In Episode 31 of Reimbursement Readiness: Business Tips for Wound Practice, Kathleen Schaum and Donna Cartwright continue the Wound and Ulcer Management Audit Readiness Series with Part 4, focusing on the importance of accurately documenting and reporting the correct Place of Service (POS).
Donna explains how Place of Service codes identify where care was provided and why they can directly affect payment, denials, and audit exposure. She reviews several of the most common settings in wound and ulcer management, including physician offices, homes, assisted living facilities, hospital outpatient departments, ambulatory surgery centers, skilled nursing facilities, nursing facilities, and independent clinics. Special attention is given to the often-confusing distinction between POS 31 and POS 32, including how Medicare Part A and Part B status, consolidated billing, and CTP payment responsibilities can change depending on the patient’s stay.
The episode also explores how Place of Service affects facility versus non-facility payment rates and why clinicians and billing teams must understand how each facility is registered with Medicare. By verifying the care setting before submitting the claim, wound care professionals can reduce denials, avoid overpayments or underpayments, and strengthen their readiness for both pre- and post-payment audits.
Click to Download Handout (https://wct-us.com/wp-content/uploads/2026/10/RR-EP.31_Place-of-Service-Handout.pdf)
8 Oct 2026
Ep.30 ADR vs Medicare Denial: Knowing the Difference Can Impact Your Revenue
In Episode 30 of Reimbursement Readiness: Business Tips for Wound Practice, Kathleen Schaum welcomes Amiee Coriano to clarify an important distinction that can directly affect reimbursement: the difference between an Additional Documentation Request (ADR) and a Medicare denial.
Amiee explains that an ADR is a request for more information, while a denial is a payment decision that requires corrective action. She walks through why ADRs are issued, what documentation Medicare contractors may be looking for, and how revenue cycle teams should respond before a request escalates into a denial. The episode also reviews common denial reasons, appropriate next steps such as rebilling, recoding, redetermination, or appeal, and best practices for tracking recurring issues.
The discussion closes with a broader look at the financial impact of poor ADR and denial management, including delayed payments, increased administrative costs, lost revenue, and higher audit risk. By recognizing the difference early, responding appropriately, and using trends to improve documentation and coding processes, wound care organizations can strengthen compliance and protect their revenue cycle.
Downloads:
Medicare ADR Response (https://wct-us.com/wp-content/uploads/2026/10/RR_Handout_Medicare_ADR_Response.pdf)
Episode Survey:
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17 Sept 2026
Ep.29 Plan of Care and Progress Notes
In Episode 29 of Reimbursement Readiness: Business Tips for Wound Practice, Kathleen Schaum and Donna Cartwright continue the Wound and Ulcer Management Audit Readiness Series with Part 3, focusing on two of the most important components of the medical record: the plan of care and progress notes.
Donna explains how a comprehensive plan of care supports medical necessity, communicates treatment goals, tracks changes over time, and helps auditors understand why specific services, procedures, and products were selected. She also reviews what should be documented for each wound or ulcer, including measurable goals, expected outcomes, barriers to healing, prior treatments, patient instructions, coordination with other clinicians, and changes made when treatment is not progressing as expected.
The episode also takes a closer look at progress notes and how they should tell the ongoing story of each wound—from prior treatment results and clinical decision-making to measurements, wound appearance, signs of infection, overall assessment, and next steps. By keeping documentation consistent and showing how the patient is progressing from one encounter to the next, wound care teams can strengthen medical necessity and better prepare for payer audits.
Downloads
Plan of Care and Progress Notes Checklist (https://wct-us.com/wp-content/uploads/2026/09/RR-Episode-29-Plan-of-Care-and-Progress-Notes-Checklist.pdf)
Episode Survey
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