Medicare Compliance – Built in Rules

Custom Hard-Stop Compliance feature prevents the #1 reason for denied Medicare claims – incomplete/errors in patient treatment records. We sync your patient’s records with appointment schedules to ensure eligibility is never interrupted by denied claims!

• Current Plan of Care signed by a physician or nurse practitioner in a timely manner
• Progress reports every 10 visits or 30 days
• Proper code for electrical stimulation
• Correct NCCI edits
• Correct modifiers for your area of practice
• Correct modifiers for certain CPT codes used together
• Correct CQ/CO modifiers
• Follow 8-minute rule
• Track Medicare reimbursement/apply KX modifier at right time

• Tracking of Medicare KX modifier Threshold

• Hard-Stop on 10-day visit/30-day Progress Note requirement.
• Hard-Stop on POC/Prescription Expiration
• Hard-Stop to correct G0283 coding requirement.
• NCCI coding alert with appropriate modifier application if therapist approved.
• Effortless MIPS participation through a QCDR
• 150 – 500 words of required MIPS-specific defensive documentation recommended, touch free
• 80 – 200+ words of compliant, defensive, evaluation code rationale documentation recommended, touch free