Preventing Therapy Reimbursement Denials

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In 2003, the Medicare Modernization Act created the Recovery Audit Contractor (RAC) program, employing independent contractors to single out overpayments and deniable claims. These contractors, motivated by generous commissions, have been liberally using their DENIED stamp ever since. RACs often single out claims made by SNFs and IRFs because there is a good deal of revenue to be made in skilled nursing and rehab therapy.

The best strategy for avoiding therapy reimbursement denials is preventing it from happening in the first place—starting with your documentation. But there are also steps you can take to successfully appeal a denied claim, as two-thirds of hospitals did in Q1 2014.

Fill out the form on the right to learn how to prevent and appeal therapy reimbursement denialse to: If your claim is legitimate, you owe it to your team of therapists and skilled nurses—as well as to the future of your facility—to fight for your revenue.

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