WebPT Blog - insurance
-
0 CommentsMar 29, 2013| Stacey Abelman
Today’s blog comes from WebPT’s Billing Onboarding & Operations Manager Stacey Abelman. Thanks Stacey! I wish I could tell you that today’s blog was going to be about how to make rehab therapy billing a breeze. But it’s not. There’s no magic answer, no simple solution, and certainly no easy-as-pie fix. Not to fear, though. There are things you can do—steps you can take—to make sure your billing processes are at their very best so you’ll increase your revenue and decrease your headaches. Here are ten:
1. Make a Plan
What’s your clinic’s one-year plan? How about your five-year? Oftentimes, the answer is purchase new equipment, open a second location, or bring on an additional provider. Regardless of your particular goal, though, the first step is always the same: start making a plan of how you’re going to achieve it. And I’m guessing that increasing cash revenue will fall somewhere on this plan. If so, it’s time to start looking at your billing department. Maybe, to meet your practice goal, you need to set some billing specific goals—like decreasing accounts receivable (A/R) greater than 90 days down to less than 10% or sending all claims to carriers in less than two business days. Regardless of your goals—billing-specific and overall clinic—put it on paper, communicate it to your team, and break it into manageable steps.
-
Mar 26, 2013| Heidi Jannenga PT
Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
Yesterday, I discussed the importance of not waiving patient fees. So what to do instead? Develop a system or procedure to collect all patient fees (including copays, deductibles, coinsurance, and payment for non-covered services and supplies) at the time of service. Here are steps based off an article from the APTA. 1.) Establish and enforce written policies and procedures for copay and other fee collection. Make sure you cover everything, including how the front desk will determine fees, what the is process for patient acknowledgement, and ways you’ll collect payment. To facilitate this collection, consider these:
- Get a credit or debit card transaction machine.
- Keep sufficient petty cash on hand to make change for those paying cash.
- Depending on your location, talk with a local bank about installing an ATM in the lobby of your building to encourage cash payments.
- Provide a mechanism for bill payment on your website.
-
Mar 25, 2013| Heidi Jannenga PT
Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
Today, copays are the norm, and they’re only becoming more costly. To top it off, many insurance plans—especially those that individuals and small businesses purchase (including HSAs)—have very large deductibles that patients must meet before insurance will pay for anything. While it’s obvious that these increased copays and deductibles put a burden on patients, they also burden physical therapy practices. How? Many practices don’t have the procedures in place for effective fee collection from patients—especially not in person. Instead, many are willing to simply write off cash collections when the patient doesn’t pay. But with declining insurance reimbursements, successful over-the-counter collections are more important than everWhat are the implications of not collecting?
In an APTA Podcast, Nancy White says, “studies show that the chance of collecting from a patient drops almost 20% as soon as the patient leaves the office.” Anecdotally, I think its higher—especially after patient discharge. While some front offices may find it easier to simply mail a statement after the visit, there are usually hidden costs associated with this. In fact, according to Nancy White, there is data that indicates “it may cost between $5–$10 per patient to send and process each statement by mail.” Not to mention that when you mail statements rather than collect upfront, you’re decreasing your chances of receiving payment and there’s a self-made waiting period for any payments patients do send. -
Dec 26, 2012| Erica Cohen
Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
With the holidays quickly approaching, we thought this would be the perfect time to write a post on best practices when hiring a substitute, or contractor, to cover for you while you’re basking in the sun, boarding down a mountain, hanging out with the in-laws, or doing whatever it is you do to take a much deserved break.
When bringing in another therapist to treat your patients, many PTs face the “bill as” problem: in order to receive reimbursement from your insurance companies, the contractor you hire to cover you must be fully credentialed with the same insurance companies whose benefactors you treat. One of the best ways to assure this is to seek out a contractor from a qualified agency with vetted insurance credentials. This may be a slightly more costly way of doing things compared to simply hiring a friend or associate, but in order to “bill as” correctly, hiring a fully credentialed contractor is your best choice. While this is important for all insurance companies, it is imperative that if you treat Medicare patients, the contractor who steps in for you while you’re on vacation be Medicare credentialed. Otherwise, you risk problems beyond just denied reimbursements.
-
Aug 9, 2012| Charlotte Bohnett
This blog post comes from WebPT copywriters Charlotte Bohnett and Erica Cohen.
Medicare compliance is one very tough nut to crack as is navigating the murky waters of medical insurance billing. We’ve filled this month’s blogs with all sorts of valuable and applicable information on everything from HIPAA to autonomy. But what Medicare obstacles do you grapple with daily? Today, let’s talk the five most frequently asked questions regarding Medicare.
1.) What is the Therapy Cap?
According to the APTA’s FAQs on the Therapy Cap and KX Modifier, under the Balanced Budget Act (BBA) of 1997, Congress placed an annual cap on rehabilitation services through Medicare. That means that Medicare will only reimburse you as the rehabilitation therapist up to a certain dollar amount per patient regardless of services provided.
In 2012, that annual per beneficiary therapy cap is $1,880 for physical therapy and speech language pathology services combined, and there is a separate $1,880 amount allotted for occupational therapy services.
Note: While the Medicare Advantage plan may apply a $1,880 therapy cap with an exceptions process, many Medicare Advantage plans have chosen not to apply a therapy cap in the past. Please check with your Medicare Advantage plan regarding its payment policies.
Read WebPT cofounder, COO, and PT Heidi Jannenga’s take on the therapy cap in her blog post, “Save the Day the CMS Way.” -
Aug 6, 2012| Charlotte Bohnett
Today’s blog post comes from WebPT cofounder and COO Heidi Jannenga, PT, MPT, ATC/LTo all of our Super Therapists working diligently to improve their patients’ functional level and quality of life, the Center for Medicare and Medicaid Services (CMS) has tossed a chunk of Kryptonite into our clinics.
As you know, CMS has implemented many changes this year and continues to have the Proposed Rule for prospective payment and data collection pending. Keeping up to date with these changes is crucial if you are treating patients with Medicare insurance. As our fellow superhero Spiderman says, “Whatever comes our way…we always have a choice...It's the choices that make us who we are, and we can always choose to do what's right.” As therapists, we want to do what’s right for our patients, and that means producing excellent documentation that aligns with Medicare’s compliance requirements. Our skillset as therapists includes validating the need for our services, and we can only achieve this through thorough documentation and use of tests and measures to help show progress during the episode of care. EMRs can help to enforce Medicare compliance, while improving workflow efficiency, but ultimately you’re the last line of defense.
-
Aug 2, 2012| Charlotte Bohnett
Today's post comes from WebPT copywriters Charlotte Bohnett and Erica Cohen.
The Health Insurance Portability and Accountability Act (HIPAA) is as dense as it is important. But for any healthcare provider handling private personal health information, which you promised to protect as part of the Health Information Privacy Rule, there are a few things you must know.
First, a little background information on HIPAA: US Congress established the Health Insurance Portability and Accountability Act in 1996. They implemented Title II: Preventing Health Care Fraud and Abuse to protect a patient’s private health information (PHI).
Under this act, all healthcare providers, insurers, and their business associates may only collect, share, or use a patient’s PHI in approved methods and only for the explicit purpose of furthering patient care.
PHI is defined as demographic information; medical history; test and laboratory results; insurance information; and any other data health professionals collect to identify individual patients and determine their appropriate care.
