Reimbursements For Therapy Medical Billing

One of the biggest eyebrow raisers for carriers as far as medical billing claims go are any claim submitted for reimbursement for therapy based medical billing claims. Most therapy claims are 100% legitimate but because of the amount of fraud that has been perpetrated by a few unscrupulous individuals all of these types of claims get closer looks than ever. One way to insure your claims are submitted correctly is to make sure the documentation is done absolutely accurately in your therapy department.

In a recent audit of claims, the CMS found that the number one error in reporting therapy medical billing claims is with the minutes billed. Make sure the amount of therapy given to the patient is signed off on as accurate by the therapist at the time of the service. It is much easier to record accurate information at the time the services are rendered to the patient than to try to go back and remember who got how much therapy.

The key to getting your medical billing claims paid is in the documentation. You already have the medical necessity issue handled, now make sure the timing and billing of the therapy sessions completed for the patient are accurate.

A word of advice, never turn in “corrected” therapy logs. Nothing will raise eyebrows faster and they aren’t needed. Only the most accurate, current information in your medical billing claims. Use only originally written logs with the accurate therapy sessions noted so the medical billing forms can be completed with the RVUs in order of highest to lowest so you can receive the highest returns possible for the therapy sessions for your patients.

View all Articles by: Kathryn Etienne, CCS-P