Why Reviews Happen
- Purpose of RAC and documentation review
- General process of review
- Identify red flags
- Billing
- Rends (OP- Medicare B, In-patient – Medicare A, HH)
Most Commonly Reviewed
- Top three areas
- Qualified clinician
- Skilled level of care
- Medical necessity
- Appeals process: what to do if a review is requested
- Requirements of a “maintenance program”
Five Platforms of Successful Documentation
- Underutilized terminology
- Trap phrases to avoid
- Address commonly reviewed areas
- Case studies:
- Joint mob
- Gait ther-ex
- Transfer training