Wiki Physical Therapy Auditing

[Arosboro]

Hi!
Does anyone have any input into billing and auditing Physical Therapy?
I have just started a new position and am responsible for the PT billing and auditing.
For the billing I am just interested in a reference guide and for the auditing I am interested in the difference between auditing a patient through their whole experience vs auditing random visits. Any advice or knowledge is appreciated. Thank-you! Alison

 

[Tamn2@comcast.net]

Compliance Auditor

Morning,

For PT charges, is your provider doing the services, or is your facility billing for an outside company that comes in to do the Actual PT work? The reason I ask is that a local Rehab was just fined 2 Million dollars for billing without appropriate documentation for an outside Rehab company.

The billing is straight forward, is it an initial visit or follow up? How many modalities were done, was the time documented correctly? Also, was the correct CPT code chosen for the modality performed. This is the basis of both the billing and audit process. When auditing PT, random or full review, we also check to see if the claim was paid. If it wasn't, we tally the reason i.e. no referral, WC denial an no referral back up etc. This information is used for education.


I hope this helps and have a wonderful day.
Tammy