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Items the Therapist Must Note or Communicate to Document Preparers to Ensure Integrity, Accuracy and Professionalism…

Livonia, MI – When a document prepares arranges documentation for a rehabilitation provider, this must be based upon what the treating therapist communicates. This includes goal setting. This item provides a basis for determining what the therapist should communicate. Then the document prepares takes those s notes and prepares service documentation. At the end of […]

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Attendant Care and Its Necessity…

By Electronic Medical Services, LLCMedical foster care providers across the country— and especially in states with strong post-accident rehabilitation mandates, such as Michigan—are facing an ever-growing challenge: caring for residents whose medical, behavioral, or quadriplegic conditions far exceed what traditional “general supervision” models can safely support. For these populations, Attendant Care is not a luxury;

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Understanding the Role of Activities in Residential Care: Clarity on Clinical Intent and Billing Standards

By Direct Care Training & Resource Center, Inc. In the dynamic and evolving field of residential care—especially in settings such as Adult Foster Care, Medical Foster Care Homes, and other community-based alternatives—there is often a need to clearly distinguish between informal resident engagement activities and billable skilled interventions. Misunderstanding this difference can result in regulatory

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A Word of Caution: Flexibility and Documentation Matter When Seeking Upgraded Services for Catastrophically Injured Patients

By Electronic Medical Services and Direct Care Training & Resource Center, Inc. A recent Michigan court ruling and guidance from the Department of Insurance and Financial Services (DIFS) underscore a critical point for post-acute care providers: reasonableness is not merely about what you charge—it also encompasses what you do, how you do it, and whether

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Balancing Collections with Connection: Why Care Providers Must Think Long-Term in Workers’ Comp and Michigan PIP

By Bruce W. McCollum, Long-Term Care Project Developer In the care industry—especially in complex, high-stakes sectors like workers’ compensation and Michigan’s Personal Injury Protection (PIP) system—providers must walk a fine line. On one side lies the need for fiscal responsibility: collecting what is owed, maintaining cash flow, and securing rate agreements that reflect the true

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Ignoring Reality: The Unreasonable Denial Requests by Insurers in Michigan’s PIP System

In Michigan’s Personal Injury Protection (PIP) system, insurers have increasingly adopted tactics to delay or avoid rightful reimbursement for essential services. One of these tactics includes requiring an injured party’s health insurance to first issue a denial before the PIP insurer will consider payment. However, this demand often disregards the reality that certain services—such as

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Navigating Attendant Care Deductions in Michigan’s PIP System: What Providers Need to Know

By Direct Care Training & Resource Center, Inc. & Electronic Medical Services, LLC Providers delivering care in Michigan’s Personal Injury Protection (PIP) system must be aware of an often-overlooked financial adjustment that can impact reimbursement for attendant care services. When a foster care resident receiving 24-hour attendant care also participates in outpatient therapy sessions, insurers

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The Legal and Ethical Dangers of Allowing Non-Nurses to Edit Nurse Documentation…

In healthcare settings, the integrity of nursing documentation is critical to ensuring patient safety, regulatory compliance, and legal protection. Nursing notes, medication records, and care plans serve as official medical records that directly impact patient care decisions, reimbursement, and potential legal liability. When a non-nurse—someone without a nursing license—modifies, edits, or refines nurse-prepared documentation, serious

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Aquatic Therapy and Proper Billing Under Michigan PIP No-Fault Insurance…

Aquatic therapy is an essential rehabilitative service for individuals recovering from catastrophic injuries, including those covered under Michigan’s Personal Injury Protection (PIP) No-Fault Insurance system. However, proper CPT Code usage and provider qualifications are critical to ensuring compliance with MCL 500.3157, which governs the legitimacy of reimbursable medical expenses. CPT Codes and Licensed Providers When

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Coding and Avoiding Fraud: The Importance of Understanding CPT Coding in Medical Billing

Medical billing is a complex process that requires a thorough understanding of Current Procedural Terminology (CPT) codes to ensure compliance with federal regulations and ethical billing practices. These codes are not just numerical representations of services—they come with specific definitions that outline the obligations for how services must be executed, including requirements regarding licensed professionals

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