• Denial Management FAQ Image

    articleMay 26, 2017 | 22 min. read

    Denial Management FAQ

    During our denial management webinar , we discussed the difference between rejections and denials, explained how to handle both, and provided a five-step plan for stopping them in their tracks. The webinar concluded with an exhaustive Q&A, and we’ve amassed the most common questions here. Insurance Issues Claim Quandaries Compliance Qualms Documentation Dilemmas Front-Office Frustrations Insurance Issues We’ve had issues with auto insurances denying 97112 (neuromuscular re-education) for non-neuro diagnoses, even in cases when the patient’s medical …

  • 10 Defensible Documentation Tips for PTs Image

    downloadDec 22, 2016

    10 Defensible Documentation Tips for PTs

    Therapists often view documentation as onerous. But, as you well know, that certainly doesn’t mean the practice is invaluable or meaningless. In fact, documentation tells your patients’ stories and serves as a verifiable record of patient care, thereby giving key decision-makers (i.e., payers) the right information to determine your value. More importantly, defensible documentation helps you, the rehab therapist, prove your ability to achieve patient outcomes—and get paid. Still need some tips to tell your patients’ stories …

  • Should I Stop or Should I Go? What to Do When a Patient Hits the Therapy Cap Image

    articleNov 7, 2016 | 4 min. read

    Should I Stop or Should I Go? What to Do When a Patient Hits the Therapy Cap

    Halloween and the whole pretend thing may be over, but follow me for a second: when a Medicare patient comes to you for treatment, it’s critical that you also play the roles of investigator and lawyer (though costumes are optional). Clearly documenting the therapy services you are providing during the current benefit period —without skimping on the details—can potentially save you from an audit. In fact, your documentation is like evidence in a court case . So, …

  • Why Issuing Blanket ABNs is a No-No Image

    articleOct 28, 2016 | 4 min. read

    Why Issuing Blanket ABNs is a No-No

    With Medicare routinely changing and tightening its rules on reimbursement, PTs may be worried about receiving payment in a timely, efficient manner. Fortunately, Advance Beneficiary Notices of Noncoverage (ABNs) help you cover all your financial bases, as they: put the onus on your Medicare patients to decide whether they would like to accept financial liability (i.e., pay out-of-pocket) for the therapy services you provide; and safeguard you when Medicare denies a claim. So, why not issue ABNs …

  • Why Medicare-Enrolled PTs Can't Always Provide Treatment on a Cash-Pay Basis Image

    articleOct 27, 2016 | 3 min. read

    Why Medicare-Enrolled PTs Can't Always Provide Treatment on a Cash-Pay Basis

    Even if you feel comfortable with all things Medicare, chances are there’s a new rule in the works ( oh, looky here ) that could trip you up. Yes, the rules are always changing—and even the ones that have been in place for a while could get you stuck in a pickle (mmm, pickles). That’s especially true with the rules around providing treatment on a cash-pay basis , because your restrictions and obligations vary based on your …

  • Undoing Denials: Managing Claim Rejections and Appeals in PT Billing Image

    articleOct 20, 2016 | 7 min. read

    Undoing Denials: Managing Claim Rejections and Appeals in PT Billing

    When the stakes aren’t high, people are more forgiving of flubs. If you have a bad hand, a missed stroke, or a poor toss, you may cry, “Mulligan!”—and get a do-over. But, what happens when the stakes are high—like when you’re billing for physical therapy services, and you suffer a denied claim? Do you get a mulligan? The short answer: yes. The long answer: I wouldn’t necessarily call appealing a denied claim a “do-over,” but the important …

  • The Complete PT Billing FAQ Image

    articleMay 24, 2016 | 25 min. read

    The Complete PT Billing FAQ

    Over the years, WebPT has a hosted a slew of billing webinars and published dozens of billing-related blog posts. And in that time, we’ve received our fair share of tricky questions. Now, in an effort to satisfy your curiosity, we’ve compiled all of our most common brain-busters into one epic FAQ. Don’t see your question? Ask it in the comments below. (And be sure to check out this separate PT billing FAQ we recently put together.) Questions …

  • Medicare and Cash-Pay PT Services, Part 3: Maintenance Care and Self-Payment Image

    articleDec 17, 2015 | 5 min. read

    Medicare and Cash-Pay PT Services, Part 3: Maintenance Care and Self-Payment

    Based on the first two articles (which you can read here and here ) in this series, we now know there are two key factors that determine when you can accept private payment from a Medicare beneficiary: Your/your clinic’s provider relationship with Medicare Whether the service is “covered” by Medicare We ended the last article with a detailed discussion of medical necessity, which leads us to the final step in determining when a service is covered. Maintenance …

  • Medicare and Cash-Pay PT Services, Part 2: Covered vs. Non-Covered Services and Therapy Cap Essentials Image

    articleDec 16, 2015 | 6 min. read

    Medicare and Cash-Pay PT Services, Part 2: Covered vs. Non-Covered Services and Therapy Cap Essentials

    In the first article of this series on Medicare and Cash-Pay PT Services, we defined the three relationships a PT can have with Medicare and explained how each one influences the types of services (i.e., “covered” and “non-covered”) we can provide to beneficiaries on a self-pay basis. So, now we need to define which services are covered and which are not covered, as well as pinpoint the scenarios in which covered services may become non-covered. 3 Scenarios …

  • What is Defensible Documentation, and Why Does it Matter? Image

    articleNov 23, 2015 | 4 min. read

    What is Defensible Documentation, and Why Does it Matter?

    I think Julie Andrews was spot-on when she sang the following verse about physical therapists: “When the dog bites, when the bee stings, when you’re feeling sad, you simply remember your defensible documentation , and then you don’t feel so bad.” That is how it goes, right? No? Whoops. Looks like I mixed up some of the lyrics. But, even if defensible documentation isn’t one of your favorite things, that doesn’t make it trivial. In fact, it’s …

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