FOTO
ENHANCES JUSTIFICATION FOR NEEDED THERAPY
Requests
for Medicare Therapy Cap Exceptions Need Justification
Recent
Congressional action required CMS to implement an exceptions process for the
Medicare therapy cap. The process
adopted and described in Medicare transmittals, recognizes the methods and
processes employed by FOTO customers as useful in justifying continued therapy.
FOTO’s
“objective evidence”
collected with “standardized patient assessment instruments, outcomes measurement
tools” and “measurable
assessments of functional outcomes” … “will enhance the justification for
needed therapy.”
-- CMS
Medicare Transmittal
CMS
has identified the type of information required when therapists request Medicare
approval for therapy to continue beyond the Medicare cap.
In
addition to requiring that therapy be reasonable and necessary, documentation
must demonstrate that:
·
Maximum improvement is yet to be attained;
·
There is an expectation that the anticipated improvement is
attainable in a reasonable and generally predictable period of time.
FOTO's Patient Specific Reports Provide Just Such Information!
The
Functional Health Status Summary Percent Change Score, when compared to predicted improvement for similar
patients, provides a clear
indication of whether the patient’s maximum improvement has been attained.
In addition to that, the FOTO comparative identifies what is reasonable in
terms of "maximum
improvement."
Even
in the case of automatic exceptions from the cap, the provider/supplier must
be able to provide documentation to justify additional treatment. The FOTO
system provides the needed evidence that can be used to justify continued
therapy. According to CMS: “Such
tools are not required, but their use will enhance the justification for
needed therapy."
Manage
your patients by evidence not anecdote. Justification
of continued care for Medicare patients with the use of FOTO outcomes data is .
. .
·
Clear
·
Concise
·
Comprehensive
·
Convincing
.
. . when you have the strength of FOTO’s
robust (1.6 million episodes)
database behind you.