Marilyn Mines

Untimely certifications, missed or incorrectly billed Change of Therapy documentation, and lack of documentation supporting a signed physician order for skilled therapy are among the top reasons facilities are battling Medicare claims denials, an expert said in late April.

With Change of Therapy documentation, “if we have a Medicare meeting, and have the MDS and therapy people talk, we can avoid some of these problems,” said Marcum Senior Manager of Advisory Services Marilyn Mines, RN, BC, RAC-CT, during LeadingAge Illinois’s annual meeting.

Lack of Advance Beneficiary Notices also can cause problems. n