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Payment for Services Rendered (GEN)
Posted February 1, 2007
Medicare may periodically ask you for records in relation to specific claims. The judgments are made on the basis of legible documentation. That legible documentation should be concise and readily identify and describe the services which you have provided for which you submit a claim. It is not the amount of verbiage which is essential; it is that which is pertinent to the beneficiary’s problem(s) and needs. The complaint or complaints which are being managed should be clearly described. Examination appropriate to those complaints should be recorded. The plans and management of the problems identified through the history and examination allow the record reviewer to determine if the codes claimed are appropriate.
If the documentation is for a procedure, please adequately describe what was done so the reviewer will have a full picture of that procedure as provided. |
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