• Denied but Not Dead: How to Submit a Medicare Appeal Image

    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 …

  • Can PTs Bill for Telehealth Services? Image

    articleOct 12, 2018 | 5 min. read

    Can PTs Bill for Telehealth Services?

    Telehealth is not exactly new. In fact, medical professionals have been using telemedicine since as early as 1940—but that’s because the term “telemedicine” technically refers to any electronic transfer of patient information. The way we think of telemedicine has changed quite a bit over the years. While the definition continues to encompass electronic transfer of medical records, most of us use the term “telehealth” to describe treatments or interventions delivered across electronic means. PTs and Teletherapy Like …

  • When to Use the KX Modifier Image

    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 …

  • 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 …

  • Medicare Open Forum Image

    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 …

  • 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 …

  • The Cap is Gone, But KX Lives On: How to Handle Therapy Claims in 2018 Image

    articleApr 9, 2018 | 5 min. read

    The Cap is Gone, But KX Lives On: How to Handle Therapy Claims in 2018

    It happened in the middle of the night: after months of debate and hours of back and forth that went until 3 AM on February 9, 2018, the Senate voted 71-28 in favor of a stopgap budget bill—known as the Bipartisan Budget Act of 2018—that officially repealed the Medicare cap on therapy services . PTs, OTs, and SLPs around the country—especially those with Medicare claims sitting in limbo as they awaited further instruction from CMS—breathed a collective …

  • What's Going On with the 2018 Therapy Cap? Image

    articleFeb 6, 2018 | 7 min. read

    What's Going On with the 2018 Therapy Cap?

    Update: The therapy cap has been repealed as of February 9, 2018. Scroll to the last section of this post for details. Nowadays, you might be tempted to tune out, turn off, and log out at the mere mention of anything political. And considering the current climate within our legislative system, I certainly wouldn’t fault you for wanting to avoid the chaos. However, putting on the blinders could prevent you from learning crucial information. After all, the …

  • 7 Simple Rules for Holiday Gifting in Health Care Image

    articleDec 18, 2017 | 6 min. read

    7 Simple Rules for Holiday Gifting in Health Care

    It’s the most wonderful time of the year, but if you’re not adhering to gift-giving rules this holiday season, it can be the most legally risky time of the year. Now, I’m not talking about gift-giving between friends—although there should probably be a law against regifting fruitcake, am I right? I’m talkin’ specifically about gifts between patients and their providers. Let’s be honest: your patients adore you. And why shouldn’t they? You give them the gift of …

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