articleOct 18, 2018 | 6 min. read
The Ins and Outs of ABNs
If the rules of Advance Beneficiary Notices of Noncoverage (ABNs) make you a bit confused, you’re definitely not alone. In an effort to shed some light on the ins and outs of ABNs and to highlight some recent changes to ABN requirements, Medicare created this set of FAQs clarifying their use. Here’s some info to help bring you up to speed: What is an Advance Beneficiary Notice of Noncoverage (ABN)? An ABN is a form practitioners use …
articleOct 15, 2018 | 9 min. read
Denied but Not Dead: How to Submit a Medicare Appeal
You know the drill: you provided Medicare-covered, medically necessary services to a patient who has active Medicare coverage. And yet, for some reason, CMS denied your claim. While you could chalk it up to a complicated government payer system and write off the costs of those services, that may not be the best solution—especially if you have the documentation to support the validity of your claim. In that case, you may very well want to appeal Medicare’s …
articleOct 10, 2018 | 5 min. read
7 Things to Do When Medicare Requests Your Patient Records
October is finally upon us, which means it’s time for spooky memes , pictures of Corgis in costumes , trick-or-treating, and a scary story or two. If you’re a physical therapist, occupational therapist, or speech-language pathologist, though, there are few tricks more bone-chilling than the prospect of a Medicare audit . But, here’s a treat: being audited by Medicare doesn’t have to be a fright fest. Just make sure you follow these tips: 1. Have a procedure …
articleOct 8, 2018 | 3 min. read
When to Use the KX Modifier
In the months since the elimination of the hard cap on therapy services , it seems like rehab therapists are more confused than ever about when they should affix the KX modifier versus issue an Advance Beneficiary Notice of Noncoverage (ABN) . The truth of the matter is that not much has changed operationally since the Medicare therapy cap repeal—aside from the name of the cap (i.e., what was once the “hard cap” is now called the …
articleSep 13, 2018 | 12 min. read
The 8-Minute Rule: What it is and How it Works in WebPT
With most buyer-seller transactions, calculating the cost of a product or service is fairly simple. There are no complicated formulas for determining the monetary value of a pizza or a movie ticket; you simply pay the business’s advertised price. When it comes to Medicare’s payment for rehab therapy services, however, things aren’t always so simple. Yes, I’m talking about the dreaded 8-Minute Rule (a.k.a. the Rule of Eights). So, here’s a rundown of the rule as well …
articleSep 11, 2018 | 7 min. read
What is an Ethics and Compliance Program, and Why is it Important to Rehabilitation Providers?
In a recent blog post , Veda Collmer (Chief Compliance Officer at WebPT) summarized seven elements of an effective compliance program. In this post, we will add detail around the origins, elements, and mechanisms of ethics and compliance programs. What is a Compliance and Ethics Program? A compliance program is a set of policies and procedures that a company puts in place to avoid violating laws and/or government regulations, thus protecting the company or brand. These policies …
webinarAug 31, 2018
Medicare Open Forum
Medicare making you shout and scream? Then join our expert compliance team! We’ll answer all your toughest Q’s. Because you’ve gotta know the rules, or you’re bound to lose! If receiving accurate reimbursements were a game, Medicare would certainly be one of the toughest opponents—and that’s especially true for rehab therapists. After all, the rules are constantly changing, and it seems like Medicare is always trying to sneak in a trick play to prevent PTs, OTs, and …
articleAug 18, 2018 | 34 min. read
Common Questions from Our PT Billing Open Forum
Last week, WebPT’s trio of billing experts—Dr. Heidi Jannenga, PT, DPT, ATC/L, WebPT President and Co-founder; John Wallace, PT, MS, WebPT Chief Business Development Officer of Revenue Cycle Management; and Dianne Jewell, PT, DPT, PhD, WebPT Director of Clinical Practice, Outcomes, and Education—hosted a live open forum on physical therapy billing . Before the webinar, we challenged registrants to serve up their trickiest PT billing head-scratchers—and boy, did they deliver! We received literally hundreds of questions on …
articleAug 9, 2018 | 7 min. read
The How and Why of an Effective Rehab Therapy Compliance Program
It’s no secret that the US healthcare industry is heavily regulated—and those regulations are strictly enforced. Take this recent press release from the Department of Justice (DOJ), for example. It explains how the DOJ charged 601 individuals with fraud—the largest healthcare fraud takedown in history. Among them: 71 physicians charged with falsely billing Medicare, Medicaid, and TRICARE in cases involving the prescription and distribution of narcotics. And in New York, 13 individuals were charged with conspiracy for …
webinarJul 16, 2018
Physical Therapy Billing Open Forum
It’s a bird; it’s a plane; it’s—a physical therapy billing expert? If you’re a physical therapy practice owner, manager, or biller, then you’ve probably wished for a billing superhero at one point or another. After all, while the PT billing process seems fairly simple on paper—therapists provide services, submit the CPT codes for those services, and receive payment—any seasoned pro knows it’s anything but. Rejections, denials, and reimbursement delays are more common than any of us would …
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