Eli's Rehab Report
Inpatient Facility:
3 Ways to Make More Strategic Decisions For Your Rehab Facility
Making time for training pays off in unexpected ways. Growing up in Kentucky, Renee Ki... Read more
3 Ways to Make More Strategic Decisions For Your Rehab Facility
Making time for training pays off in unexpected ways. Growing up in Kentucky, Renee Ki... Read more
ABNs:
Prevent Lost Revenue for Uncovered Procedures
Meet with your patients to improve ABN success. Good news, rehab providers: A signed a... Read more
Prevent Lost Revenue for Uncovered Procedures
Meet with your patients to improve ABN success. Good news, rehab providers: A signed a... Read more
Regulations:
Final Rule Roundup
Get a breakdown of the key provisions in the final rules that will impact your practice ... Read more
Final Rule Roundup
Get a breakdown of the key provisions in the final rules that will impact your practice ... Read more
OPPS:
Opioid Crisis: Rehab Providers Are On the Front Lines
The recently released 2017 outpatient prospective payment system (OPPS) implemen... Read more
Opioid Crisis: Rehab Providers Are On the Front Lines
The recently released 2017 outpatient prospective payment system (OPPS) implemen... Read more
Home Health:
Try Something Different in 2017
Emphasize how your therapy work keeps patients out of Acute Care, SNFs. “In reha... Read more
Try Something Different in 2017
Emphasize how your therapy work keeps patients out of Acute Care, SNFs. “In reha... Read more
Want to open your own private rehab practice? Don't do these 6 things
Don’t underestimate the challenge of referrals. Many rehab therapists who want t... Read more
Don’t underestimate the challenge of referrals. Many rehab therapists who want t... Read more
Look to Zip Code Analysis for New Opportunities
For an easy, data-driven way to conduct market research on the areas you’re consid... Read more
For an easy, data-driven way to conduct market research on the areas you’re consid... Read more
Workers' Comp:
Get Your Workers' Comp Claims Paid With These Expert Tips
BONUS: 5 Handy Checklists Make Workers’ Comp a Breeze! Handling workers’ c... Read more
Get Your Workers' Comp Claims Paid With These Expert Tips
BONUS: 5 Handy Checklists Make Workers’ Comp a Breeze! Handling workers’ c... Read more
Workers' Comp:
Revealed Common CMS-1500 Form Mistakes That Cause Denials
The devil is always in the details, and when it comes to workers’ comp, it’s... Read more
Revealed Common CMS-1500 Form Mistakes That Cause Denials
The devil is always in the details, and when it comes to workers’ comp, it’s... Read more
Inpatient Rehab:
Study Reveals 'Potentially Preventable' Causes for Interruptions, Transfers
While as many as one in three patients with neurological conditions in an inpatient reha... Read more
Study Reveals 'Potentially Preventable' Causes for Interruptions, Transfers
While as many as one in three patients with neurological conditions in an inpatient reha... Read more
Physical Therapy:
Back and Forth: Study Examines the Effectiveness of PT for LBP
Question: Is physical therapy an effective non-surgical treatment option for low back pa... Read more
Back and Forth: Study Examines the Effectiveness of PT for LBP
Question: Is physical therapy an effective non-surgical treatment option for low back pa... Read more
Whistleblowers:
Unnecessary Rehab Services Cost SNF Chain $145 Million
Keep medical necessity in your focus. Life Care Centers of America and its owner have ... Read more
Unnecessary Rehab Services Cost SNF Chain $145 Million
Keep medical necessity in your focus. Life Care Centers of America and its owner have ... Read more
Marketing:
What Happens When Someone Googles You?
The answer to that can boost your business — or put you out of it. The vast majo... Read more
What Happens When Someone Googles You?
