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

    articleJul 30, 2014 | 4 min. read

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

    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 sure to inquire directly with the carrier. If I did not submit …

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

    articleJul 29, 2014 | 6 min. read

    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 …

  • 5 Things You Need to Know About Medicare Audits Image

    articleJul 16, 2014 | 6 min. read

    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 …

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

    articleJul 14, 2014 | 3 min. read

    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 …

  • Should Physical Therapists Enroll as Medicare Providers? Image

    articleJul 8, 2014 | 9 min. read

    Should Physical Therapists Enroll as Medicare Providers?

    If you’re starting—or have ever started—a private physical therapy practice, then you’ve almost certainly grappled with the decision of whether to accept Medicare patients. And unless your patient demographic absolutely demands that you do, I’m guessing it is—or was—a pretty tough call to make. I’ll be upfront: the title of this post is perhaps a bit misleading, because honestly, there is no one-size-fits-all answer to this question. As such, I can’t, in good conscience, definitively tell you …

  • Common Questions from our Modifier Open Forum Image

    articleJul 7, 2014 | 10 min. read

    Common Questions from our Modifier Open Forum

    Should I have my patients sign an advance beneficiary notice of noncoverage (ABN) just in case Medicare doesn’t pay? No, by having your patient sign an ABN, you are acknowledging that you do not believe that the services you are providing are either medically necessary or covered by Medicare. If you have an ABN on file, you should include a modifier GA or GX modifier on your claim so Medicare knows to deny the claim and assign …

  • WebPT Staff Spotlight on Ted Stokes Image

    articleJun 27, 2014 | 4 min. read

    WebPT Staff Spotlight on Ted Stokes

    With so many rules to follow, codes and modifiers to deal with, and hoops to jump through, the billing process isn’t exactly the most enjoyable part of a physical therapist’s job. But Ted Stokes, WebPT’s Director of Billing Services, relishes in it—especially when he has the opportunity to help therapists overcome the barriers that stand between them and their reimbursements. “I like removing problems for people so they can move forward, whether that’s for our Members or …

  • Negotiating Payer Contracts (Part 2): Taking Action Image

    articleJun 24, 2014 | 6 min. read

    Negotiating Payer Contracts (Part 2): Taking Action

    You’ve done all of your research and amassed a wealth of supporting data. Now you’re ready to make a super strong case for increasing your reimbursement rates with a particular private payer. (If you missed my post about preparing for payer contract negotiations, you can check it out here .) But this isn’t your average business negotiation; making a deal with a health plan representative is a little more complex than, say, haggling over the price of …

  • How to Negotiate Payer Contracts (Part 1): Making a Plan Image

    articleJun 23, 2014 | 7 min. read

    How to Negotiate Payer Contracts (Part 1): Making a Plan

    In today’s healthcare payment landscape, every dollar counts—especially in the physical therapy realm, where increasing regulations and decreasing reimbursements seem to be the name of the game. That’s why now, more than ever, it’s crucial that you get the most out of your private payer contracts—and to do that, you’ve got to negotiate. To help you make a case for the rates you deserve, I’ve put together a two-part guide to successfully negotiating payer contracts. Today, I’ll …

  • Choosing the Right Billing Method for Your Practice: In-House, Outsourced, or Offshore? Image

    articleJun 4, 2014 | 6 min. read

    Choosing the Right Billing Method for Your Practice: In-House, Outsourced, or Offshore?

    For many physical therapists, billing is kind of like weeding a garden. It’s a chore that—though tedious and generally unenjoyable—is absolutely necessary. Because just as your pansies and geraniums will suffer if you let weeds overrun them, your practice will suffer if you let outstanding balances and backed-up appeals overrun your billing department. However, while most people would find it fairly easy to hire someone to pull their dandelions, many practitioners are reluctant to turn over their …

  • Ten Ways Physical Therapists Can Maximize Billing Image

    articleJun 2, 2014 | 7 min. read

    Ten Ways Physical Therapists Can Maximize Billing

    In a perfect world, physical therapists wouldn’t have to deal with billing. They’d simply treat, heal, and magically receive payment for their services. But we don’t live in that fantasy world, and unfortunately, the billing process is anything but magical. If you’re a PT, submitting claims comes with the territory. Luckily, there are a few things you can do to optimize your billing process to give yourself more revenue—and fewer headaches. Here are our top ten: 1. …

  • Hiring the Right Marketing and Sales Person for Your Practice Image

    articleMay 15, 2014 | 5 min. read

    Hiring the Right Marketing and Sales Person for Your Practice

    As a physical therapist, you know that the vast majority of the general public could benefit from your services in one way or another. The sad reality, though, is that most people don’t even know what physical therapists do —let alone how seeing a PT could drastically improve their quality of life. In any business, though, profits are driven by demand. And if you want to keep your doors open—or better yet, grow your practice—then you have …

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