2008.

The latest update of the three year Demonstration project in Florida, California and New York reveals that providers are right to have concerns about RAC improper application of Medicare guidelines.

Type of Reviewer% of improper payment denials appealed by provider% of appealed claims overturned in favor of provider% of all improper payment denials overturned in favor of provider
Claims Processing Contractors4%59%2.3%
Recovery Audit Contractors22.5%34%7.6%

Since the percent of all 'improper payment denials' for RACs is almost three times the rate of MACs the data lend credence to the belief that RACs are not correctly interpreting Medicare guidelines.

Since RACs return overpayments successfully overturned at any level of the appeals process what can providers do to create a strong disincentive for RACs to incorrectly deny your claim?


Call 941.729.1800 to RSVP for Saturday's seminar.

You can get more information at www.BulletproofPT.com

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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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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.