tci Medicare Compliance & Reimbursement - 2015 Issue 6

Therapy: Follow 6 Steps To Survive The Return Of Therapy MMRs

Assemble — and prepare — your ADR response team now. The Manual Medical Review (MMR) program is back — so brace yourself for an onslaught of additional development requests (ADRs) for your therapy claims from your recovery audit contractor (RAC). Facilities: CMS is Picking on You The Centers for Medicare & Medicaid Services (CMS) announced the resumption of MMRs for Medicare therapy claims exceeding the $3,700 threshold for outpatient therapy per calendar year. Although paused since February 2014, CMS has approved the four current RACs to resume sending ADRs as of Jan. 16, 2015.  CMS had placed...

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