SOAP 2.0 | Medicare Threshold: Alerts and Reporting
  • 02 Jan 2024
  • 2 Minutes to read
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SOAP 2.0 | Medicare Threshold: Alerts and Reporting

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Article Summary

Overview

When a therapist is approaching or exceeding the Targeted Medical Review Threshold guidelines for Medicare ($2,330.00) an alert displays in SOAP 2.0. Alerts are available for the PT/SLP and OT thresholds, and the alert displays based on the user type of the patient's assigned therapist.

Alert Visibility

This alert is currently visible to therapist users (PTs, OTs, SLPs, ATCs, DCs, and RTs.)

Data Notes

The Medicare Threshold report and patient chart alerts in 1.0 will not update with SOAP 2.0 data. Follow the instructions below to manage the threshold for your patients in SOAP 2.0



Medicare Threshold Alerts

SOAP 2.0 | Medicare Threshold Alerts

You’ll receive approaching and exceeded threshold alerts on the patient’s SOAP 2.0 chart.

  • Once you’ve exceeded the threshold, the alert prompts you to add the KX modifier. The alert does not prevent you from creating new notes.
    EMR_2.0_Patient Profile_Alerts Drawer_Medicare Threshold Alert

  • You can quickly view the Medicare Threshold Used in the Case Summary.
    EMR_2.0_Patient Profile_Case Summary_Medicare Threshold Used



Dismissing Alerts

SOAP 2.0 | Dismissing Alerts

The Medicare Threshold Alert is automatically dismissed by adding the KX or GA modifier on the patient's case.
 

  1. Click Patient Info from the patient’s 1.0 chart.
    EMR_1.0_Patient Chart_Patient Chart Menu_Patient Info_SOAP 2 Example

  2. Click the Edit icon on the Case that needs the modifier.
    EMR_Patient Manager_Patient Info_Edit Case_SOAP%202%20Example

  3. Choose the appropriate modifier from the Apply Modifier section.
    EMR_Patient Manager_Patient Info_Case_KX-GA Modifier_Radio Button_Off

  4. Click Ok and then Save Patient.

  5. The alert will no longer display on the Patient’s 2.0 chart.



Tracking Medicare Patients' Threshold

How can I track my Medicare patients' progress toward the threshold?

Track your patient’s progress on the patient’s SOAP 2.0 chart as shown above or through the Medicare Threshold Analysis Grid in Analytics.

Analytics Access


Medicare Threshold Reporting

WebPT Analytics | Medicare Threshold Report

  1. Click the Analytics icon on the Global Navigation Header at the top of your the WebPT EMR Dashboard.
    EMR_Global Navigation Header_Analytics

  2. Click on the Reports menu to the left.
    EMR_Analytics_Reports menu_Reports red box

  3. Go to the Visits subsection, and select Medicare Threshold.
    EMR_Analytics_Visits Report Menu_Medicare Threshold

  4. The Medicare Threshold analysis grid report displays a list of all patients with Medicare insurance by year. This defaults to the current year.
    EMR_Analytics_Analysis Grid_Reports_Medicare Threshold_Year

  5. Click on the Amount Remaining column and choose Sort A-Z. This puts the patients who are closest to or over the threshold at the top of the list.
    EMR_Analytics_Analysis Grid_Reports_Medicare Threshold_Amount Remaining Column_Sort_A-Z

  6. When you’ve identified the patients who need the KX modifer, you can click on the Patient Name to go to their chart.
    EMR_Analytics_Analysis Grid_Reports_Medicare Threshold_Patient Name Column

Remove Patients with KX Modifier

You can also use the list to find patients who already have the KX modifer applied to their case by using the steps below.
a. Click on the KX Modifier column header and select Filter.
b. In the Filter tab, click the (...) button to select Yes.
c. Click Add.
d. The filter ensures only patients with the KX appear in the report.

Filter Discharged Patients

You can quickly remove discharged patients from this list by filtering by Case Status using the steps shown below.
a. Click on the Case Status column header and select Filter.
b. In the Filter window, click the (...) button to select Active.
c. Click Add.
d. The filter ensures only patients with active cases appear in the report.

Want to save time?
Try using the Saved Report functionality to maintain your filters and sorting views. Discover more about Saving Reports.




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