Direction on Demand from Encompass Consulting & Education, LLC</= title>  <link rel=3DthemeData href=3D"Jan_2010_files/themedata.thmx"> <link rel=3DcolorSchemeMapping href=3D"Jan_2010_files/colorschememapping.xm= l">  <style>  </style>  </head> <body bgcolor=3Dwhite lang=3DEN-US link=3Dblue vlink=3Dpurple style=3D'tab-= interval:.5in'> <div class=3DSection1> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184;mso-padding-a= lt: 0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"99%" style=3D'width:99.32%;padding:.75pt .75pt .75pt .75pt'> Having trouble vie= wing this email? <a href=3D"http://campaign.constantcontact.com/render?v=3D001lnBTEkB9iIF8NXH= 6Efh9gaLsqtFm_ArHgFhnQJQh5xF-Kcj-vqWUPnVfXH8NjNEz7sMGEfjRZbcNApw-GWi0NMZubv= R7zeDuOhkGG0f5UTcTELMu_3Gxlzdpfi_x3oh8mYqZidpcygwf3wQTiKMkYA%3D%3D" track=3Doff>Click here </a><o:p></o:p> </td> </tr> </table> </div> <o:p> </o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184;mso-padding-a= lt: 0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"100%" style=3D'width:100.0%;padding:.75pt .75pt .75pt .75pt'> <div> You are receiving = this email from Encompass Consulting & Education, LLC because you subscrib= ed on our website or have recently attended one of our seminars and indicated that you wished to subscribe. 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Franko, PT, MCSP"><o:p></o:p> First of all many thanks to the many people taking our Medicare Made Easy seminars last year. You made it a great success.<o:p></o:p></s= pan> This year we are making changes to our 2 day Medicare Made Easy for SNF and consolidating it down into a one day presentation that is focusing on= the nitty gritty of succeeding in SNF with Parts A and B. We have elimina= ted a lot of the historical information and have expanded the workbook to= be a permanent resource for the regulations that the therapists work und= er. <o:p></o:p> We have also taken the second day of the program and made it specific to= the Part B provider. Included in this seminar will be the rules and regulations concerning the provision of Part B services by all provid= er settings, along with how to document to ensure reimbursement and a su= ccessful Medical Review.<o:p></o:p> We have initially scheduled 3 presentations, one in March, April and May= and will be posting other Seminar information on our website by the begin= ning of February.<o:p></o:p> Medicare Made Easy for SNF<o:p></o:p> Charlotte, NC. - March 12th 2010<o:p></o:p> Dallas, TX - April 16th 2010<o:p></o:p> Atlanta, GA - May 14th 2010<o:p></o:p> Medicare Part B Made Easy<o:p></o:p> Charlotte, NC. - March 13th 2010<o:p></o:p> Dallas, TX - April 17th 2010<o:p></o:p> Atlanta, GA - May 15th 2010<o:p></o:p> Visit our website for a list of planned locations. If you have location suggestions or have facilities that we can use, let us know.</= span> <= o:p></o:p> </td> </tr> </table> <div class=3DMsoNormal align=3Dcenter style=3D'text-align:center'> <hr size=3D2 width=3D"100%" align=3Dcenter> </div> <o:p> </o:p> </td> <td width=3D420 rowspan=3D2 valign=3Dtop style=3D'width:315.0pt;backgro= und:white; padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 7.5pt'></td> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 1.5pt'> Dear Pauline,<= /span> <o:p></o:p> Happy New Year to you and your family. May 2010 be a h= ealthy and successful year.<o:p></o:p> Who can believe we have just entered the second decade of the 21st centur= y, WOW. Guess what's interesting? We still have the Medicare Therapy CAP= s in place that were first introduced in January 1999. Presently, the only difference from 11 years ago is that the monies amount has increased a whopping $360 from $1500 to $1860.Learn more about what you need to be doing in our new section News You Can Use <o:p><= /o:p> What a difference a day makes! The unanticipated election of the new senat= or for Massachusetts has put a different complexion on Health Care Reform. I guess we will have to wait and see what happens to the bills already passed by the House and Senate as far as the therapy caps and the exception process goes.<o:p></o:p> I want to thank you for your continued support and subscription to "Direction On Demand", the free e-zine from Encompass Consulting & Education, LLC. This edition will be the last newsle= tter in this format and we will be going under the new name of News and Rules for Therapists so be ready for that headline in February.<o= :p></o:p> If you enjoy this newsletter, feel free to forward it to others who you think would also enjoy the content. Please use the link at the= end of this page to forward to a friend. