Medicare Compliance: Why Our Eval Is the Best

Our eval compliantly encompasses the following Medicare requirements:

• The patient’s primary concerns are recommended
• The patient’s pain scale, at onset, at worst, and at best, are recommended for each identified concern
• The patient’s prior level of function is recommended for each identified concern
• The outcome test is auto-scored. The test name and score are documented
• Functional goals specific to the selected functional deficit(s), are recommended
• The Plan of Care lists every CPT code on the flow sheet and recommends the clinical rationale that defends why each code is necessary to restore the selected functional deficit(s)
• 150 – 200 words of patient-specific defensive documentation are recommended to defend the eval code severity chosen (mild, moderate, or high)
• When coding triggers the Medicare CCI edit index, the therapist is cued in real time to defend the use of the related mutually exclusive codes before Systems 4PT adds the appropriate 59-modifier
• Medicare’s “Minute/Unit Rule” is validated in real-time
• Medicare’s “Direct Therapy” rule is validated in real time. If the therapist charges more than 5 units of direct therapy in any 60-minute time period, validation asks if the associated documentation includes the necessary co-signatures
• The patient-specific, MIPS-specific, defensive documentation described above is recommended to the therapist in the blink of an eye

With Systems 4PT, 900-1200 words are recommended in the typical evaluation, saving the therapist an average of 24 minutes of typing or eliminating 33 minutes of check-box drudgery.

Slow documentation consumes your nights and weekends, and your compliance is lower than it should be because your EMR is obsolete.

Treat More, Type Less™

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