|
Top 3 reasons claims are denied or
downcoded.
-
Past family and social history is not fully documented.
-
Review of Systems is not fully documented
-
Documentation of medical decision making is not fully documented.
AMA definition of legibility - three of the physician's peers must be
able to decipher the notes.
When is Time Important?
Psychiatry & Physical Therapy- Need to document START and FINISH time.
Total Time is not sufficient. With Physical Therapy the same code is billed
in 15-minute increments.
Medicare Questions and Answers:
Questions: |
Answers |
| How often do you need to have MCE signature
form signed? |
Only if rescinded. Only if Medigap insurance
changes. |
| How long are claims held? |
Electronic Claims - 13 days held before check
cut.
Paper Claims - 26 days held before check cut. |
| How far back do they retain records? |
Current Year, Preceding Year and Last Quarter. |
|
