A Complete Guide to Increasing Reimbursement and Reducing Denials

The How-To Manual for Rehab Documentation, Third Edition
A Complete Guide to Increasing Reimbursement and Reducing Denials

Rick Gawenda, PT


Up-to-speed with Medicare documentation requirements for 2009 and beyond?

Increase cash flow and reduce Medicare claim denials by using strategies provided in the Third Edition of The How-To Manual for Rehab Documentation.

Written by national consultant Rick Gawenda, PT.

Since our last edition, there have been significant changes to the rules and regulations surrounding documentation in therapy settings. And now that the RACs are underway it is even more important to have accurate and thorough documentation. Mistakes can lead to delayed payments and denials, so how do ensure that you are in compliance with the current guidelines?

Make it easy. Order your copy of The How-To Manual for Rehab Documentation, Third Edition: A Complete Guide to Increasing Reimbursement and Reducing Denials.

Written by author and national consultant Rick Gawenda, PT, of Gawenda Seminars, this book and CD-ROM setfocuses on the clinical aspects of documentation and offers proven methods to strengthen documentation and decrease the frequency of denials. Gawenda encourages b documentation methods that have worked for him and help you conquer potentially tough concepts such as maintenance therapy and CPT codes.

What’s new in the third edition?

• Clarification of certification and re-certification requirements regarding how long they are valid for and how soon they need to be signed
• Explanation of delayed certification
• Tips to write function-based short- and long-term goals
• Updated examples of well-written goals
• Updated payer documentation guidelines for evaluations, progress reports, daily notes, discharge reports, and re-evaluations

The How-To Manual for Rehab Documentation, Third Edition: A Complete Guide to Increasing Reimbursement and Reducing Denials outlines proper documentation strategies starting from the moment a patient registers and receives treatment to billing for time and services. Gawenda encourages b documentation methods that have worked for him and help you conquer potentially tough concepts such as maintenance therapy and CPT codes.

This comprehensive book and CD-ROM, helps you:

• Improve therapy billing through better documentation
• Prevent denials as a result of better documentation practices
• Maintain quality assurance through proper documentation
• Optimize your reimbursement from both Medicare and third-party payers
• Avoid audits and targeted medical reviews
• Document care in a more efficient way
• Take the critical steps to verify therapy benefit coverage prior to a patient's initial visit
• Support skilled therapy services with inclusion of required documentation
• Understand Medicare certification and recertification time frames and requirements for all therapy settings
• Understand and use the most commonly used CPT codes and modifiers in rehabilitation therapy

Table of Contents:

Chapter 1: The Role of the Registration Staff
Registration Basics
Benefit Verification
Preregistering

Chapter 2: Initial Documentation
Evaluation Format
Documentation Components
Evaluation Process
Objective Criteria
Assessment Documentation
Goals
POC Documentation
Creating a Solid Foundation

Chapter 3: Certification and Recertification
Physician Referrals
Physician Referral Denials
Outpatient Therapy Settings
Certification and Recertification
SNF Part A Therapy Services Reimbursed Under the Prospective Payment System (PPS)
Home Health Agency Part A Therapy Services

Chapter 4: Daily Documentation
Daily Documentation
Documentation Requirements
Home Exercise Programs (HEPs)
Plan Documentation

Chapter 5: Progress Reports, Discharge Reports, and Reevaluations
Progress Reports
Discharges
Reevaluations

Chapter 6: Maintenance Therapy
What is an FMP?
Coverage Criteria
Documentation Requirements
Billing
Cover All Your Bases

Chapter 7: Wound Care Under Medicare
Discharge Criteria
Additional Pointers

Appendix A: Navigating the CMS Web site
Getting Started
Final Word

Rick Gawenda, P.T., graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Mr. Gawenda is currently director of physical medicine and rehabilitation at Detroit Receiving Hospital and owner of Gawenda Seminars. He is the current President of the Section on Health Policy & Administration of the American Physical Therapy Association and President of the Michigan Association of Medical Program Rehabilitation Administrators.