Medicare audit denials have become an increasing concern among inpatient rehabilitation facilities. The course will be a presentation of how the EHRs (electronic health record systems) at 2 large freestanding inpatient rehabilitation facilities were utilized to appeal these denials. Use of EHR reporting capacity to capture minutes of therapy and documentation of reasons for missed therapy sessions, use of the EHR to notify the provider when Medicare mandatory documentation is due and subsequent reporting of provider compliance, both on an individual and group level, will be covered. Mandatory documentation includes Pre-Admission Screening Note, 24 Hour PAPE, Team Conference and Day 4 Individualized Plan of Care note. Furthermore, 'Training the auditors' techniques about how to look at the charts, based on training approaches used for our own staff, and anticipation of the auditors' needs, will be discussed.This presentation will provide the learner with tools such as improved workflows in their organization's EHR and new reports which could help reduce the denial rate if their facility is audited.

Learning Objectives

  • Describe how templated, automated and pre-placed text helps medical necessity, mandatory elements and Quality Indicator documentation, while minimizing repetitive typing in Progress, Team Conference, Pre-admission screening, IOPOC notes and PAPE.
  • Identify 5 elements that a Medicare auditor typically may expect to see within the Medical record; describe how to make sure these elements are easily discovered and how to train the auditor where to look.
  • Describe reporting functions that can assist a rehabilitation therapy manager keep track of obligations such as 180 minute rule compliance on a concurrent basis, and have time to resolve discrepancies on a day to day basis.