Episodes with PT? Palmetto agencies better state ‘short-term’ and ‘long-term goals’

Effective Dec 4, 2014
Published Dec 8, 2014
Last Reviewed Dec 4, 2014

When it comes to episodes with physical therapy, agencies that bill Medicare administrative contractor (MAC) Palmetto GBA may be in for a surprise: Claims can be denied when documentation fails to show both short-term and long-term goals for the patient. A number of agencies recently learned the hard way that without both, they wouldn’t be reimbursed and that appealing such denials could land them in the more than three-year wait for an administrative law judge (ALJ) hearing. Adding to the uncertainty is a Palmetto article, released Oct. 30, that states short-term and long-term goals aren’t always necessary.

 
Subscription Required

You must log in to view the content you requested.

Not a subscriber? Start accessing the article you’re seeking right away plus weekly, home health-specific news, analysis, guidance and specific tools that enable your agency to increase referrals and profitability during times of increased competition and regulatory scrutiny.
Need multi-user access? Ensure uninterrupted individual access and maximum coding productivity for your whole team. For site license inquiries call: 1-855-CALL-DH1

Subscribers receive 12 monthly issues of the Home Health Line to help them:

  • Comply with the latest CMS regulations
  • Boost referrals with effective marketing and sales tactics
  • Recruit and retain talented clinicians and administrative staff
  • Improve productivity with time-saving strategies
  • Steer clear of anti-kickback and Stark violations
  • Benchmark your agency against competitors
  • Cut costs with smart operational practices

Home Health Line and its companion website, homehealthline.com, are the home health 30-DAY 100% No-Risk Guarantee — By using the tips, tools and expert business-boosting guidance you receive as a subscriber, you will increase revenue and decrease costs enough to more than cover your subscription cost or we’ll refund your subscription fee!

Login

User Name:
Password: