• Why PTs Should Approach ACOs with Caution Image

    articleMay 28, 2015 | 6 min. read

    Why PTs Should Approach ACOs with Caution

    While many ACOs are enjoying success , that hasn’t been the case for everyone—especially when it comes to CMS-sponsored programs. As of September 2014, only 19 of the original 32 organizations that joined the Medicare Pioneer Accountable Care Organization program were still involved. Despite the program’s total savings of more than $384 million over two years, the economic model didn’t work for all participants. Some of the Pioneer organizations weren’t able to make large enough improvements in …

  • CMS Can See Clearly Now, Releases PQRS Strategic Vision Image

    articleMay 21, 2015 | 3 min. read

    CMS Can See Clearly Now, Releases PQRS Strategic Vision

    All month long, we’ve talked about the healthcare industry’s rapid evolution from the fee-for-service Stone Age to the pay-for-performance Enlightenment Period. Yes, payment reform is upon us , but don’t take our word for it—take it straight from America's largest payer of healthcare services: The Centers for Medicare and Medicaid Services (CMS). In an effort to “contribute to improved healthcare quality across the nation,” CMS recently published the Physician Quality Reporting Programs Strategic Vision , detailing a …

  • To ACO or Not to ACO: The Efficacy Question Image

    articleMay 20, 2015 | 4 min. read

    To ACO or Not to ACO: The Efficacy Question

    Yesterday, I told you about accountable care organizations (ACO) and how they might affect your physical therapy practice . Just one of several alternative payment models , the ACO approach seems to foster better and more expedient care, lower costs, and greater emphasis on physical therapists’ role as care coordinators. But CMS has experienced high dropout rates with its Pioneer program, and Medicare has already gone through three iterations of its ACO model, including the recent release …

  • What PTs Need to Know About ACOs Image

    articleMay 19, 2015 | 5 min. read

    What PTs Need to Know About ACOs

    As a physical therapist, you’re likely well-versed in the acronyms that drive your documentation practices: HIPAA , CPT , CMS , PQRS , FLR , and FML (just kidding). But there’s one more to watch for: ACO. By now, you’ve probably heard this one being bandied about in discussions about healthcare reform and alternative payment models, but you might not be super familiar with what it means. So, here you go: In response to the Affordable Care …

  • The 411 on UB-04: What PTs Need to Know Image

    articleApr 29, 2015 | 4 min. read

    The 411 on UB-04: What PTs Need to Know

    Developed by the Centers for Medicare and Medicaid Services (CMS) and implemented in 2007 , the UB-04 form—also known as CMS-1450—is the standard claim form providers use to bill CMS. But plenty of other government and commercial insurance carriers use it, too. As CMS explains , UB-04 can be “used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for …

  • Mad Maximizing Reimbursements: Revenue Road Image

    articleApr 23, 2015 | 3 min. read

    Mad Maximizing Reimbursements: Revenue Road

    We might not live in a post-apocalyptic world like the characters in the latest Mad Max film , but it certainly feels familiar in the world of physical therapy, where private practices fight to survive against ever-shrinking profit margins and federal legislation that threatens to erode bottom lines. Our weapon of choice in this furious battle? Increased efficiency. Here’s the strategy: Technology Processing Paper claims process in six to eight weeks, while electronic claims process in about …

  • Senate Repeals SGR in Landslide Vote Image

    articleApr 15, 2015 | 1 min. read

    Senate Repeals SGR in Landslide Vote

    Well, folks, the fix is in—the fix for the sustainable growth rate (SGR), that is. In a 92 to 8 vote, the Senate approved the SGR repeal bill, called HR2. In addition to an SGR repeal, the bill also officially extends the therapy cap exceptions process until December 31, 2017. This result is better than no therapy cap exceptions process at all; however, it’s disappointing to know that we came so close to achieving a full repeal …

  • Brace Yourself: Decreased Payments Might be Coming Image

    articleApr 14, 2015 | 3 min. read

    Brace Yourself: Decreased Payments Might be Coming

    As we warned at the end of last month , the times they are a-changin’. You’re likely well aware of the legislation that could do away with the Sustainable Growth Rate (SGR)—and extend the therapy cap for another two years. We had hoped to have better news for you at this point, but we’re still hanging tight while the Senate sings their own off-key version of Wilson Phillips’ “Hold On.” It’s April 14, 2015. That means the …

  • The Claim Game: How to Manage Overpayment Image

    articleApr 9, 2015 | 4 min. read

    The Claim Game: How to Manage Overpayment

    If you’ve recently discovered that a patient or insurance company overpaid you for services rendered, you might be tempted to consider it “free money.” It’s like you’re playing Medicare Monopoly, and you just pulled a Community Chest card that reads: “Insurance error in your favor. Collect claim overpayment.” However, overpayments give you an inflated appraisal of your total revenue and might even encourage embezzlement —both of which can wreak havoc on your balance sheet. Worse yet, if …

  • There’s no “I” in Team (But There are Two in Billing): Here’s Why Your People Matter Image

    articleApr 6, 2015 | 4 min. read

    There’s no “I” in Team (But There are Two in Billing): Here’s Why Your People Matter

    Your billing process is spot-on and your billing system runs like a ’66 Shelby 427 Cobra—but somehow your payment cycle is stuck in an Abbott and Costello skit with Who on first, What on second, and I Don’t Know on third. So, what’s causing such a major-league breakdown in your revenue stream? The human factor. Before your season’s over for good, it’s time to give a darn about your billing team. Here’s what to watch for when …

  • Not Your Mom’s Family Newsletter: Creating Marketing Emails Your Patients Will Actually Read Image

    articleMar 26, 2015 | 4 min. read

    Not Your Mom’s Family Newsletter: Creating Marketing Emails Your Patients Will Actually Read

    You know that email newsletter your mom sends out each Christmas? Yeah, the one filled with crummy Microsoft Word clip art ( may it rest in peace ), a banal list of little Becky’s latest soccer triumphs, updates on your brother’s spring wedding plans (can you say allergies?), and pictures of the family dog dressed up like a bee for Halloween (cute, but no). Your patients deserve better, so I’m here to kick your newsletter game up …

  • How to Solicit Patient Reviews Image

    articleMar 17, 2015 | 4 min. read

    How to Solicit Patient Reviews

    Today, we’re going to talk about solicitation. No, not that kind (get your mind out of the gutter—jeez). I’m talking about soliciting your clients for reviews. Why? Because online reviews are critical— now more than ever before —to the success of your business. If you really want to broaden your patient base and increase your revenue, you’ll need a strategy for getting your current and former patients to sing your praises publicly, so pay attention. (Yes, this …

Pages

Get exclusive content delivered right to your inbox.