• Is Professional Liability Insurance Worth it? Image

    articleJul 23, 2014 | 5 min. read

    Is Professional Liability Insurance Worth it?

    You’ve got health insurance, dental insurance, vision insurance, auto insurance, home insurance, life insurance—and if those weren’t enough, if you’re a practice owner or an independent contractor, you probably have professional liability insurance, too. But what if you’re a PT or PTA on staff at a clinic, hospital, or rehab center? Do you need your own liability insurance policy? According to Jonathan Bassett, author of this Advance article, it all “depends on whom you ask.” For the …

  • HHS Proposes Auto-Enrollment Plans for Marketplace Consumers Image

    articleJul 21, 2014 | 2 min. read

    HHS Proposes Auto-Enrollment Plans for Marketplace Consumers

    Last month, the Department of Health and Human Services (HHS)—with help from the National Association of Insurance Commissioners—proposed a new rule that would essentially automatically re-enroll health insurance beneficiaries who obtained their plans via an exchange or marketplace. According to this article , HHS thinks this system could ensure continuity of coverage, reduce administrative complexity, and protect insurers’ market share. However, some, like Elizabeth Carpenter, the director of Avalere Health , believe that individuals may benefit from …

  • Common Medicare Compliance Rules for Substitute, Almost-Credentialed, and Non-Credentialed Therapists Image

    articleJul 15, 2014 | 3 min. read

    Common Medicare Compliance Rules for Substitute, Almost-Credentialed, and Non-Credentialed Therapists

    Medicare compliance rules for fully credentialed therapists can be more than a bit complicated, so it’s not too surprising that the rules governing substitute, almost-credentialed, and non-credentialed therapists would be equally perplexing. With that in mind, here are some common rules to help you navigate these murky Medicare waters: For Substitute Therapists It is officially summer—and with warmer temps, there will naturally be a lot more vacation requests. If you’re looking to hire substitutes to cover for …

  • 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 GA or GX modifier on your claim so Medicare knows to deny the claim and assign financial …

  • Blue Cross Blue Shield and Other Payers Add FLR to Select Plans Image

    articleJul 2, 2014 | 2 min. read

    Blue Cross Blue Shield and Other Payers Add FLR to Select Plans

    As of July 1, 2013, the Centers for Medicare and Medicaid Services requires that all practice settings providing outpatient therapy services—and billing for those services under Medicare Part B—complete functional limitation reporting (FLR) on all eligible Medicare patients in order to receive reimbursement for their services. From the initial whispers of FLR, we’ve explained that private payers will most likely follow Medicare’s lead , and indeed they have. In the months since FLR became mandatory, a handful …

  • 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 …

  • Workers' Compensation Billing Tips for Physical Therapists Image

    articleJun 18, 2014 | 3 min. read

    Workers' Compensation Billing Tips for Physical Therapists

    Billing in itself is tricky and a lot to manage. Toss in workers’ compensation (WC) claims and the plot only thickens. Thankfully, there are steps you can take to ensure your WC claims not only get paid, but get paid quickly. But, first, a definition: According to the American Association of Professional Coders (AAPC), “Workers’ compensation provides coverage for wage replacement benefits, medical treatment, vocational rehabilitation, and other benefits to workers who are injured at work or …

  • Physical Therapy Billing for Beginners, Part 2 Image

    articleJun 17, 2014 | 3 min. read

    Physical Therapy Billing for Beginners, Part 2

    Yesterday, we covered some of the basics of physical therapy billing. (If you missed it, you can read the article in full here. ) Today, let’s keep things moving with a few more therapy billing tips: (In case you missed this blurb in the last post, I’ll say it once more for good measure: This article is by no means comprehensive, so we definitely recommend you seek the services of a billing expert before taking action.) The …

  • Enhance Your Billing With Effective Patient Registration  Image

    articleJun 12, 2014 | 3 min. read

    Enhance Your Billing With Effective Patient Registration

    To quote the Physicians Practice , “the revenue cycle starts with patient registration.” Regardless of your practice’s billing system ( in-house vs. outsourced ), there are steps you can take to ensure your claims are processed quickly and correctly—the first one being effective patient registration. When a patient calls to schedule an appointment, your front office staff should ask a series of questions. That way they can collect pertinent billing and insurance information. If you have patient …

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