Medical Billing Forum

Payments => Insurance Payments => Topic started by: Courtney on April 07, 2011, 06:03:16 PM

Title: New PT/OT clinic in assisted living NH possibly committing medicare fraud
Post by: Courtney on April 07, 2011, 06:03:16 PM
My question is this.
I am in a 4 person partnership that started a new ot/pt clinic at an assisted living nursing home. I'm not sure on how to be medicare compliant. We try to keep a daily tentative schedule but these patients come and go as they please. In addition, all four of us do our own units and billing. This is because some of the therapist work longer hours and want to get paid more. My question on this is what if one of the other therapist is charging 4units for every patient even if they only treat for about 30minutes. If we were audited would that particular therapist get in the trouble since they bill their own and not collectively as the partnership. Please someone help!!! Ask me questions so I can provide more info to help me figure this out.

Thanks bunches in advance.
 :-* :-* :-*
Title: Re: New PT/OT clinic in assisted living NH possibly committing medicare fraud
Post by: PMRNC on April 07, 2011, 06:09:02 PM
In a word YES.  Liability is on all of you in that practice.  You should however get an attorney's opinion on how to rectify this immediately.
Title: Re: New PT/OT clinic in assisted living NH possibly committing medicare fraud
Post by: dekenn on April 08, 2011, 10:23:26 AM
Is it a partnership with one tax id number?  Or do you all have your own tax id and npi numbers and bill as individuals?  How is the Partnership set up?  Just all four of you working independently, but making sure the facility is covered, or as one entity?