• Legal Compliance: One More Reason to Collect Patient Deductibles and Copays Image

    articleJul 24, 2017 | 6 min. read

    Legal Compliance: One More Reason to Collect Patient Deductibles and Copays

    Collecting coinsurance, copays, and deductibles upfront is an important piece of the effort to accurately value the services we provide. And yet, we still hear about practices that routinely waive their patients’ deductibles and copays. Today, I’ll discuss another reason not to routinely waive deductibles and copays. In the past, I’ve written about collecting deductibles and copays when a patient presents with a federally funded insurance like Medicare . In cases involving the Department of Justice, the …

  • 9 Most Common Medicare Misconceptions for PTs, OTs, and SLPs Image

    webinarSep 8, 2016

    9 Most Common Medicare Misconceptions for PTs, OTs, and SLPs

    To say that Medicare regulations are confusing is an understatement. But, it’s not just the barely-readable government gobbledygook that throws providers for a loop; it’s also the fact that the rules are always changing. If you treat Medicare patients, we’re willing to bet you’ve been tripped up by at least one of these common misconceptions—maybe without even knowing it. And that could leave a nasty bruise on your practice’s bottom line—especially if you ever find yourself at …

  • The PT’s Guide to Surviving a Medicare Audit Image

    articleMay 30, 2016 | 5 min. read

    The PT’s Guide to Surviving a Medicare Audit

    “How can I avoid being audited by Medicare?” This is one of the compliance questions I hear most frequently, and the honest answer is, quite simply, that you can’t. Just because CMS or one of its auditing entities hasn’t come knocking on your door doesn’t mean you’re not being audited. In fact, every claim you submit undergoes statistical analysis, and Medicare compares your claims data to the data for all other claims submitted. Furthermore, Medicare now analyzes …

  • The Legality of Performance-Based Employee Incentive Programs in Rehab Therapy Practices Image

    articleJan 14, 2016 | 3 min. read

    The Legality of Performance-Based Employee Incentive Programs in Rehab Therapy Practices

    The concept of pay-for-performance (PFP)—that is, the idea that an individual receives payment based on what he or she produces—seems very American to me and is certainly part of our capitalistic society. To use a sports analogy, a professional athlete who is one of the top performers in his or her sport commands higher compensation than an average or poor performer. So, why would therapy practice owners, directors, and executives not consider offering salary/compensation rates based on …

  • What PTs Must Know About Holiday Gift-Giving Image

    articleDec 22, 2015 | 3 min. read

    What PTs Must Know About Holiday Gift-Giving

    It’s December, which means the holidays are here—and this typically is the time of year that our thoughts turn to gift-giving. We’ve talked about this before, but I thought this would be a good opportunity to remind you of a few considerations to keep in mind as you give gifts to employees, patients, referring physicians, and other providers. As we’ve discussed in the past , when giving gifts to referral sources, the primary area of concern is …

  • Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks Image

    articleJul 9, 2015 | 5 min. read

    Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks

    Hello, readers. Over the past several weeks, I’ve enjoyed answering a number of your questions regarding billing for PT services, so I’m excited to address the topic right here on the WebPT Blog. On June 19, 2015, the Office of the Inspector General (OIG) released a report involving an outpatient private practice physical therapy provider. In case you weren’t aware, the OIG—which is part of the US Department of Health and Human Services (HHS)—is basically the CMS …

  • New Year’s Resolution: Compliance Plans Image

    articleJan 27, 2015 | 4 min. read

    New Year’s Resolution: Compliance Plans

    Ah, the new year—a perfect time for reflection: What did we do well? What could we do better? What do we need to change? These questions lead us to our resolutions. At the heart of any New Year’s resolution is a person’s strong desire to protect where he or she is in life. People work hard to achieve what they have, and they don’t want to lose that. In a very real sense, compliance plans speak to …

  • Compliance Considerations with Holiday Gift Giving Image

    articleDec 11, 2014 | 4 min. read

    Compliance Considerations with Holiday Gift Giving

    The holidays are here; I love this time of year—it’s a time for reflection, for feeling grateful, and for giving gifts. As you create your gift-giving list, you may find yourself adding friends who also are your peers. Unfortunately, a problem can arise when you give a gift to someone who has the ability to refer patients to you, because you could inadvertently violate the Anti-Kickback Statute (AKS). This is a good place for me to insert …

  • Direct Access: What are the Risks? Image

    articleOct 9, 2014 | 4 min. read

    Direct Access: What are the Risks?

    All states have amended their PT practice acts to allow for providing some form of PT services under direct access—or, put more simply, treating without a physician referral. But with this right comes added risks. It’s important to understand some of the potential risks and, hopefully, avoid them as much as possible. With that in mind, here are some main points to consider. 1.) Each state has its own rules governing direct access; therefore, it’s important to …

  • Social Media, HIPAA, and You Image

    articleSep 11, 2014 | 5 min. read

    Social Media, HIPAA, and You

    At this point, who doesn’t use some form of social media?  I’m not very technologically savvy, but even I have social media accounts—they’re great for staying in touch with my family on the west coast. Of course, when it comes to how I use my personal account, I still must use discretion regarding what I post. For example, I have a Labrador retriever. We brought her to the beach with us for vacation, and she loves to …

  • Creating a Compliance Plan for Your Practice Image

    articleJul 17, 2014 | 5 min. read

    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 …

  • The Modifier Open Forum Image

    webinarJun 27, 2014

    The Modifier Open Forum

    Not sure when to apply modifier 59? Wondering why you have to use the KX modifier? Let’s face it: modifiers can get pretty confusing. There are a lot of rules to keep straight—and most of them are anything but cut-and-dried. That’s why we focused this month’s webinar on all things modifiers. WebPT founder Heidi Jannenga, PT, teamed up with compliance expert Tom Ambury to host an open forum. They devoted the first half of the webinar to …

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