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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Certification and Recertification of the Plan of Care

Members have full access to the guides below and can contact us with questions regarding and Medicare documentation or billing issue, consider joining today if you need assistance. 

Certification of the POC

    • What does it mean to have the POC certified?
    • Is a referral or order required under Medicare?
    • What methods of certification are allowed?

When does the POC need to be Certified? 

    • When is certification consider to be "timely"?
    • What happens if the certification cannot be obtained on time?

Recertification of the POC

    • When does the POC need to be recertified?
    • Is a recertification the same as a reevaluation?
    • Does Medicare require the patient to visit the physician/NPP before recertification? 

Who can Certify the POC?

    • Which practitioners are allowed to certify a POC?
    • Which practitioners are not allowed to certify a POC?
    • What does "under the care of the physician" mean?

Problems Obtaining Certification

    • What should I do if the physician/NPP does not respond to request for signature? 

Denials Due to Certification Issues

    • Can a denial based on certification be appealed?
    • Examples of when certification issues cause denials

About Us

Therapy Comply is a healthcare compliance firm that seeks to bring high quality web-based compliance guidance and one-on-one consulting services to small and medium size physical, occupational, and speech therapy practices.

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