Medicare Claims Audit Analysis

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Compliance Issues in Physical Therapy According to the American Physical Therapy Association, physical therapist must comply with the Medicare claims audit. The Medicare claims audit most clearly state that physical therapist will be under extreme pressure to guarantee consistence with compliance. The Medicare Claims audit compliance includes coverage, coding, documentation, and payment necessities. The accompanying assets are planned to assist physical therapist with agreeability in arrangement for a review and also give apparatuses to use all through the review process. (Medicare Claims Audit, 2012). Accurate coding and documentation are imperative in the billing process of Medicare claims. The following key compliance issues are commonly discovered to be significant to physical therapy practice, which includes submitting claims that are not medically necessary, billing for services not provided to the patient, unbundling and upcoding, and documentation is not consistent with units of time performed. (Fearson and Levine, 2009). Other issues may consist of waiving copays and deductibles. For example, in the U.S. v. Mackby case, the physical therapist misused provider…show more content…
Everybody says they, as well, face the same predicament. In light of time limitations, the consideration and nurturance they can provide for customers is restricted, and it is hard to treat customers similarly. After some open deliberation, they concur that each customer ought to get the proper physical therapy treatment. When a patient, for example, Ms. Bitter need more nurturance than a physical therapist can give, they ought to be referred to different facilities, such as social services agencies. (“Ethics and Jurisprudence”). The code of ethics for physical therapists is to provide direction while facing ethical dilemmas or difficulties, paying little respect to their professional roles and

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