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:2.25pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:2.25pt'></td> </tr> <tr style=3D'mso-yfti-irow:2;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'padding:1.5pt 1.5pt 1.5pt 1.= 5pt; height:1.5pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:1.5pt'></td> </tr> </table> <a name=3Darticle1.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = News You Can Use: Medi= care changes and how to apply them.<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> As of January 1st , 2010 the financial amount for each therapy cap is $1860 AND the exten= sion of the automatic exception process has expired. <sp= an style=3D'mso-bookmark:"article1\.bg1"'><o:p></o:p></span= > So what does that = mean for you? Well, first of all of your patients, either new or current h= ave the total amount of the caps monies available to them as long as they qualify for Medically Necessary Services. And you no longer add the KX modifier to the January claims for the patients that were utilizing the exception process in 2009. <o:p></o:p>= </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'> </s= pan><a href=3D"http://rs6.net/tn.jsp?et=3D1102962526607&s=3D1&e=3D00= 1hb-KSXDciDkhAKlGsHMc0FSatvpDhR0FE221YLWt6Wn9P2u8gV_NGL6ArMzJFq_XWUR2Ztoy_q= rqowXXLi50yQjynkBw-VDndnli1MNwQmkmuLZVp2iMM1ekbR8tdDF9WIphwSAiUrpTeU9deZ-nB= FwDW-AM7ma4fpNeLMULDB2ra1KOWUn9CO7-tPdCYQ3dYmPgaYQMlXs=3D" color=3D"#003366" shape=3Drect>Article Link</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle1.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Tip of the Month: Surv= iving a RAC Attack!<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> The RAC contractors have been busy these past few months. The first "issues"= they have been going after have been the billing of more than one uni= t of non-timed codes. This is really a no brainer but obviously it is done= in sufficient numbers to make it very worth while. The beauty of this ty= pe of denial is that they get to keep their money because it is not appealable as it's against the rules. <o:p></o:p> So what can you do? Make sure that the claim is reviewed before submission to check that = this has not occurred. This should be easy for therapists as we do not have many non-time sensitive codes. <o:p></o:p> Remember: <= /b><o:p></o:p></span= > <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>ALL evaluation and re-evaluation codes are single unit codes, along = with the speech codes for swallowing and language treatments. These l= ast two were biggies in the demonstration. <o:p></o:p>= </li> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>Supervised modalities are 1 unit codes even if you treat multiple locations under Medicare guidelines.<o:p></o:p></li> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>Group treatment is a non-timed procedure.<o:p></o:p></li> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>And finally for those of you who provide wound care, both of the bil= ling codes are non-timed AND include the dressings.<o:p></o:p>= </li> </ul> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Updates on Medical Review Activities= : CERT Contractor Denials<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> It appears that the CERT contractor is no longer publishing the National Annual Report on their medical review findings since their website has not been update= d since May 2008. The question is now being asked "Where can we find that information?" <o:p></o:p> Well presently the only way that information is available is through the individual MAC websites. You may or may not be aware that the information found on e= ach MAC's website varies considerably, so you are dependent on what your = MAC feels is important enough to share. However, there are a few MACs whi= ch publish the CERT findings for their region on their website. <o:p></o= :p> As it appears that most of the denials are based on the same types of errors, we are covering some of the most common denial reasons in this article.