The answer to that can boost your business — or put you out of it. The vast majo... Read more
Coding:
Your ICD-10 Honeymoon Is Over
Outpatient rehab providers brace for more than 1,000 new codes in 2017. Think your reh... Read more
Your ICD-10 Honeymoon Is Over
Outpatient rehab providers brace for more than 1,000 new codes in 2017. Think your reh... Read more
Outpatient Reimbursement:
What MACRA Has In Store for Rehab Providers
Here’s what you must know to plan a profitable future for your therapy practice. ... Read more
What MACRA Has In Store for Rehab Providers
Here’s what you must know to plan a profitable future for your therapy practice. ... Read more
MACRONYMS:
Your MACRA Jargon Cheat Sheet
ACI (Advancing Care Information): One of the four MIPS categories — the one that&r... Read more
Your MACRA Jargon Cheat Sheet
ACI (Advancing Care Information): One of the four MIPS categories — the one that&r... Read more
SNF:
Handy MDS 3.0 Decoder Kit for Therapists
Tip: Look beyond Section O. to optimize interdisciplinary collaboration at your SNF. S... Read more
Handy MDS 3.0 Decoder Kit for Therapists
Tip: Look beyond Section O. to optimize interdisciplinary collaboration at your SNF. S... Read more
SNF:
Spotlight on B1000 Vision
How, specifically, can therapists and MDS staff work together to get residents the thera... Read more
Spotlight on B1000 Vision
How, specifically, can therapists and MDS staff work together to get residents the thera... Read more
SNF:
Translation Tool: Transfers
Your Guide to the Difference Between MDS-Speak & Therapy Speak When MDS describes ... Read more
Translation Tool: Transfers
Your Guide to the Difference Between MDS-Speak & Therapy Speak When MDS describes ... Read more
SNF:
Translation Tool: MDS Section K & Swallow Phase
Your Handy Guide to How MDS-Speak Corresponds to Therapy-Speak When it comes to eating... Read more
Translation Tool: MDS Section K & Swallow Phase
Your Handy Guide to How MDS-Speak Corresponds to Therapy-Speak When it comes to eating... Read more
Inpatient Rehab Hospitals:
Adverse Events: How Does Your Facility Compare?
Medication issues top the list. The data miners at the HHS Office of Inspector General... Read more
Adverse Events: How Does Your Facility Compare?
Medication issues top the list. The data miners at the HHS Office of Inspector General... Read more
Medicare:
Heads Up: Bundled Payment Initiatives Expand to Cardiac Care
If your geographic location is selected for the demo, hospital participation is man... Read more
Heads Up: Bundled Payment Initiatives Expand to Cardiac Care
If your geographic location is selected for the demo, hospital participation is man... Read more
Payment Initiatives:
Get a Sneak Peek at New Cardiac Rehab Incentives
In CMS’ proposed rule for expanding bundled payment programs to include cardiac ca... Read more
Get a Sneak Peek at New Cardiac Rehab Incentives
In CMS’ proposed rule for expanding bundled payment programs to include cardiac ca... Read more
Home Health:
Watch for Therapy Visits to Vanish from HH PPS
Plus: Episodes shortened to 30 days if new payment model adopted Home health providers... Read more
Watch for Therapy Visits to Vanish from HH PPS
Plus: Episodes shortened to 30 days if new payment model adopted Home health providers... Read more
Home Health Payment Reform Debuts New Categories
Accurate diagnosis coding in the spotlight. ICD-10 diagnosis coding plays an important... Read more
Accurate diagnosis coding in the spotlight. ICD-10 diagnosis coding plays an important... Read more
Compliance:
Know When You Need a BAA
Hint: State agencies may get a pass. Maintaining the privacy of your patient’s m... Read more
Know When You Need a BAA
Hint: State agencies may get a pass. Maintaining the privacy of your patient’s m... Read more
HIPAA:
Threats to Your Organization Could Come from Within
Prevent and mitigate internal risks with these 6 expert pointers. If you’ve been... Read more
Threats to Your Organization Could Come from Within
Prevent and mitigate internal risks with these 6 expert pointers. If you’ve been... Read more
Outpatient Outlook:
Wake Up to Eval Code Overhaul in Proposed Medicare Physician Fee Schedule
Say goodbye to 97001-97004 and hello to 6 new codes. The proposed 2017 Medicare Physic... Read more
Wake Up to Eval Code Overhaul in Proposed Medicare Physician Fee Schedule
Say goodbye to 97001-97004 and hello to 6 new codes. The proposed 2017 Medicare Physic... Read more
MPFS:
What about SLP Evaluation Codes?
