Taking on the MMR Pre-payment Review Process

Written By: Kathy Boyarko, PT, CDP, Program Development Manager

With continuing reimbursement challenges in the forms of audits, Blue Sky Therapy has implemented a process to address the MMR threshold of $3,700 and the new prepayment review process implemented on April 1, 2013.  With our advanced software, we are able to identify those patients approaching their threshold and complete an comprehensive documentation audit prior to receiving the Additional Development Request from Medicare.

Our dedicated QA team and ongoing staff education through webinars, on-line training videos, customized individual and team education, and documentation tips and examples that are sent out each week provide  numerous educational opportunities to ensure our staff is documenting to support the services being billed and  that the services are medically necessary.

Blue Sky is committed to being proactive with all documentation reviews and working through the process as outlined by Medicare to appeal all denials and achieve a positive outcome in the form of payment received for all services provided to our residents.