Tip. Start with the guide that matches the denial or audit question in front of you.
Florida law says Medicaid goods and services are treated as excessive or not medically necessary unless the medical basis and specific need are fully documented in the record, and that an overpayment determination rests on contemporaneous records (section 409.913, F.S.). That makes the session note the first line of defense for every unit you bill.
Guides in this section
Common questions
What must an ABA session note include in Florida?
Per coverage policy section 6.2.4: date, time, location and duration; maladaptive behaviors observed; replacement skills targeted; the recipient's response; any protocol modification or therapist direction; an explanation if the parent or guardian was absent; and participants. The note must be signed and dated by the rendering practitioner.
Does Florida Medicaid audit providers at random?
Yes. Section 409.913(2), F.S., says at least 5 percent of all audits shall be conducted on a random basis.
Other sections
Stop denials where they start.
Most of what payers reject was visible in the note. Let us show you on your own claims.