With all the buzz about stratifying the existing PT and OT evaluation codes, many are le... Read more
What about SLP Evaluation Codes?
With all the buzz about stratifying the existing PT and OT evaluation codes, many are le... Read more
Fraud & Abuse:
HEAT Scorches Wrong Doers
Does your coding meet Medicare requirements? With federal enforcement agencies steppin... Read more
HEAT Scorches Wrong Doers
Does your coding meet Medicare requirements? With federal enforcement agencies steppin... Read more
SNF Therapy:
Utilize PEPPER Data to Verify Appropriate Plan of Care
Proportion of Ultra-High Therapy RUG days versus all therapy RUG days under scrutiny. ... Read more
Utilize PEPPER Data to Verify Appropriate Plan of Care
Proportion of Ultra-High Therapy RUG days versus all therapy RUG days under scrutiny. ... Read more
Patient Termination Policy:
Employ These Expert Patient Termination Tips
Ending the relationship should only be a last resort. No practice wants to discontinue... Read more
Employ These Expert Patient Termination Tips
Ending the relationship should only be a last resort. No practice wants to discontinue... Read more
Industry Notes:
Two Radical Changes in OPPS
The Centers for Medicare & Medicaid Services (CMS) released the Outpatient Prospecti... Read more
Two Radical Changes in OPPS
The Centers for Medicare & Medicaid Services (CMS) released the Outpatient Prospecti... Read more
Outpatient Outlook:
See What's Cooking with New Targeted Manual Medical Reviews
You’ll hear from an SMRC instead of a RAC this time. The new manual medical revi... Read more
See What's Cooking with New Targeted Manual Medical Reviews
You’ll hear from an SMRC instead of a RAC this time. The new manual medical revi... Read more
Speech Spotlight:
Code 92507 or 97532? That is the Question
Careful: Using both will get you a denial. Most of the physical medicine CPT® code... Read more
Code 92507 or 97532? That is the Question
Careful: Using both will get you a denial. Most of the physical medicine CPT® code... Read more
SNF Therapy:
Insulate Your Facility from Medical Review
Are you running the risk of duplication of services? With the HHS Office of Inspector ... Read more
Insulate Your Facility from Medical Review
Are you running the risk of duplication of services? With the HHS Office of Inspector ... Read more
Why Functional Training Is Taking On New Dimensions
Section GG designed to give the IMPACT Act reality. All SNF coders and billers need to... Read more
Section GG designed to give the IMPACT Act reality. All SNF coders and billers need to... Read more
Fraud & Abuse:
OIG Seeks Reduction of SNF Therapy Pay
Fight against fraud and abuse takes new turn. Ultra-high therapy billing remains the ... Read more
OIG Seeks Reduction of SNF Therapy Pay
Fight against fraud and abuse takes new turn. Ultra-high therapy billing remains the ... Read more
Cyber Security Threats:
Guard Against Ransomware Attacks
Having a well thought-out recovery plan in place is vital. Implementing safeguards and... Read more
Guard Against Ransomware Attacks
Having a well thought-out recovery plan in place is vital. Implementing safeguards and... Read more
Industry Notes:
Keep Track of Your Business Associates with Help from OCR
One of the HIPAA audit features that practices find most daunting is how they’ll k... Read more
Keep Track of Your Business Associates with Help from OCR
One of the HIPAA audit features that practices find most daunting is how they’ll k... Read more
Outpatient Outlook:
Radical Medicare Payment Changes to Hit Physicians -- And Rehab's Next
Experts recommend test-driving the new system before it goes live. The physician world... Read more
Radical Medicare Payment Changes to Hit Physicians -- And Rehab's Next
Experts recommend test-driving the new system before it goes live. The physician world... Read more
Reimbursement:
