• 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 …

  • Creating a Compliance Plan for Your Practice Image

    article Jul 17, 2014

    Creating a Compliance Plan for Your Practice

    Today, we will "chat" about the system of checks and balances your practice should have in place to ensure you follow compliance regulation requirements—in other words, your compliance plan. I know, at least lately, it seems the regulatory requirements to participate in health care have been sharply increasing. At PT Compliance Group, we have been focusing on the federal level, but state regulations and private insurance requirements also are changing. Below, I’ve addressed some of the questions …

  • 5 Things You Need to Know About Medicare Audits Image

    article Jul 16, 2014

    5 Things You Need to Know About Medicare Audits

    If you treat Medicare patients, then you know all-too-well that the only thing worse than having to understand—and follow—Medicare’s thick book o’ rules is having to worry about the ever-present threat of a potential audit. After all, the national media love a good fraud story , and even if you’re fairly confident that you are doing everything right, each breaking audit headline probably plants a small seed of worry somewhere deep in your subconscious. With that in …

  • Common Medicare Compliance Rules for Substitute, Almost-Credentialed, and Non-Credentialed Therapists Image

    article Jul 15, 2014

    Common Medicare Compliance Rules for Substitute, Almost-Credentialed, and Non-Credentialed Therapists

    Medicare compliance rules for fully credentialed therapists can be more than a bit complicated, so it’s not too surprising that the rules governing substitute, almost-credentialed, and non-credentialed therapists would be equally perplexing. With that in mind, here are some common rules to help you navigate these murky Medicare waters: For Substitute Therapists It is officially summer—and with warmer temps, there will naturally be a lot more vacation requests. If you’re looking to hire substitutes to cover for …

  • The Rehab Therapist’s Guide to Co-Treatment Under Medicare Image

    article Jul 14, 2014

    The Rehab Therapist’s Guide to Co-Treatment Under Medicare

    If you treat in a setting that offers multiple types of therapy (e.g., physical therapy, occupational therapy, and/or speech-language pathology), then you likely have—or will—come upon a situation in which it is in a patient’s best interest to receive treatment in more than one discipline during a single session. And while this practice is absolutely permissible under Medicare policy, there are some special rules governing the manner in which you provide—and bill for—such services. These rules vary …

  • Supervision: PT Assistants, Aides, and Students Image

    article Jul 10, 2014

    Supervision: PT Assistants, Aides, and Students

    Physical therapist assistants (PTAs) and aides as well as PT students can be a big help to therapy practices. But, per state and Medicare law, not all titles are created—or treated—equally. Read on to learn how you can incorporate the services of assistants, aides, and students into your practice—and still get paid. Physical Therapist Assistants Under Medicare, physical therapist assistants can provide physical therapy services in an outpatient private practice setting—as long as those services are performed …

  • Medicare Part B Documentation Requirements for Physical and Occupational Therapy Image

    article Jul 9, 2014

    Medicare Part B Documentation Requirements for Physical and Occupational Therapy

    Medicare reimburses for Part B physical and occupational therapy services when the claim form and supporting documentation accurately report medically necessary covered services. Thus, developing legible and relevant documentation is only one piece of the reimbursement puzzle. Your documentation must also: Justify the services you bill Comply with all applicable Medicare regulations Support any listed CPT codes Conform to state and local laws as well as the professional guidelines of the American Physical Therapy Association (APTA) or …

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