Upcoming Seminars: Documentation and Payment Issues in Outpatient Physical Therapy: Assuring Compliance & Avoiding Fraud and Abuse October 16-17, 2008 — Great Wolf Lodge, Mason, Ohio Payment & Policy Challenges in Outpatient Physical Therapy: Tools for Success in 2008 & Beyond! October 24-25, 2008 — Raleigh-Durham, North Carolina Audio Conference: The Advanced Beneficiary Notice: How to Legally Collect Cash from a Medicare Patient September 9, 2008 — Partnership with APTA Chapters Audio Conference: The OIG Self Disclosure Protocol: Should You Notify the Government if you suspect a Problem, and How to Minimize Your Risk of an Audit October 7, 2008 — Partnership with APTA Chapters Audio Conference (2 Part): Part 1: Establishing a Fee Schedule for your Facility: Using the Medicare Resource Based Relative Value Scale (RBRVS) as a Guide November 11, 2008 — Partnership with APTA Chapters Audio Conference (2 Part): Part 2: Determining Your Cost per Visit: Understanding Basic Financial Statements and Answering the Question: Should I Sign This Payer Contract? November 18, 2008 — Partnership with APTA Chapters Read more	Expertise & Consulting Services — Documentation, Coding, and Billing Compliance The pace of changing regulations and requirements is so rapid that even the best prepared private practitioner and well-staffed corporation or hospital department are hard pressed to establish and maintain the training, policies, and standards of documentation of and coding for clinical services. Despite the importance of adequate documentation and appropriate coding and billing for physical therapy services, most physical therapists did not receive adequate, if any, training to ensure that they comply with the ever-evolving requirements in these areas. Given recent studies from the Office of the Inspector General (OIG) and current government initiatives such as the Comprehensive Error Rate Testing (CERT) program and the Recovery Audit Contractor (RAC) initiative, Medicare and others have renewed and accelerated their efforts to reduce and recover overpayments for services. In addition, the issue of medical necessity has become the primary reason for payer and agency audits in an environment that requires documentation to justify clinically appropriate services. Although in the past the lack of adequate documentation of medical necessity would have resulted in the provider having to repay any monies collected from the insurer, today’s environment has made billing for services that are not adequately justified in the medical record an issue of potential fraud and abuse, carrying a much greater risk to the provider. The principals of RCRI are nationally recognized experts in the areas of CPT coding, the Resource Based Relative Value Scale (RBRVS) and its application to fee schedule development, physical therapy peer and utilization review, and documentation education and training. This expertise will provide the confidence you need when dealing with issues surrounding these areas of compliance: Assessment of current documentation content, format, methodology, and compliance Assessment of current CPT coding applications and billing procedures Assessment of ICD-9 diagnosis coding and related compliance with local payment policy Analysis and assessment of facility/practice charge master and fee schedule Analysis and assessment of charge capture methodology Identification of areas of risk related to documentation, coding, and billing practices Performance of documentation and billing audits using government-accepted audit tool Assessment of practice adherence to federal medical necessity guidelines Identification of potential claims and documentation audit review flags and development of strategies to minimize risk of audits Assistance with fee schedule modifications and/or development Assistance with minimizing risk of Medicare audit and recovery Training in methods to minimize the impact of any CERT or RAC audit Staff education and training related to adequacy and compliance with documentation, coding, and billing requirements Education and training in internal peer review and utilization management methodologies and techniques Assistance with development of self assessment tools for documentation, coding and billing compliance Assistance with payer relations in regards to coverage issues, contract negotiations, and payment policy issues