Guest guest Posted July 17, 1998 Report Share Posted July 17, 1998 RE>> Florida reimburse According to a Florida Blue Cross/Blue Shield rep, every new rehab provider in Florida is automatically placed under 25% review. Besides that, the rep estimates that just under 300 rehab providers are under 100% review in Florida. Raquel Pelzel Managing Editor Briefings on Outpatient Rehab, Reimbursement & Regulations 781/639-1872 raquel_pelzel@... -------------------------------------- Date: 7/16/98 6:55 PM To: Raquel Pelzel From: ptmanager@... by review, I mean that a percentage of submitted claims are denied payment by the fiscal intermediary. in this case, Blue Cross Blue Shield of Florida. the reason for the review is supposedly faulty documentation, treatments not medically necessary, etc; while not the case with my company, entities under investigation for fraud and abuse would also have their claims denied or a % of claims denied payment. (see the Eli Report, been several articles about this in the past few months) Eli Reports that 50% of Florida's rehab providers are under some type of prepayment review, dramatically impacting a company's cash flow, and forcing many out of business. hope this helps, any comments would be appreciated Favis, CEO/COO First Rehab Plus, Inc. St. sburg, FL ---- Read this list on the Web at http://www.FindMail.com/list/ptmanager/ To unsubscribe, email to ptmanager-unsubscribe@... To subscribe, email to ptmanager-subscribe@... -- Start a FREE E-Mail List at http://makelist.com ! ------------------ RFC822 Header Follows ------------------ From ptmanager-return-225-opuscomm!raquel_pelzel=opuscomm.com@... Thu Jul 16 18:32:12 1998 Received: from findmail.com (vault.findmail.com [209.185.96.136]) by shore.shore.net (8.8.7/8.8.7) with SMTP id SAA06642 for ; Thu, 16 Jul 1998 18:32:12 -0400 (EDT) Received: (qmail 10708 invoked by uid 505); 16 Jul 1998 21:23:03 -0000 Mailing-List: contact ptmanager-help@...; run by ezmlm Precedence: list X-URL: http://www.findmail.com/list/ptmanager/ X-Mailing-List: ptmanager@... Reply-To: ptmanager@... Delivered-To: mailing list ptmanager@... Received: (qmail 10660 invoked by uid 7770); 16 Jul 1998 21:23:01 -0000 Received: from imo13.mx.aol.com (198.81.17.3) by vault.findmail.com with SMTP; 16 Jul 1998 21:23:01 -0000 Received: from Mjfcoo@... by imo13.mx.aol.com (IMOv14_b1.1) id XNAAa11436 for ; Thu, 16 Jul 1998 17:22:12 -0400 (EDT) Message-ID: Date: Thu, 16 Jul 1998 17:22:12 EDT To: ptmanager@... Mime-Version: 1.0 Subject: Re: Florida reimbursement & focused medical reviews Content-type: text/plain; charset=US-ASCII Content-transfer-encoding: 7bit X-Mailer: AOL 4.0 for Windows 95 sub 170 ---- Read this list on the Web at http://www.FindMail.com/list/ptmanager/ To unsubscribe, email to ptmanager-unsubscribe@... To subscribe, email to ptmanager-subscribe@... -- Start a FREE E-Mail List at http://makelist.com ! Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.