Wonder if your documentation is up to snuff to pass an audit? Tune into this episode where hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS interviewed Phyllis Goldstein, a speech-language pathologist with extensive experience in Medicare audits and appeals! She shares her journey from clinical work to becoming an expert in navigating the complex world of therapy documentation and reimbursement. Phyllis emphasizes the critical importance of detailed, skilled documentation using precise language that explains exactly what makes their intervention unique and necessary.
The discussion explores the challenges therapists face, particularly in neurological specialties, when transitioning patients between skilled therapy and maintenance programs. Phyllis stresses the difficulty of determining when therapy becomes repetitive and no longer medically necessary, while acknowledging therapists' genuine desire to help patients maintain their functional abilities. She provides insights into the Medicare audit process, sharing her strategies for successfully appealing denied claims and her impressive 85-90% overturn rate. She also addresses the big question of are there a lot of cases of therapists going to court for charging cash for wellness services that should really be billed to Medicare as therapy?
Get in touch with Phyllis here:
410-382-900
Phyllis@pgconsultants.net