The IPPS 2017 Rule Impact Could Be Overwhelming
There’s good news and bad for you. Providers don’t know whether to rejoice... Read more
The IPPS 2017 Rule Impact Could Be Overwhelming
There’s good news and bad for you. Providers don’t know whether to rejoice... Read more
IPPS:
Note These Additional IPPS Provisos
If you offer therapy in a hospital, then you need to take note of some of the newer meas... Read more
Note These Additional IPPS Provisos
If you offer therapy in a hospital, then you need to take note of some of the newer meas... Read more
Documentation:
Heed OIG Warning and Cut Down On Claims' Reversals
Overcome errors with clear, legible notes to avoid big financial losses. Do you know w... Read more
Heed OIG Warning and Cut Down On Claims' Reversals
Overcome errors with clear, legible notes to avoid big financial losses. Do you know w... Read more
Reimbursement:
5 Tips to Bill PT and Avoid OIG Audits
Use these expert tips to secure payment and stay out of the U.S. HHS Office of the Inspe... Read more
5 Tips to Bill PT and Avoid OIG Audits
Use these expert tips to secure payment and stay out of the U.S. HHS Office of the Inspe... Read more
Industry Notes:
Posting Patient Testimonials Could Land You in HIPAA Hot Water
Watch out: The HHS Office for Civil Rights (OCR) is enforcing the HIPAA Privacy Rule req... Read more
Posting Patient Testimonials Could Land You in HIPAA Hot Water
Watch out: The HHS Office for Civil Rights (OCR) is enforcing the HIPAA Privacy Rule req... Read more
Reader Question:
Intensity of Therapy Changed? COT OMRA Needed
Question: In what types of situations must I complete a COT OMRA since I render the... Read more
Intensity of Therapy Changed? COT OMRA Needed
Question: In what types of situations must I complete a COT OMRA since I render the... Read more
Compliance:
Get Your HIPAA Ducks in a Row: Understand Your Forms
Prepare for a fresh round of audits too. You hand every new patient a “HIPAA for... Read more
Get Your HIPAA Ducks in a Row: Understand Your Forms
Prepare for a fresh round of audits too. You hand every new patient a “HIPAA for... Read more
Payment Models:
Multidisciplinary Care Planning Payment Incentives to Hit Select SNFs
Make plans for more staff training. Better care planning could equal bigger bucks for ... Read more
Multidisciplinary Care Planning Payment Incentives to Hit Select SNFs
Make plans for more staff training. Better care planning could equal bigger bucks for ... Read more
Rotator-Cuff Injuries:
Learn Your ICD-10 and CPT® Coding Options for Sports Injuries' Rehab
Tip: You can’t use the referring physician’s diagnosis codes. Summer means... Read more
Learn Your ICD-10 and CPT® Coding Options for Sports Injuries' Rehab
Tip: You can’t use the referring physician’s diagnosis codes. Summer means... Read more
Timed Therapy:
Slash Therapy Coding Denials by Following These Simple Tips
Remember: The total treatment time counts. Traditionally, rehab facilities and their M... Read more
Slash Therapy Coding Denials by Following These Simple Tips
Remember: The total treatment time counts. Traditionally, rehab facilities and their M... Read more
Industry Notes:
Say Goodbye to Home Health Therapy Money Under MedPAC's Latest Recommendations
If Congress listens to the Medicare Payment Advisory Commission (MedPAC), it will pass t... Read more
Say Goodbye to Home Health Therapy Money Under MedPAC's Latest Recommendations
If Congress listens to the Medicare Payment Advisory Commission (MedPAC), it will pass t... Read more
Reader Question:
Exercise Caution When Coding Sports Physicals
Question: A fellow coder recently suggested reporting codes 97005 and 97006 for spo... Read more
Exercise Caution When Coding Sports Physicals
Question: A fellow coder recently suggested reporting codes 97005 and 97006 for spo... Read more
Practice Pointers:
Take a Closer Look: What Is True 'Skilled Maintenance' Therapy?
