PM&R (Physiatry)

Top denial drivers

• Functional status and progress documented narratively instead of with a validated instrument
• Coordination with primary care not captured in a way quality reporting can use
• Documentation reviewed against a generic template instead of the current payer policy

What reviewers expect to see

• Functional status recorded with a validated instrument, not inferred from narrative notes
• Primary care coordination captured explicitly
• Documentation aligned to the current policy of the specific payer it is going to