"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, May 3, 2012

Can We #SolvePT Medicare Audits Using Data Drilling to Fight Fraud?

Excellent webcast describes data-drilling for healthcare fraud by Thompson Reuters and XL Health.

Log-in here.

Complex, computer driven algorithms described in this webinar scan Medicare and Medicaid databases to look for "patterns of suspicious behavior".

For instance, the famous "ambulance trips to nowhere" are described here.

The take-home message is that fraudsters are finding it MORE difficult to use the healthcare system's inherent complexity to their advantage.

The data-drilling maps the healthcare providers referral patterns

What should be apparent after watching this webinar is that the typical physical therapist in private practice is NOT your typical fraudster.

Despite having a these documentation characteristics:
...most physical therapists should not be on the list of "high-risk providers".

I wonder how we can #SolvePT when we're talking about Medicare Audits?

Free Tutorial

Get free stuff at BulletproofPT.com

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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American Physical Therapy Association

American Physical Therapy Association
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.