OIG: Texas physical therapist's Medicare claims do not meet requirements
Healthcare Auditing Weekly, January 15, 2008
An OIG review of a Texas physical therapist's Medicare claims for 2002 found that none of the claims met the Medicare reimbursement requirements.
According to the OIG audit, none of the sampled claims met Medicare's reimbursement requirements. In total 688 of 702 services documented on 97 claims did not meet one or more of Medicare's reimbursement requirements. The physical therapist improperly billed Medicare and received $12,652 for the 688 services. The OIG audit also found the physical therapist did not understand Medicare reimbursement requirements and did not have effective policies and procedures in place to ensure proper billing.
The OIG recommended:
- The physical therapist refund $281,325 in unallowable payments for therapy services provided in 2002
- Develop quality control procedures to ensure that therapy services are provided and documented in accordance with Medicare reimbursement requirements
Click here to read the OIG audit report.
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