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02

Jul 2014

Just When You Thought You Had It All Figured Out

You did everything you knew to do. You educated yourself. You trained your staff. You knew this stuff backwards and forwards. Yet, here you are in the first quarter of 2014 scratching your head trying to figure out why your Medicare claims are being returned unpaid because of functional limitation reporting issues. Well, you’re not alone. Providers everywhere are having...

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02

Jul 2014

An Update on PQRS (aka Please Quit Revising Stuff)

Last month’s blog entry hinted at some of the impending changes for PQRS in 2014.  CMS finally released the measure specifications in late December.  Let’s take a look at some of the changes that will directly impact providers who are reporting individual measures via claims (the most common reporting method for therapists). First, as mentioned in the previous blog entry,...

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02

Jul 2014

2014 Therapy Cap and SGR Reform

The Pathway for SGR Reform Act of 2013 signed into law by President Obama on December 26th not only served as a three month “patch” to prevent a 20.1% reduction to the conversion factor in the physician fee schedule associated with the SGR formula, but it also extended the current therapy cap exception process through March 31st, 2014.  As a...

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Functional Limitation Reporting Processes: The Pursuit of Perfection

21

Feb 2014

Functional Limitation Reporting Processes: The Pursuit of Perfection

My kids love playing the classic, heart attack-inducing game Perfection.  For those of you who have never played Perfection, the object of the game is very simple: fit all these little, shaped pieces in a grid within a minute and then stop the timer before the whole grid blows up in your face.  Fun, right?  On the surface, it doesn’t...

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Using Your ABNs Wisely (and Appropriately)

21

Feb 2014

Using Your ABNs Wisely (and Appropriately)

As we get later into the year and more Medicare beneficiaries are meeting or exceeding their annual therapy cap, I have been fielding a lot of questions regarding the proper use of Advanced Beneficiary Notices (ABNs).  Recent changes pertaining to the use of ABNs for therapy services have seemed to create some confusion among providers.  Prior to January 1, 2013,...

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2014 SGR Reform

21

Feb 2014

2014 SGR Reform

The Pathway for SGR Reform Act of 2013 signed into law by President Obama on December 26th not only served as a three month “patch” to prevent a 20.1% reduction to the conversion factor in the physician fee schedule associated with the SGR formula, but it also extended the current therapy cap exception process through March 31st, 2014. As a...

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