Billing

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How to Handle Modifier 59 Denials for 97530 and 97140

Following several CMS announcements that providers were overusing modifiers 25 and 59 as a means to bypass edit pairs (without supplying proper documentation to support those bypasses), multiple commercial payers—including Anthem, Aetna, and Humana—adopted front-end claim edit policies for claims containing these modifiers.

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Everything PTs Need to Know About Accepting Medicare Assignment

Over the years, we’ve written quite a few blog posts about Medicare—covering everything from Medicare and direct access to Medicare supervision requirements—and I don’t foresee that stopping any time soon. After all, there are so many intricacies and nuances to navigating Medicare that we have fodder to write until, well, either the end of time or the end of Medicare—whichever comes first.

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Billing Software or RCM Service?

Which billing solution is right for your practice: billing software, RCM service, or a hybrid of the two? Rehab therapists have several options for handling their billing processes—but knowing which one is best for their practice isn’t always easy. That’s why we created this handy flowchart, which can help point PTs, OTs, and SLPs to the billing solution that’s right for them and their practices. Enter your email address below to receive a free copy of our

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Medicare Part A vs. Part B: What PTs, OTs, and SLPs Need to Know

Whether you’re just starting out as a Medicare provider—or you’re making the switch from inpatient to outpatient—there’s a lot to keep straight when it comes to the complicated rules, regulations, and policies that govern Original Medicare (which consists of both Part A and Part B).

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The Complete Guide to Physical Therapy Billing

When you think about physical therapy billing, what words come to mind? If you’re like most people, it’s probably not “simple” or “stress free.” The fact is, PT billing is less like a stroll in the park and more like a journey through a labyrinth. It’s confusing, and the rules are ever-changing. But, if you want your practice to be successful, it’s also very, very necessary. That’s why we decided to create this comprehensive PT billing guide

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Timely Filing: A Cheat Sheet for PTs

When it comes to punctuality, here’s my motto: “If you’re early, you’re on time. If you’re on time, you’re late.” Maybe I think that way because I have a Type A personality (holy organization, Batman). Or, maybe it’s because this rule truly applies in many situations—even in physical therapy billing.

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Timely Filing Cheat Sheet for PTs

Have you ever wondered how long you have to submit a claim before a payer will deny it out of hand? You’re not alone! Timely filing deadlines are non-standardized and totally hard to keep track of—which is why we created this printable PDF timely filing cheat sheet. It includes the timely filing deadlines for some of the largest payers and 33 different Blue Cross Blue Shield regional offshoots. Simply enter your email address below to get your

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