Jimmie, thanks for posting this. I read it on "the other" list and was truly amazed at the report!
If you haven't read it go to: http://www.oig.hhs.gov/oas/reports/region6/60300085.pdf The report is not really a valid representation of OT because out of ten therapists participating in the reports only ONE was an OT. Sad, but true! Ron ===========> Original Message Follows .... On4/14/2005, Jimmie Arceneaux, <[EMAIL PROTECTED]> said: > Hey, > To make the point about limited skill documented in notes a little > clearer along with the financial implications see below (copied for > another list serve post). > Jimmie > Date: Tue, 12 Apr 2005 14:57:35 EDT > From: [EMAIL PROTECTED] > Subject: From the OIG > Dear PTManager Listserv: > I copied the below from an OIG email I received today. It made me think. > ------------------------------------------------------------------------ > Results of the Medical Reviews Performed on Selected Medicare Claims for > Physical and Occupational Therapy Services Provided During Calendar Year 2002 > in > the State of Texas (A-06-03-00085) > http://www.oig.hhs.gov/oas/reports/region6/60300085.pdf > This report provides the results of our review of a non-statistical sample of > 100 physical and occupational therapy claims submitted for payment by 10 > therapists in Texas during calendar year 2002. Our audit objective was to > determine if the therapy services billed on these claims met Medicare > reimbursement > requirements. Medical reviewers from TriCenturion, a Program Safeguard > Contractor for the Centers for Medicare and Medicaid Services, determined > that 2,709, > over 99 percent, of the 2,734 services contained in the 100 sampled claims > did not meet one or more of Medicare's reimbursement requirements because the > therapists did not maintain adequate documentation, the therapists did not > meet > the plan of care requirements or someone other than the billing therapists > performed the services. Based on the results of the medical review, the > therapists received $57,253 for services that should not have been billed to > Medicare. > We recommended that TrailBlazer Health Enterprises, ! > LLC (TrailBlazer), a Medicare Part B carrier, recover these improper > payments. TrailBlazer agreed with our findings and recommendations. > _______________ > Jimmie Arceneaux, LOTR > Metro Preferred Home Care > 3501 N. Causeway Blvd., Ste 200 > Metairie, LA 70002 > 504-838-7080 > Fax 504-833-9309 > *** NOTICE--The attached communication contains privileged and > confidential information. If you are not the intended recipient, DO > NOT read, copy, or disseminate this communication. Non-intended > recipients are hereby placed on notice that any unauthorized > disclosure, duplication, distribution, or taking of any action in > reliance on the contents of these materials is expressly prohibited. > If you have received this communication in error, please delete this > information in its entirety and contact the Amedisys Privacy Hotline > at 1-866-518-6684. Also, please immediately notify the sender via > e-mail that you have received this communication in error. *** > -- > Unsubscribe? > [EMAIL PROTECTED] > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > Archive? > www.mail-archive.com/[email protected] > Help? > [EMAIL PROTECTED] -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