</spa= n> <o:p></o:p>= </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'> </s= pan><a href=3D"http://rs6.net/tn.jsp?et=3D1102962526607&s=3D1&e=3D00= 1hb-KSXDciDn3w1H7SpITZ8I49_32hUpV11T3k2DHoxIFYIkMAGDnxidwojjPij9B9KUoQb2iSF= fO-vPSTbReP4ejyixK6oKWvFMckZPno_9zn5a517jcInGsjt6zsWvEwFFhMxGLAp1g65Z6S1D35= Zl89yEI90aR6bWa7G-71GQpG6mbhFYGH1q9pser5oRJ" color=3D"#003366" shape=3Drect>Article Link</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Q&A: Use = of the 59 modifier for CCI edits<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question: <= /b>I attended one of your s= eminars last September and have a follow-up question for you regarding CCI ed= its. I have noted that you mentioned CCI edits can be bundled between disciplines, (such as speech treatment and therapeutic activities by = PT, or PT and OT treatments on the same service date). But all the Medica= re information that I find states the codes have to be from the same provider to be bundled. Did I misunderstand you at the seminar? <o:p>= </o:p> Answer: </b= >For all Part A providers= billing Part B services, (SNF, CORF, Rehab Agencies, Home Health and Hospital= s) the Part A entity is the provider not the therapist. So as the= CCI edits are provider specific any codes billed on the same day by t= hat entity are subject to the edit Even though the bill clearly identifies the discipline specific modifier (GO, GP and GN), the contractors automatic review systems are not programmed to recognize those, just = the 59 modifier. <o:p></o:p> Remember that the = CCI edits were developed primarily for physician services and the "true" Part B providers (therapists in private practice) ha= ve always been under these edits. Their bills do not cross discipline li= nes as they bill discipline specific due to each therapist being the Medi= care provider. Thus in those instances, as well as the times when other Pa= rt B providers provide only the one discipline, the application of the 59 modifier must be determined by the individual therapist, not the biller, and the documentation must clearly support distinct a= nd separate services. = <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle5.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Our Company<o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Direction on Deman= d is brought to you by Encompass Consulting & Education, LLC. A therap= ist owned company specializing in Consulting and Educational services for= therapists and other professionals providing Medicare services in SNF, Rehab Agencies, Private Practice, and Hospital Outpatient Facilities.<o:p><= /o:p> Pauline M. Franko,= PT, MCSP is owner and CEO of the company and is also known as the "Medicare Advisor" for the "Advance for" family of News Magazines.She acts as a resource for the respected Eli Reports.<= /span> <o:p></o:p>= </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle5.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Please participate in our survey</sp= an><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> We will be adding surveys to our newsletter in order to find out what is of most value = for you. 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Please download a browser that supports Web Archive, such as Windows® Internet Explorer®. ------=_NextPart_01CA9DB5.CC7E6F80 Content-Location: file:///C:/2209C650/Jan_2010.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Direction on Demand from Encompass Consulting & Education, LLC</= title>  <link rel=3DthemeData href=3D"Jan_2010_files/themedata.thmx"> <link rel=3DcolorSchemeMapping href=3D"Jan_2010_files/colorschememapping.xm= l">  <style>  </style>  </head> <body bgcolor=3Dwhite lang=3DEN-US link=3Dblue vlink=3Dpurple style=3D'tab-= interval:.5in'> <div class=3DSection1> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184;mso-padding-a= lt: 0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"99%" style=3D'width:99.32%;padding:.75pt .75pt .75pt .75pt'> Having trouble vie= wing this email? <a href=3D"http://campaign.constantcontact.com/render?v=3D001lnBTEkB9iIF8NXH= 6Efh9gaLsqtFm_ArHgFhnQJQh5xF-Kcj-vqWUPnVfXH8NjNEz7sMGEfjRZbcNApw-GWi0NMZubv= R7zeDuOhkGG0f5UTcTELMu_3Gxlzdpfi_x3oh8mYqZidpcygwf3wQTiKMkYA%3D%3D" track=3Doff>Click here </a><o:p></o:p> </td> </tr> </table> </div> <o:p> </o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184;mso-padding-a= lt: 0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"100%" style=3D'width:100.0%;padding:.75pt .75pt .75pt .75pt'> <div> You are receiving = this email from Encompass Consulting & Education, LLC because you subscrib= ed on our website or have recently attended one of our seminars and indicated that you wished to subscribe. 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If you haven't done so already, click to <a href=3D"http://visitor.constantcontact.com/c.jsp?t=3D1102962526607.1.6211= 4275.2&m=3D1101399613904&wl=3DF" target=3D"_blank">confirm</a> your interest in receiving email campaigns = from us. <o:p></o:p> <div> <o:p></o:p><= /span> </div> <div> You may <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZf5= Cw4pNfqOqfZLL0WIuxCdqsguxN3JCrG72rVjkUrPe7ZAHY5SFMdAd0VfQUq_SqCNZlZ7U%3D" target=3D"_blank">unsubscribe</a> if you no longer wish to receive our em= ails.