Compliance


Company Aims to Support Medicare Functional Reporting in EMR Software

clinicient softwareClinicient, headquartered in Portland, Ore, emphasizes support for Medicare functional limitation reporting in its web-based electronic medical record (EMR) software. The support comes in response to the mandate made to the Centers for Medicare and Medicaid Services (CMS) as part of the Middle Class Tax Relief Act of 2012. CMS has been mandated to collect data on beneficiary function on claim forms to inform future Medicare payment reforms.

Clinicient notes in a recent news release that in order to assist CMS in collecting this data, therapy providers will be required to include nonpayable G-codes and modifiers that capture the beneficiary’s functional limitations at the outset of the therapy episode, at a minimum every 10th visit and at discharge. Following a testing period effective through July 1, claims without G-codes and modifiers will be returned unpaid.

According to the company, key components in its effort to simplify functional limitation reporting for therapists includes a Functional Limitation Wizard to guide therapists through the reporting process, automated tracking, coding, and reporting, functional limitation reporting prompts, alerts, and workflow tools. Additionally, Clinicient is offering a functional assessment tool, sign-off controls, and single system with billing designed to automatically pass G-codes directly to claims.

Jim Plymale, CEO, Clinicient, notes that the company’s goal centers on taking the “guesswork” out of reporting for therapists through the use of integrated reporting tools engineered to streamline reporting and prevent the submission of claims that do not have the proper G-codes or modifiers. Plymale adds that in order to minimize Medicare compliance risks, practices require an integrated EMR system designed to provide a logical structure in order to generate legible, understandable, and defensible documentation. Systems must demonstrate proven success handling Medicare requirements for outpatient rehabilitation in the challenging health care environment, Plymale says.

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[Source: Clinicient]