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medicare-audit

Medicare Audit on Therapy Claims

Have you or your treatment facility ever thought about what potential changes are coming from Insurance Companies? What about the outlook for reimbursement in 4th Quarter or 2017?

2016 has seen massive sweeping changes in reimbursement rates in the first 8 months alone. The transition from ICD-9 to ICD-10, changes in medical necessity criteria and accepted CPT coding have all impacted a vast majority of treatment providers. Changes like these will continue as the industry evolves.

Medicare has issued a review for 60 minute psychotherapy sessions as a potentially over used CPT code. What this means is that claims being submitted with specific CPT codes will likely begin being audited and/or red flagged for review.

Are you happy with the quality of information and customer service your current billing company affords you? Do they tell you when when reimbursement changes happen, or do you not find out until months later?

AVA is founded on the principal that, “We thrive, by ensuring you thrive”. Knowledge, Information, and Honesty are some of the principles of which AVA was founded on.

Original Article: https://www.aapc.com/blog/36077-psychotherapy/

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