<o:p></o:p> </div> </div> </td> </tr> </table> </div> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i1033" src=3D"http://rs6.net/on.jsp?t=3D1102962526607.0.1101399613904.1&ts=3DS= 0451&o=3Dhttp://ui.constantcontact.com/images/p1x1.gif" alt=3D" ">= <o:p></o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D610 style= =3D'width:457.5pt; mso-cellspacing:1.5pt;background:#CC3366;mso-yfti-tbllook:1184;mso-padding= -alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'background:white;padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padd= ing-alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <i= mg border=3D0 width=3D600 height=3D129 id=3D"_x0000_i1032" src=3D"http://ih.constantcontact.com/fs035/1101399613904/img/1.jpg?a=3D= 1102962526607" alt=3D"Direction on Demand"><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:45.0pt'> <td colspan=3D2 style=3D'background:white;padding:0in 0in 0in 0in;heigh= t:45.0pt'> Encompass Consulting & Education, = LLC E-Zine= <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style=3D'padding:0in 0in 0in 3.75pt'> Vol. 5, No. 1<= /span><o:p></o:p><= /p> </td> <td style=3D'padding:0in 3.75pt 0in 0in'> January 2010<o:p></o:p><= /p> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#CCCCCC;mso-yfti-tb= llook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:1.5pt;background:#CC3366;mso-yft= i-tbllook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:ye= s'> <td valign=3Dtop style=3D'background:white;padding:0in 0in 0in 0in'> <s= pan style=3D'font-size:10.0pt;font-family:"Georgia","serif";mso-fareast-f= ont-family: "Times New Roman";color:#993366'>In This Issue<o:p></o:p></span= > </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:#CCCCCC;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <o:p> </o:p> <a href=3D"#column" color=3D"#003366" shape=3Drect>Encom= pass Seminars 2010</a><o:p></o:p> <a href=3D"#article1.bg1" color=3D"#003366" shape=3Drect>News You= Can Use: Medicare changes and how to apply them.</a><o:p></o:p><= /b> <a href=3D"#article1.bg2" color=3D"#003366" shape=3Drect>Tip of t= he Month: Surviving a RAC Attack!</a><o:p></o:p> <a href=3D"#article2.bg1" color=3D"#003366" shape=3Drect>Updates = on Medical Review Activities: CERT Contractor Denials</a><o:p></o:p> <a href=3D"#article2.bg2" color=3D"#003366" shape=3Drect>Q&A:= Use of the 59 modifier for CCI edits</a><o:p></o:p>= <a href=3D"#article5.bg1" color=3D"#003366" shape=3Drect>Our Comp= any</a><o:p></o:p> <a href=3D"#article5.bg2" color=3D"#003366" shape=3Drect>Please p= articipate in our survey</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dtop style=3D'background:#CC3366;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <div> <o:p></o:p> </div> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#C= CCCCC; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:ye= s'> <td style=3D'padding:0in 0in 0in 0in'> <div> <a na= me=3Dcolumn shape=3Drect> </a>Encompass Seminars 2010<o:p></o:p> </div> <img border=3D0 width=3D91 height=3D110 id=3D"_x0000_i1031" src=3D"http://ih.constantcontact.com/fs035/1101399613904/img/2.jpg?a= =3D1102962526607" alt=3D"Pauline M. Franko, PT, MCSP"><o:p></o:p> First of all many thanks to the many people taking our Medicare Made Easy seminars last year. You made it a great success.<o:p></o:p></s= pan> This year we are making changes to our 2 day Medicare Made Easy for SNF and consolidating it down into a one day presentation that is focusing on= the nitty gritty of succeeding in SNF with Parts A and B. We have elimina= ted a lot of the historical information and have expanded the workbook to= be a permanent resource for the regulations that the therapists work und= er. <o:p></o:p> We have also taken the second day of the program and made it specific to= the Part B provider. Included in this seminar will be the rules and regulations concerning the provision of Part B services by all provid= er settings, along with how to document to ensure reimbursement and a su= ccessful Medical Review.<o:p></o:p> We have initially scheduled 3 presentations, one in March, April and May= and will be posting other Seminar information on our website by the begin= ning of February.<o:p></o:p> Medicare Made Easy for SNF<o:p></o:p> Charlotte, NC. - March 12th 2010<o:p></o:p> Dallas, TX - April 16th 2010<o:p></o:p> Atlanta, GA - May 14th 2010<o:p></o:p> Medicare Part B Made Easy<o:p></o:p> Charlotte, NC. - March 13th 2010<o:p></o:p> Dallas, TX - April 17th 2010<o:p></o:p> Atlanta, GA - May 15th 2010<o:p></o:p> Visit our website for a list of planned locations. If you have location suggestions or have facilities that we can use, let us know.