• 7 Things to Do When Medicare Requests Your Patient Records Image

    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 …

  • What is an Ethics and Compliance Program, and Why is it Important to Rehabilitation Providers? Image

    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 …

  • Code This, Not That: How to Maximize Your PT Billing by Using the Right CPT Codes Image

    articleAug 21, 2018 | 4 min. read

    Code This, Not That: How to Maximize Your PT Billing by Using the Right CPT Codes

    Physical therapy billing is equal parts art and science. On one hand, we want our codes to accurately represent the services we have provided, but on the other, we want to generate maximum reimbursement—while avoiding the risk of fraudulent billing . While compliance experts might be able to code like ninjas without breaking a sweat, the rest of us often struggle to walk the billing and coding line. Using CPT codes to their fullest is a great …

  • Common Questions from Our PT Billing Open Forum Image

    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 …

  • The How and Why of an Effective Rehab Therapy Compliance Program Image

    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 …

  • 6 Surefire Signs Medicare Will Audit Your PT Practice (and How to Fix 'Em) Image

    articleNov 30, 2017 | 7 min. read

    6 Surefire Signs Medicare Will Audit Your PT Practice (and How to Fix 'Em)

    Camping season may be over, but I’m in the mood to tell a scary campfire story. So, here goes: It’s an average work day. Your last patient just left, and you’ve got a little downtime between appointments to grab a cup of coffee and catch up on documentation. As you sit down at your desk, you notice a stack of envelopes. “The mail must’ve come early today,” you think to yourself. As you thumb through the advertisements …

  • Maintenance, Medicare, and Medical Necessity: Unpacking the Jimmo Update Image

    articleOct 5, 2017 | 5 min. read

    Maintenance, Medicare, and Medical Necessity: Unpacking the Jimmo Update

    Hey, have you heard the good news? CMS has completed all required action items laid out in the Jimmo v. Sebelius settlement. If you’re scratching your head and wondering why that matters, here’s the rundown: a few years ago, a group of Medicare providers alleged that CMS contractors made determinations on claims for skilled care based on an inappropriate “Improvement Standard.” These providers took CMS to court, and the court determined that CMS needed to clarify and …

  • 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 …

  • Tales from the Table: How PTs Have Successfully Negotiated Payer Contracts Image

    articleJan 27, 2017 | 5 min. read

    Tales from the Table: How PTs Have Successfully Negotiated Payer Contracts

    No private practice owner should approach payer contract negotiations haphazardly—or worse, not understand specific terms before signing on the dotted line. And for good reason: Continued claim denials and decreasing reimbursements make it tough for many rehab therapy practice owners to get the most out of their private payer contracts. But while the mere thought of going head-to-head with large health plans in your physical therapy provider network is probably enough to form a knot in your …

  • Should PTs, OTs, and SLPs use the New X Modifiers? Image

    articleDec 7, 2016 | 4 min. read

    Should PTs, OTs, and SLPs use the New X Modifiers?

    In the world of rehab therapy, determining—and billing—the right codes and modifiers can be one of your biggest challenges. That’s certainly true when it comes to properly using modifier 59—and the blog posts we’ve previously written on this topic have generated a lot of reader questions. To complicate matters even more, back in January 2015, CMS rolled out four new HCPCS modifiers for healthcare practitioners to use in lieu of modifier 59—thus giving providers a way to …

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