Dear List,
Responding to pre-payment audits have become daily routine at work for a lot of us these days, and we are learning effective ways of gathering documentation and responding to these audits each day. There have been times when I have wanted to talk to some auditor who looks at my claims directly, and ask a few questions or clear a doubt/confusion (or maybe just vent out my frustration or just yell). While exploring my options for the same, I came across the ‘Ask-the-contractor’ teleconferences that i realized, all jurisdictions conduct periodically, giving you the opportunity to ask questions or clarify your doubts directly with the Contractors who audit your claims.
For some of us who have not known about this and missed these, they also have an archive of previously recorded teleconferences on their websites. I came across something very interesting while looking at the summary of one such teleconference conducted by NGS (CMS Contractor for Jurisdiction B). Here are parts of what the presenter responded to documentation related questions:
“If youa?Tve have a specialist who types up a letter to the family physician a?” as Ia?Tll put it a?” send a letter over to them. In order for that to become a part of the family physiciana?Ts records, the physician will need to review that letter, they need to sign it, they need to date, they also need to annotate if they agree with whata?Ts in that letter or if they disagree whata?Ts in that letter. Then that would become a part of the record for that physician.”
“What we also hear a lot is that the physician records dona?Tt have the information, but the prosthetista?Ts records have that information. So, what the prosthetist should be doing is contacting the physician, by sending their records over to the physician, so the physician can review that documentation that has been made by the prosthetist, and then that way, the physician (go) ahead and sign and date that report, along with annotating if they agree or disagree, so that information does become a part of the record”
I was under the impression so far that if a Prosthetist sends his detailed evaluation notes to the Physician, the physician has to transcribe the notes (or type it into or write it himself) into his progress notes, and only then will it be considered part of his medical record. But the medicare contractor’s response above clearly says that the physician can just sign on the prosthetist note, date it, add annotations, write on it if he agrees, save it, and that’s it- now it’s a part of his medical record!! At least that is what I understand.
I have immediately signed up for the next teleconference for Jurisdiction B, because I sure have a lot of questions for them. Below are the links to the teleconference schedules and archives for all jurisdictions (I thought I could put together this information for my fellow professionals). Please visit, read through old archives of the teleconferences and register for upcoming ones AND ASK YOUR QUESTIONS!! Hope this helps:
Jurisdiction A:
http://www.medicarenhic.com/dme/dme_act.shtml
Jurisdiction B Past Teleconference Summaries:
http://www.ngsmedicare.com/wps/portal/ngsmedicare/!ut/p/c5/rZDNboJAFEafxRfg3uGfJS0DijCgM1icjaGkNmARY4xWnr7YmHQFLuzcxSzOPblfPpDQz744V5_FqWr3xRfkIM0NhvzV9Q0dMXYQZ67J_SBATTdIz9fD3MQn7IRZT9nqA_sNctQ3vL4eZt2uW9YdvzKqq_yYXWKPfovjvP_DMK5LFB5LmfAjIVYp250iUjpk5S-oS1suVZzckww8Fx8mkWMbtxZH-G9Po1y98-F8a5DWn58Evtf7RNjJPF5MUwTxj12FIKv3RrmUjYKKZlsaIQ72V1VbI4YJ-Quwadt8wKHJsuwcmUu6ZVumT34Ax4bLug!!/dl3/d3/L2dBISEvZ0FBIS9nQSEh/
Jurisdiction B New Teleconference Registration for 7th February 2013:
http://apps.ngsmedicare.com/ADC/EventList.aspx?fromdate=1/2013&todate=28/2013&display=nth&type=blic&eventidn 41&view=entDetails&information_id192
Jurisdiction C:
http://www.cgsmedicare.com/jc/education/act.html
Jurisdiction D:
https://www.noridianmedicare.com/dme/train/act/act_schedule.html
Regards,
Sagar Shetty
Bionic Prosthetics & Orthotics
