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09/12/14

First Coast Releases August 2014 Newsletter

First Coast Service Options has released their August 2014 Medicare Connection newsletter for both private practices and institutional settings. For institutional providers (i.e.non-private practices), click HERE to access the newsletter. This newsletter discusses adjustments of hospital outpatient therapy claims as well as electronic claims reopenings. For private practices, click HERE to access the newsletter. This newsletter discusses clarification of the “confined to the home” definition as well as ICD-10 testing opportunities.

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09/12/14

Want to Know What You & Your Colleagues Were Paid by Medicare in 2012?

If you are a physical therapist, occupational therapist, or speech-language pathologist in private practice and you treated and billed Medicare beneficiaries in calendar year 2012, keep on reading. The Centers for Medicare and Medicaid Services (CMS), in an effort to promote transparency, has published Medicare provider utilization and payment data on physicians as well as physical therapists, occupational therapists and speech-language pathologists in private practice. The CMS look-up tool will return information on services and procedures provided to Medicare beneficiaries, including utilization information, payment amounts (allowed amount and Medicare payment), and submitted charges organized by Healthcare Common Procedure Coding System

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09/11/14

NGS to Host Outpatient PT/OT Webinar

National Government Services will be hosting a webinar on September 23, 2014 for their outpatient PT and OT providers in the states of Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. For additional information and to register, click HERE.

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09/09/14

Medicare Enrollment & Claim Submission Guidelines

The Centers for Medicare and Medicaid Services has issued a booklet explaining the Medicare enrollment process and claim submission guidelines. The information in this publication applies only to the Medicare Fee-For-Service Program. Information discussed in the booklet includes: enrolling in the Medicare program, submission of Medicare claims including timely filing requirements, deductibles, coinsurance and deductibles, beneficiary notices of noncoverage, billing requirements, and claim processing. To access the booklet, click

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09/02/14

UHC Delays FLR

UnitedHealthcare Medicare Solutions has announced they have

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09/02/14

Automation of the Request for Reopening Claims Process

The Centers for Medicare and Medicaid Services (CMS) have issued instructions in changes to the Reopening process for non-private practices (i.e. institutional settings). These changes were necessary due to a non-standard approach of requesting a Reopening from one Medicare Administrative Contractor (MAC) to another. In an effort to streamline and standardize the requesting process, CMS has petitioned the National Uniform Billing Committee (NUBC) for a “new” bill type frequency code that can be used by providers to indicate a Request for Reopening and a series of Condition Codes that can be utilized to identify the type of Reopening being requested.

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09/02/14

Skilled Nursing Facility Certifications & Recertifications

The Centers for Medicare and Medicaid Services (CMS) has issued a special publication that alerts providers that a major reason for claims being denied is failure to obtain certification and recertification statements from physicians or NPPs. The routine admission order established by a physician is not a certification of the necessity for post hospital extended care services for purposes of the program. Your therapy and billing staff needs to be aware of the requirements outlined below of what is an acceptable certification statement, what is an acceptable recertification statement, and how and when to document the certification and recertification statements.

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08/28/14

WPS to Host Outpatient Therapy Seminar

Wisconsin Physician Services (WPS) will be hosting an outpatient therapy seminar on September 25, 2014 in Merrillville, IN. Topics covered in the program include the following: Requirements for a Plan of Care Certifications and Recertifications Evaluations and Reevaluations  Therapy Caps Advanced Beneficary Notice of Noncoverage Documentation Requirements  Functional Reporting Requirements For additional information and to register, click HERE.

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