‘Improvement standard’ is obsolete for Medicare, but have your payers said&n... Read more
Take a Closer Look: What Is True 'Skilled Maintenance' Therapy?
‘Improvement standard’ is obsolete for Medicare, but have your payers said&n... Read more
Therapy Caps:
Manual Medical Review Process Gets Tweaked
High amounts of therapy beyond the threshold could flag you. You may not get reviewed ... Read more
Manual Medical Review Process Gets Tweaked
High amounts of therapy beyond the threshold could flag you. You may not get reviewed ... Read more
SNF Therapy Usage:
Brace Yourself: RACs Ready to Dig into Your RU & RV RUGs
Key indicator: Percentage of patients receiving therapy at minimum minutes’ thresh... Read more
Brace Yourself: RACs Ready to Dig into Your RU & RV RUGs
Key indicator: Percentage of patients receiving therapy at minimum minutes’ thresh... Read more
Medical Supplies:
Prior Authorization of DMEPOS Likely to Hit Your Bottom Line
Reimbursement for limb prosthetics just got a little trickier. If some of your patient... Read more
Prior Authorization of DMEPOS Likely to Hit Your Bottom Line
Reimbursement for limb prosthetics just got a little trickier. If some of your patient... Read more
Clip & Save:
Spot Respiratory Distress -- And Reduce Readmissions -- With This List
Keep distress signs front-and-center in your practice. Recognizing and treating your p... Read more
Spot Respiratory Distress -- And Reduce Readmissions -- With This List
Keep distress signs front-and-center in your practice. Recognizing and treating your p... Read more
Reader Question:
Know When to Use Z Codes
Question: We were wondering if Z codes can be used as Primary/Admitting Dx in a Nur... Read more
Know When to Use Z Codes
Question: We were wondering if Z codes can be used as Primary/Admitting Dx in a Nur... Read more
Reader Question:
Stay Unshaken When Coding Tremors
Question: I hope you can shine some light on this as we have another dilemma today ... Read more
Stay Unshaken When Coding Tremors
Question: I hope you can shine some light on this as we have another dilemma today ... Read more
Compliance:
Safeguard Your Practice from Unforeseen Stark and Anti-Kickback Violations
Wellness centers: Fertile ground for profit or a ticking legal time bomb? Creative bu... Read more
Safeguard Your Practice from Unforeseen Stark and Anti-Kickback Violations
Wellness centers: Fertile ground for profit or a ticking legal time bomb? Creative bu... Read more
Coverage Determinations:
Get Up to Speed On These Coding and Coverage Scenarios
You could be bleeding cash, if you don’t keep these guidelines in mind. Accurate... Read more
Get Up to Speed On These Coding and Coverage Scenarios
You could be bleeding cash, if you don’t keep these guidelines in mind. Accurate... Read more
Medical Records:
Foster Trust When Responding to Patient Request
Don’t overlook your patient’s right to access her medical records. Staying... Read more
Foster Trust When Responding to Patient Request
Don’t overlook your patient’s right to access her medical records. Staying... Read more
Industry Note:
CMS Ups Therapy Caps for 2016
You have another $20 to work with if you furnish outpatient Part B therapy to patients i... Read more
CMS Ups Therapy Caps for 2016
You have another $20 to work with if you furnish outpatient Part B therapy to patients i... Read more
Industry Note:
Look for These Red Flags in Therapy Reporting & Documentation
If you use a contractor to provide therapy to your residents, beware that the contractor... Read more
Look for These Red Flags in Therapy Reporting & Documentation
If you use a contractor to provide therapy to your residents, beware that the contractor... Read more
Reader Question:
Don't Allow Anyone to Bully You
Question: Often I find myself dealing with some really rude patients. Some bully me... Read more
