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Thread Topic: Medicare Timely Documentation Guidelines
Topic Originator: Christina Thompson
Post Date August 23, 2012 @ 2:41 PM
Medicare Timely Documentation Guidelines

Christina Thompson
August 23, 2012 @ 2:41 PM Reply  |  Email Friend   |  |Print  |  Top

We have been told that Medicare has a 30 day requirement from the date of service to document for an encounter.  Could anyone direct me to written documenation of this "timely documentation" requirement?  Our physician's are trying to fight us about this.  Any help would greatly be appreciated.  Thanks so much in advance!

August 24, 2012 @ 9:41 AM Reply  |  Email Friend   |  |Print  |  Top

I dont know the Medicare rule, BUT, it is recorded in Federal Law:
42 CFR 482.24.  The law specifically states that the medical record documentation must be completed within 30 days.  

When Medicare requests a medical record, the request is well spelled out.  They will tell you that they must receive a copy of the medical record within X days.  They are well within their rights to deny the claim because they didnt receive the medical record copy within the timeframe requested.  If your doctor cant provide foundation to the care provided, the claim could be denied payment.  

There is an old saying:  Document the medical record as if you had to go to court.  

If the doctor cant prove, through the medical record of what was provided, the carrier could investigate the provider for possible fraud and they can go back 10 years and thats 10 years of medical records they can request.

Christina Thompson
August 24, 2012 @ 3:09 PM Reply  |  Email Friend   |  |Print  |  Top

Thank you Steve for your reply.  I know that this is the standard for hospitals, but I work for a physician's office.  Do you know if there are any specific documentation guidelines for "timely documentation" when it applies to physician practices?  I appreciate any help in this matter.  Thank you in advance.

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