LCDs: The ADR Cheatsheet No One Knows About

Описание: You did everything right, passed your survey, documented thoroughly, and followed every policy.
So why did Medicare still deny your claim?

In this episode, Mariam Treystman breaks down the one tool that could transform your agency’s ADR outcomes: Local Coverage Determinations (LCDs).

Learn how LCDs help interpret Medicare’s clinical standards, guide your charting practices, and protect your agency from ADR denials. Whether you’re a home health administrator, DPCS, or compliance lead, this episode will help you close the gap between “doing everything right” and actually getting paid for it.

📘 In this episode, you’ll learn:
• What Local Coverage Determinations (LCDs) actually are
• How LCDs differ from survey standards and CoPs
• Why your charts can pass survey but fail ADR review
• How to use LCDs to strengthen your documentation and billing
• Practical tips for DPCS and clinical teams to stay compliant

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0:00 - Intro
0:35 - What is an LCD (Local Coverage Determination)
2:41 - What is an ADR (Additional Documentation Request)
10:53 - Depending on "Who is Asking for the ADR" The Purpose of the ADR Changes
11:59 - Appropriate Charting & Treatment Starts with Understanding "What People Expect of You"
12:23 - LCDs = Medicare Approved way to treat & Document Specific Conditions, Diseases, & Issues
15:06 - How LCDs Work?
15:49 - How Do You Use LCDs?
20:53 - In Home Health the Elegibility Criteria is Vague