Don't Allow Anyone to Bully You
Question: Often I find myself dealing with some really rude patients. Some bully me... Read more
Business Strategies:
Here's How to Bring in Cash-Pay Patients
It may be time to raise your prices, too. While the insurance market dominates —... Read more
Here's How to Bring in Cash-Pay Patients
It may be time to raise your prices, too. While the insurance market dominates —... Read more
Home Health Therapy:
Know When to Code for A Sign, Symptom, Or Ill-Defined Condition
Tip: Check the guidelines to find the location of a particular diagnosis. If you furni... Read more
Know When to Code for A Sign, Symptom, Or Ill-Defined Condition
Tip: Check the guidelines to find the location of a particular diagnosis. If you furni... Read more
Home Health Therapy Review:
Don't Expect Therapy Goal Storm to Blow Over
Bad news: Potential recoupments related to therapy downcoding in the offing. If you ha... Read more
Don't Expect Therapy Goal Storm to Blow Over
Bad news: Potential recoupments related to therapy downcoding in the offing. If you ha... Read more
Reimbursement:
MedPAC Wants Therapy Out of PPS Equation
Commission won’t let copay issue drop. In addition to a rate freeze, the Medicar... Read more
MedPAC Wants Therapy Out of PPS Equation
Commission won’t let copay issue drop. In addition to a rate freeze, the Medicar... Read more
Electronic Health Records:
Advice to Help You Prepare for an EHR Shutdown
Tip: Perform a “mock downtime” practice regularly. Your patient safety cou... Read more
Advice to Help You Prepare for an EHR Shutdown
Tip: Perform a “mock downtime” practice regularly. Your patient safety cou... Read more
CJR:
To Partner or Not to Partner? Prepare for Hospitals to Knock at Your Door
Physician Fee Schedule Final Rule bumps CJR start date to April 1. If you’re inv... Read more
To Partner or Not to Partner? Prepare for Hospitals to Knock at Your Door
Physician Fee Schedule Final Rule bumps CJR start date to April 1. If you’re inv... Read more
SNF Therapy:
Use This Strategy to Keep Your Documentation Compliant
Warning: The OIG is ready to pounce on your therapy billing. Skilled nursing facilitie... Read more
Use This Strategy to Keep Your Documentation Compliant
Warning: The OIG is ready to pounce on your therapy billing. Skilled nursing facilitie... Read more
COT OMRA:
Heed These Crucial Changes to RUG Calculations
Tip: Bulk of changes are in Chapter 2 of RAI Manual. If you think that there are no ch... Read more
Heed These Crucial Changes to RUG Calculations
Tip: Bulk of changes are in Chapter 2 of RAI Manual. If you think that there are no ch... Read more
HIPAA:
Take These Steps Now to Avoid Fallout From A Required Breach Report
Spot the HIPAA compliance trend and prepare. You may not have a choice about reporting... Read more
Take These Steps Now to Avoid Fallout From A Required Breach Report
Spot the HIPAA compliance trend and prepare. You may not have a choice about reporting... Read more
Industry Note:
Part B Deductibles Inch Higher
After two years of Part B deductibles that stood at $147.00, the Centers for Medicare &a... Read more
Part B Deductibles Inch Higher
After two years of Part B deductibles that stood at $147.00, the Centers for Medicare &a... Read more
Industry Note:
Avoid 'Unintended Consequences' of EHR Use
The Office of the National Coordinator for Health Information Technology (ONC)... Read more
Avoid 'Unintended Consequences' of EHR Use
The Office of the National Coordinator for Health Information Technology (ONC)... Read more
Reader Question:
Verify Your Rehabilitation MS-DRGS Sync With ICD-10
Question: Can you explain how inpatient admissions are assigned to Medicare Severity Dia... Read more
Verify Your Rehabilitation MS-DRGS Sync With ICD-10
Question: Can you explain how inpatient admissions are assigned to Medicare Severity Dia... Read more