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07/11/18

WPS SNF Consolidated Billing Teleconference

Wisconsin Physician Services (WPS) will be providing a free teleconference on skilled nursing facility (SNF) consolidated billing on July 25, 2018 from 11:00AM – 12:30PM ET. For additional information and to register, click HERE.

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07/09/18

Can I Double Book and/or Overlap Medicare Patients

People always ask me if I can double book and/or overlap Medicare patients receiving outpatient therapy services. I’m going to answer this question once and for all and the answer will not only apply to outpatient therapy services paid under Medicare Part B benefits, but will also apply to commercial and workers compensation carriers. What we need to remember is no insurance carrier cares or dictates how you schedule their patient’s for outpatient therapy services and this also includes the Medicare program. What insurance carriers, including the Medicare program, do care about is that their patient’s receive quality and medically

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07/02/18

CMS Releases 2019 Proposed Home Health Rule

On July 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule [CMS-1689-P] outlining proposed Calendar Year (CY) 2019 Medicare payment updates and proposed quality reporting changes for home health agencies (HHAs), and proposed case-mix methodology refinements and a change in the home health unit of payment from 60 days to 30 days for CY 2020. To view a Fact Sheet on the proposed rule, click HERE. To access the proposed rule, click HERE.

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07/02/18

Medicare Part B Certifications and Recertifications

I receive many questions regarding Medicare Part B certifications and recertifications as they pertain to outpatient physical, occupational and speech therapy services. In this article, I will answer the following questions: 1. How long is a certification and recertification valid for under Medicare Part B outpatient therapy services? 2. How soon must a plan of care be signed by a physician or NPP to be considered timely under Medicare Part B rules and regulations? 3. What is delayed certification and recertification?  4. What are some possible justifications to support delayed certification or recertification? 5. If I only do an evaluation

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07/02/18

NCCI Edits Version 24.2 Now Available

The Centers for Medicare and Medicaid National Correct Coding Initiative (NCCI) edits effective with dates of service July 1, 2018 – September 30, 2018 is now available for my Gold Members. The outpatient therapy specific NCCI edit “cheat sheet” is available HERE. Please make sure to log into your account to access the “cheat sheet”.

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06/28/18

AHA Submits Comments to CMS on 2 Proposed Rules

The American Hospital Association (AHA) has submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the 2019 Skilled Nursing Facility (SNF) proposed rule and 2019 Inpatient Rehabilitation Facility (IRF) proposed rule. To read the AHA comments regarding the SNF proposed rule, click HERE. To read the AHA comments regarding the IRF proposed rule, click HERE.

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06/27/18

LTCH & IRF Compare Refresh Now Available

The June 2018 quarterly Long-term Care Hospital (LTCH) and Inpatient Rehabilitation Facility (IRF) Compare refresh, including quality measure results based on data submitted to CMS between Q3 2016 – Q2 2017, is now available. To view the LTCH data, click HERE. To view the IRF data, click HERE.

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06/26/18

LTCH/IRF Provider Preview Reports

Long-term Care Hospital (LTCH) and Inpatient Rehabilitation Facility (IRF) Provider Preview Reports have been updated and are now available. Providers have until July 1, 2018 to review their performance data on quality measures based on Quarter 4 -2016 to Quarter 3 – 2017 data, prior to the September 2018 LTCH Compare and IRF Compare site refreshes, during which this data will be publicly displayed. To access the LTCH Compare, click HERE. Click HERE to access the LTCH Provider Preview Report Access To access the IRF Compare, click HERE. Click HERE to access the IRF Provider Preview Report Access

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