• Building from the Ground Up: Billing Checklist for New PTs Image

    articleAug 20, 2019 | 7 min. read

    Building from the Ground Up: Billing Checklist for New PTs

    You might say that when you’re building a table, the most important tool to have on hand would be a saw. Another person might say it’d be a sander—and another might argue that you can’t do anything without a tape measure. I’d personally say that, while you definitely need all those tools, the most important tool to have on hand is a calm, clear-headed frame of mind. (Seriously, don’t use dangerous equipment if you’re not 100% present …

  • 5 Reasons to Outsource Your PT Clinic's RCM Image

    articleAug 5, 2019 | 5 min. read

    5 Reasons to Outsource Your PT Clinic's RCM

    If you’re at a place where your clinic’s billing is the bane of your (or your staff’s) existence, it may be time to get some help. Not every practice needs to outsource its billing—let’s make that perfectly clear. If you have an expert biller (or a few) on staff—and you’re not experiencing any major billing frustrations—then outsourcing is probably not the right move for your clinic. But, for the clinics that are overloaded, overwhelmed, or completely burnt …

  • Physical Therapy Billing for Beginners Image

    articleJul 26, 2019 | 7 min. read

    Physical Therapy Billing for Beginners

    Most physical therapists chose this profession to help people—not to become the world’s greatest biller. And yet, in order to stay in business long enough to truly make a difference for your patients, you’ve got to know how to make a profit—and that requires a solid understanding of PT billing. If you’re new to physical therapy, you might be feeling a little overwhelmed by the prospect, so below, we’ve provided some billing basics:  Codes ICD To properly …

  • How to Verify Patient Insurance in Three Easy Steps Image

    articleJul 11, 2019 | 7 min. read

    How to Verify Patient Insurance in Three Easy Steps

    Remember the game of telephone? Here’s how it goes: A group of kids sit in a circle, and then someone comes up with a message and whispers it to the person on his or her right. That person whispers what he or she heard to the next person, who then whispers it to the next person—and the message travels all the way around the circle until the last person announces what he or she heard. Somehow, almost …

  • News Flash: Updated Guidance on 59 and X Modifier Use Image

    articleJul 8, 2019 | 2 min. read

    News Flash: Updated Guidance on 59 and X Modifier Use

    Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced a change to the way the agency will process modifier 59 and the X modifiers on provider claims. Previously, it would only unbundle NCCI edit pairs if providers submitted the appropriate modifier on the column two code . However, as this resource explains , there were times when it seemed less awkward for billers to affix the modifier to the column one code (usually, “when …

  • The Pros and Cons of In-Network Payer Relationships Image

    articleJul 3, 2019 | 5 min. read

    The Pros and Cons of In-Network Payer Relationships

    It’s hard to identify when you’re trapped in an unhealthy relationship—even if that relationship is just a professional business arrangement. Yes, it’s possible that your in-network payer relationships are verging on unhealthy, especially if payers constantly grind your gears, and you’re hesitant to renew your contracts with them. The good news is that you have no obligation to remain in-network with every payer—and, in some cases, it may be better to ditch the in-network relationships altogether. That …

  • How to Bill Medicare Patients for Non-Covered Services Image

    articleDec 28, 2018 | 5 min. read

    How to Bill Medicare Patients for Non-Covered Services

    If you’re a rehab therapist who works with Medicare beneficiaries, chances are you’ll find yourself performing a service that isn’t covered by their insurance. When that happens, you could find yourself in a billing predicament—if you don’t take the proper steps, that is. What are those proper steps? Read on to find out. Which services does Medicare not cover? To start, it’s important to identify which services Medicare won’t cover. Typically, Medicare denies coverage for one of …

  • The Secret to Documenting for Medical Necessity Image

    articleDec 27, 2018 | 8 min. read

    The Secret to Documenting for Medical Necessity

    Around the holidays, everyone seems to get excited about closing out the year with a bang— literally, in some cases . But there’s nothing wrong with closing out the year on a calm, gentle note—one without denials, for example. One of the best ways to avoid claim denials is to document defensibly, and to prove that your treatment was undeniably (haha—get it?) a medical necessity . So, what exactly is medical necessity? Don’t worry—that’s one term we’re …

  • 59 vs. 25: Which Modifier to Use–and When Image

    articleDec 20, 2018 | 3 min. read

    59 vs. 25: Which Modifier to Use–and When

    Rehab therapy billing : It’s a total numbers game. Between CPT codes and billing modifiers , knowing which digits belong on a claim is no simple task. After all, rules seem to change with the seasons, and they often vary from payer to payer. Here on the WebPT Blog, we receive a lot of comments and queries in response to these ever-changing rules, and one of the hottest points of confusion these days is the difference between …

  • FAQ: Unwrapping MIPS and the Final Rule: How to Prepare for 2019 Image

    articleDec 14, 2018 | 38 min. read

    FAQ: Unwrapping MIPS and the Final Rule: How to Prepare for 2019

    Earlier this week, Heidi Jannenga, PT, DPT, ATC, WebPT President and Co-Founder, and Dianne Jewell, PT, DPT, PhD, FAPTA, WebPT Director of Clinical Practice, Outcomes, and Education, hosted an hour-long webinar that unwrapped the many layers of MIPS and the 2019 physician fee schedule. Unsurprisingly, tearing through the layers of CMS’s latest gift revealed a crush of questions—many of which our experts didn’t have time to fully address. So, we compiled the most frequently asked ones for …

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