As exhibited in the news items below, small practices are not immune to HIPAA scrutiny by the federal government’s Department of Health and Human Services (DHHS)—as investigated by their enforcement agency, the Office of Civil Rights (OCR).
Does it seem like there have been more audits of therapy documentation and billing recently? It is not a figment of your imagination; they are happening at a record pace. Unfortunately, each payer has its own reasons for initiating audits, so assuaging why you were selected can be a daunting task.
Here’s a scenario I hope you never have to face: your small physical therapy practice hires a third-party billing company to manage your billing operations. Then, that billing company experiences a massive data breach affecting more than 1,000 of your patients.
Right now, our office is buzzing with excitement: in less than a month, we’ll gather in Minneapolis for our sixth annual Ascend business summit. And if Ascends of years past were any indication, we’re in for some seriously inspiring sessions and motivating discussions. This inspired me—avid watcher of TEDTalks—to put together a list of TED videos that should raise the spirits of any physical therapist, occupational therapist, and speech-language pathologist.
In our 2019 State of Rehab Therapy survey, 80% of respondents cited payer requirements as the top reason their organizations require physician referrals as a condition of treatment (even in states with unrestricted direct access).
At first glance, Medicare and Medicaid might seem like twins, or a dynamic duo, or two peas in a pod—basically, inseparable. They’re both government healthcare programs; they were both created at the same time; they’re both confusing and usually don’t boast the best reimbursement rates; and they even sound alike (they both start with “Medi-,” right?).
Healthcare billing can get even the best billers tangled up in knots—and it’s no wonder why. Between tracking and adhering to shifting payer guidelines, managing patient claims, verifying insurance, and defending against denials, billers are pulled and twisted in a million different directions.
The Merit-based Incentive Payment System, or MIPS, is one tough cookie. It’s complicated and downright frustrating at times—but it’s something that rehab therapists need to be familiar with. If you’ve been looking for a no-nonsense, easy-to-follow MIPS explainer, then you’ve come to the right place! Just play the video to understand the basics behind this latest government program.
Verifying patient insurance benefits can feel overwhelming—but you can actually accomplish it all in three easy steps!