• How Does Insurance Work from a Private Practice PT Perspective? Image

    articleJul 27, 2015 | 6 min. read

    How Does Insurance Work from a Private Practice PT Perspective?

    As a private practice physical therapy provider, you’ve made—and have yet to make—a number of decisions. Some of these decisions are easy; others, maybe not so much. For example, choosing which ice cream flavor to eat on a Friday afternoon might prove to be one of the toughest calls you have to make in your career. But no matter how hard the decision might seem, you don’t need to be afraid to pick a stance: You just …

  • Final Thoughts from CSM: Outcomes, Payment Reform, and—Purple Cows? Image

    articleFeb 9, 2015 | 19 min. read

    Final Thoughts from CSM: Outcomes, Payment Reform, and—Purple Cows?

    By Saturday morning, attendees of the APTA’s Combined Sections Meeting (CSM) were moving with a little less pep in their step—and a couple extra shots of espresso in their morning coffee. Still, the educational sessions on the final day of CSM were chock full of eager learners looking to eat up a few more morsels of wisdom before catching their planes home from Indy. Here are some highlights from day three’s informational smorgasbord (check out recaps from …

  • The 2015 Therapy Cap: Same Story, Different Year Image

    articleNov 18, 2014 | 3 min. read

    The 2015 Therapy Cap: Same Story, Different Year

    With all of the blog space we’ve devoted to PQRS this month, it’s easy to forget that Medicare’s final rule addresses more than just our favorite four-letter acronym. But buried deep within CMS’s annual 1,000-plus-page behemoth of government jargon is one more major item of interest to those in the PT, OT, and SLP industries: the therapy cap. First, the good news: in accordance with the Medicare Economic Index (MEI), both cap amounts—the one for occupational therapy …

  • Final Rule 2015: Here’s What You Need to Know Image

    articleNov 6, 2014 | 3 min. read

    Final Rule 2015: Here’s What You Need to Know

    The summary of this year’s Final Rule is hot off the presses, which means that—among other things—we now know the details regarding PQRS 2015. For those who have been following the PQRS saga since the program first came into being in 2007, it should come as no surprise that Medicare has yet again upped the ante for compliance. Based on the fact sheet CMS provided , here’s the scoop on this year’s reporting requirements: Eligible professionals who …

  • Gifts, Donations, and Discounts: What Medicare Needs You to Know Image

    articleJul 24, 2014 | 7 min. read

    Gifts, Donations, and Discounts: What Medicare Needs You to Know

    The world of private practice physical therapy is certainly competitive, so it makes sense that owners and directors consider every angle when it comes to promoting their businesses. (On that note, be sure to check out our free modern PT marketing guide to learn fresh—and legally compliant—promotional strategies.) Unfortunately, some of those angles can get you and your practice in hot water with Medicare. Today, I’ll discuss handling gifts, donations, and discounts in a way that doesn’t …

  • Common Questions from our Modifier Open Forum Image

    articleJul 7, 2014 | 10 min. read

    Common Questions from our Modifier Open Forum

    Should I have my patients sign an advance beneficiary notice of noncoverage (ABN) just in case Medicare doesn’t pay? No, by having your patient sign an ABN, you are acknowledging that you do not believe that the services you are providing are either medically necessary or covered by Medicare. If you have an ABN on file, you should include a modifier GA or GX modifier on your claim so Medicare knows to deny the claim and assign …

  • Negotiating Payer Contracts (Part 2): Taking Action Image

    articleJun 24, 2014 | 6 min. read

    Negotiating Payer Contracts (Part 2): Taking Action

    You’ve done all of your research and amassed a wealth of supporting data. Now you’re ready to make a super strong case for increasing your reimbursement rates with a particular private payer. (If you missed my post about preparing for payer contract negotiations, you can check it out here .) But this isn’t your average business negotiation; making a deal with a health plan representative is a little more complex than, say, haggling over the price of …

  • How to Negotiate Payer Contracts (Part 1): Making a Plan Image

    articleJun 23, 2014 | 7 min. read

    How to Negotiate Payer Contracts (Part 1): Making a Plan

    In today’s healthcare payment landscape, every dollar counts—especially in the physical therapy realm, where increasing regulations and decreasing reimbursements seem to be the name of the game. That’s why now, more than ever, it’s crucial that you get the most out of your private payer contracts—and to do that, you’ve got to negotiate. To help you make a case for the rates you deserve, I’ve put together a two-part guide to successfully negotiating payer contracts. Today, I’ll …

  • This Week in PT News, March 28 Image

    articleMar 28, 2014 | 2 min. read

    This Week in PT News, March 28

    S. 2110 Vote The Senate is scheduled to vote on the Medicare cap this week, so it’s your last chance to contact your local representatives and ask them to vote “yes” for the Medicare SGR Repeal and Beneficiary Access Improvement Act (S. 2110). Find your senator’s contact information here . HR 4302 Vote Yesterday, the House of Representatives passed by voice vote a proposal (HR 4302) to delay for 12 months a scheduled 24% cut to Medicare …

  • articleNov 19, 2013 | 4 min. read

    Therapy Cap Recap

    If you’re a rehab therapist who treats Medicare patients, you’ve got a bevy of rules and regulations to follow and knowing all of them inside and out is a tall order, to say the least. If decoding government legalese isn’t really your thing, don’t worry—we’ve dedicated this entire month to serving up a smorgasbord of digestible, easy-to-understand guides on the important Medicare policies that apply to you. On today’s menu: the therapy cap. As part of the …

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