by Gina Elkins | Saturday, December 1, 2012 | Compliance
This week, we have been notified that phase 2 and phase 3 providers are receiving ADRs for October claims for resident’s who were at or over the $3,700 threshold. Phase 1 providers who have pre-approval are receiving ADRs as well. If you are a Functional Pathways...
by Gina Elkins | Thursday, November 15, 2012 | Compliance
So, we are approaching December 1st. Do you see light at the end of the tunnel for the Manual Medical Review? Well, if you were in phase 1, you have been working diligently to obtain pre-approval of therapy visits for almost two full months now. And if you were in...
by Gina Elkins | Monday, October 29, 2012 | Compliance
Phase 2 providers are approaching their debut for submitting their pre-approval requests for part B therapy residents who have met or will meet the $3700 threshold for OT and $3700 threshold for PT/ST. You may have already submitted your pre-approval requests in...
by Gina Elkins | Friday, October 5, 2012 | Compliance
The manual medical review of therapy claims is well on its way for phase 1 providers. I am going to take a break from the Manual Medical Review this week and talk about our focus for the fourth quarter—coding and diagnosis selection. Therapy coverage...
by Gina Elkins | Friday, September 21, 2012 | Compliance
Are you surviving the manual medical review process? Are you preparing for your phase-in date by working on the process in your facility? I just had a challenging last two weeks rolling out trainings company-wide discussing all of the MAC/FI processes. I survived...
by Gina Elkins | Sunday, September 9, 2012 | Compliance
MAC/FI Links Below for the Manual Medical Review process. Functional Pathways’ training will begin the week of September 10th. Palmetto: Palmetto Outpatient Therapy Caps and Threshold Process CGS: CGS Therapy Cap Exception Cahaba: Cahaba GBA Manual Medical...
