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Patient Action Alert: Stop the Therapy Cap!

The exceptions process for patients needing physical, occupational, and speech therapy beyond the capped amount ended December 31, 2009. Currently there are two therapy caps, one for physical therapy and speech therapy combined and one for occupational therapy. The 2010 therapy caps are set at $1860 per beneficiary per year. The therapy cap applies to […]

Avoid Unnecessary Denials! Use your Medicare Local Coverage Determinations!

What is a “Local Coverage Determination” (LCD)?                                                                                          Medicare contracts with private companies like Palmetto, Noridian, Novitas, etc. to administrate—process and pay claims in a specific region. Medicare Carriers and Fiscal Intermediaries (FIs) are private companies that Medicare contracts with to pay bills. More recently some FI’s have been replaced with the MAC […]