• Common Questions from our G-Code Denials Webinar: Part 2 Image

    article Jul 30, 2014

    Common Questions from our G-Code Denials Webinar: Part 2

    Today’s blog post comes from WebPT writers Brooke Andrus and Erica Cohen. I heard that some private insurance carriers are now requiring functional limitation reporting. Is this true? Some non-Medicare insurers do require functional limitation reporting (e.g., Texas Workers' Compensation). Check out this blog post to see a list of the ones we know about right now. Keep in mind, however, that this list is ever-changing—so if you’re unsure of whether a particular plan requires FLR, be …

  • Common Questions from our G-Code Denials Webinar: Part 1 Image

    article Jul 29, 2014

    Common Questions from our G-Code Denials Webinar: Part 1

    Today’s blog post comes from WebPT writers Brooke Andrus and Erica Cohen. If a patient has more than one functional limitation associated with a single diagnosis, should I report G-codes and severity modifiers for all of them? No. Medicare will only accept functional limitation reporting (FLR) data for one primary functional limitation per case. Therefore, if the patient has multiple functional limitations associated with a single diagnosis, you'll need to determine which one represents the patient's primary …

  • Compliance and Cash-Based Physical Therapy Services Image

    article Jul 28, 2014

    Compliance and Cash-Based Physical Therapy Services

    Many therapists I speak with mistakenly assume that cash-based practice owners don’t need to worry about compliance issues. This faulty assumption could get you in trouble if you plan on offering cash-based physical therapy services in your practice. Here, I’ll address three common compliance myths regarding cash services. Myth #1: You don’t need to worry about billing codes and documentation. Truth: You may be shocked to know that my documentation and billing practices are not that different …

  • Stop the Denials! How to Report G-Codes so You Get Paid. Image

    webinar Jul 25, 2014

    Stop the Denials! How to Report G-Codes so You Get Paid.

    It’s been more than a year since Medicare’s functional limitation reporting (FLR) mandate went into effect. You’d think everything would be hunky-dory by now. Unfortunately, though, rehab therapists have been forced to navigate more than a few hiccups and glitches—many of which cause claim denials. Exasperating? Certainly. Insurmountable? No way, José! Join WebPT founder and COO Heidi Jannenga and PT compliance expert Rick Gawenda of Gawenda Seminars as they tackle Medicare’s many FLR curveballs. In addition to …

  • This Week in PT News, July 25 Image

    article Jul 25, 2014

    This Week in PT News, July 25

    APTA Opposes UnitedHealthcare's Plan to Require Functional Reporting On Monday, July 21, the APTA announced that they have sent a letter to UnitedHealthcare urging the carrier to halt plans to implement functional reporting on August 1, 2014. The APTA argues this move is ill-advised due to the burden it will create for therapists and lack of data regarding the effectiveness of functional limitation reporting. Read more on the APTA’s stance on UnitedHealthcare’s decision here Little League Shoulder …

  • Gifts, Donations, and Discounts: What Medicare Needs You to Know Image

    article Jul 24, 2014

    Gifts, Donations, and Discounts: What Medicare Needs You to Know

    The world of private practice physical therapy is certainly competitive, so it makes sense that owners and directors consider every angle when it comes to promoting their businesses. Unfortunately, some of those angles can get you and your practice in hot water with Medicare. Today, I’ll discuss handling gifts, donations, and discounts in a way that doesn’t rile up the big M. But before I launch into that, here’s a legal primer: Stark Law vs. Federal Anti-Kickback …

  • Is Professional Liability Insurance Worth it? Image

    article Jul 23, 2014

    Is Professional Liability Insurance Worth it?

    You’ve got health insurance, dental insurance, vision insurance, auto insurance, home insurance, life insurance—and if those weren’t enough, if you’re a practice owner or an independent contractor, you probably have professional liability insurance, too. But what if you’re a PT or PTA on staff at a clinic, hospital, or rehab center? Do you need your own liability insurance policy? According to Jonathan Bassett, author of this Advance article, it all “depends on whom you ask.” For the …

  • HHS is Cracking Down on HIPAA Breaches. Is Your Clinic at Risk? Image

    article Jul 22, 2014

    HHS is Cracking Down on HIPAA Breaches. Is Your Clinic at Risk?

    If you thought HHS’s bark about cracking down on HIPAA breaches was worse than its bite, think again. Some very high-profile healthcare organizations have spent copious amounts of money this year to atone for their privacy-violating sins. Read on to learn more. Electronic Records According to a US Department of Health & Human Services press release , New York and Presbyterian Hospital (NYP) and Columbia University (CU) recently agreed to a $4.8 million settlement regarding “charges that …

  • HHS Proposes Auto-Enrollment Plans for Marketplace Consumers Image

    article Jul 21, 2014

    HHS Proposes Auto-Enrollment Plans for Marketplace Consumers

    Last month, the Department of Health and Human Services (HHS)—with help from the National Association of Insurance Commissioners—proposed a new rule that would essentially automatically re-enroll health insurance beneficiaries who obtained their plans via an exchange or marketplace. According to this article , HHS thinks this system could ensure continuity of coverage, reduce administrative complexity, and protect insurers’ market share. However, some, like Elizabeth Carpenter, the director of Avalere Health , believe that individuals may benefit from …

  • This Week in PT News, July 18 Image

    article Jul 18, 2014

    This Week in PT News, July 18

    CMS Releases Proposed 2015 Medicare Physician Fee Schedule Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare physician fee schedule for 2015. You can read highlights of the proposed rule and access a link to view the full version here . CMS will accept public comments on the rule until September 2, 2014, and the organization is expected to release the final fee schedule on or before November 1, 2014. ACL …

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