</= span> <= o:p></o:p> </td> </tr> </table> <div class=3DMsoNormal align=3Dcenter style=3D'text-align:center'> <hr size=3D2 width=3D"100%" align=3Dcenter> </div> <o:p> </o:p> </td> <td width=3D420 rowspan=3D2 valign=3Dtop style=3D'width:315.0pt;backgro= und:white; padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 7.5pt'></td> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 1.5pt'> Dear Pauline,<= /span> <o:p></o:p> Happy New Year to you and your family. May 2010 be a h= ealthy and successful year.<o:p></o:p> Who can believe we have just entered the second decade of the 21st centur= y, WOW. Guess what's interesting? We still have the Medicare Therapy CAP= s in place that were first introduced in January 1999. Presently, the only difference from 11 years ago is that the monies amount has increased a whopping $360 from $1500 to $1860.Learn more about what you need to be doing in our new section News You Can Use <o:p><= /o:p> What a difference a day makes! The unanticipated election of the new senat= or for Massachusetts has put a different complexion on Health Care Reform. I guess we will have to wait and see what happens to the bills already passed by the House and Senate as far as the therapy caps and the exception process goes.<o:p></o:p> I want to thank you for your continued support and subscription to "Direction On Demand", the free e-zine from Encompass Consulting & Education, LLC. This edition will be the last newsle= tter in this format and we will be going under the new name of News and Rules for Therapists so be ready for that headline in February.<o= :p></o:p> If you enjoy this newsletter, feel free to forward it to others who you think would also enjoy the content. Please use the link at the= end of this page to forward to a friend. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:2.25pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:2.25pt'></td> </tr> <tr style=3D'mso-yfti-irow:2;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'padding:1.5pt 1.5pt 1.5pt 1.= 5pt; height:1.5pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:1.5pt'></td> </tr> </table> <a name=3Darticle1.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = News You Can Use: Medi= care changes and how to apply them.<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> As of January 1st , 2010 the financial amount for each therapy cap is $1860 AND the exten= sion of the automatic exception process has expired. <sp= an style=3D'mso-bookmark:"article1\.bg1"'><o:p></o:p></span= > So what does that = mean for you? Well, first of all of your patients, either new or current h= ave the total amount of the caps monies available to them as long as they qualify for Medically Necessary Services. And you no longer add the KX modifier to the January claims for the patients that were utilizing the exception process in 2009. <o:p></o:p>= </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'> </s= pan><a href=3D"http://rs6.net/tn.jsp?et=3D1102962526607&s=3D1&e=3D00= 1hb-KSXDciDkhAKlGsHMc0FSatvpDhR0FE221YLWt6Wn9P2u8gV_NGL6ArMzJFq_XWUR2Ztoy_q= rqowXXLi50yQjynkBw-VDndnli1MNwQmkmuLZVp2iMM1ekbR8tdDF9WIphwSAiUrpTeU9deZ-nB= FwDW-AM7ma4fpNeLMULDB2ra1KOWUn9CO7-tPdCYQ3dYmPgaYQMlXs=3D" color=3D"#003366" shape=3Drect>Article Link</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle1.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Tip of the Month: Surv= iving a RAC Attack!<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> The RAC contractors have been busy these past few months. The first "issues"= they have been going after have been the billing of more than one uni= t of non-timed codes. This is really a no brainer but obviously it is done= in sufficient numbers to make it very worth while. The beauty of this ty= pe of denial is that they get to keep their money because it is not appealable as it's against the rules. <o:p></o:p> So what can you do? Make sure that the claim is reviewed before submission to check that = this has not occurred. This should be easy for therapists as we do not have many non-time sensitive codes. <o:p></o:p> Remember: <= /b><o:p></o:p></span= > <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>ALL evaluation and re-evaluation codes are single unit codes, along = with the speech codes for swallowing and language treatments. These l= ast two were biggies in the demonstration. <o:p></o:p>= </li> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>Supervised modalities are 1 unit codes even if you treat multiple locations under Medicare guidelines.<o:p></o:p></li> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>Group treatment is a non-timed procedure.<o:p></o:p></li> <li class=3DMsoNormal style=3D'color:#993366;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo3;tab-stops:lis= t .5in'>And finally for those of you who provide wound care, both of the bil= ling codes are non-timed AND include the dressings.<o:p></o:p>= </li> </ul> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Updates on Medical Review Activities= : CERT Contractor Denials<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> It appears that the CERT contractor is no longer publishing the National Annual Report on their medical review findings since their website has not been update= d since May 2008. The question is now being asked "Where can we find that information?" <o:p></o:p> Well presently the only way that information is available is through the individual MAC websites. You may or may not be aware that the information found on e= ach MAC's website varies considerably, so you are dependent on what your = MAC feels is important enough to share. However, there are a few MACs whi= ch publish the CERT findings for their region on their website. <o:p></o= :p> As it appears that most of the denials are based on the same types of errors, we are covering some of the most common denial reasons in this article.</spa= n> <o:p></o:p>= </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'> </s= pan><a href=3D"http://rs6.net/tn.jsp?et=3D1102962526607&s=3D1&e=3D00= 1hb-KSXDciDn3w1H7SpITZ8I49_32hUpV11T3k2DHoxIFYIkMAGDnxidwojjPij9B9KUoQb2iSF= fO-vPSTbReP4ejyixK6oKWvFMckZPno_9zn5a517jcInGsjt6zsWvEwFFhMxGLAp1g65Z6S1D35= Zl89yEI90aR6bWa7G-71GQpG6mbhFYGH1q9pser5oRJ" color=3D"#003366" shape=3Drect>Article Link</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Q&A: Use = of the 59 modifier for CCI edits<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question: <= /b>I attended one of your s= eminars last September and have a follow-up question for you regarding CCI ed= its. I have noted that you mentioned CCI edits can be bundled between disciplines, (such as speech treatment and therapeutic activities by = PT, or PT and OT treatments on the same service date). But all the Medica= re information that I find states the codes have to be from the same provider to be bundled. Did I misunderstand you at the seminar? <o:p>= </o:p> Answer: </b= >For all Part A providers= billing Part B services, (SNF, CORF, Rehab Agencies, Home Health and Hospital= s) the Part A entity is the provider not the therapist. So as the= CCI edits are provider specific any codes billed on the same day by t= hat entity are subject to the edit Even though the bill clearly identifies the discipline specific modifier (GO, GP and GN), the contractors automatic review systems are not programmed to recognize those, just = the 59 modifier. <o:p></o:p> Remember that the = CCI edits were developed primarily for physician services and the "true" Part B providers (therapists in private practice) ha= ve always been under these edits. Their bills do not cross discipline li= nes as they bill discipline specific due to each therapist being the Medi= care provider. Thus in those instances, as well as the times when other Pa= rt B providers provide only the one discipline, the application of the 59 modifier must be determined by the individual therapist, not the biller, and the documentation must clearly support distinct a= nd separate services. = <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle5.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Our Company<o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Direction on Deman= d is brought to you by Encompass Consulting & Education, LLC. A therap= ist owned company specializing in Consulting and Educational services for= therapists and other professionals providing Medicare services in SNF, Rehab Agencies, Private Practice, and Hospital Outpatient Facilities.<o:p><= /o:p> Pauline M. Franko,= PT, MCSP is owner and CEO of the company and is also known as the "Medicare Advisor" for the "Advance for" family of News Magazines.She acts as a resource for the respected Eli Reports.<= /span> <o:p></o:p>= </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle5.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Please participate in our survey</sp= an><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> We will be adding surveys to our newsletter in order to find out what is of most value = for you. 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