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  • A Tale of Two Billing Blunders: Overbilling and Misbilling Image

    articleJul 23, 2015

    A Tale of Two Billing Blunders: Overbilling and Misbilling

    Billing for physical therapy services is tricky, time-consuming, and nerve-wracking. After all, there are so many rules to follow, and it seems like those rules are constantly changing. That makes mistakes tough to avoid. And in many cases, you might not even know you’re making them. And while an occasional billing error probably isn’t a huge deal, if you’re unknowingly messing up left and right, you could end up in hot water. And if you’re purposely messing …

  • Eligibility Verification and Your Front Office Image

    articleJul 22, 2015

    Eligibility Verification and Your Front Office

    The success or failure of each patient claim begins and ends in the front office. Why? Patient insurance  eligibility verification  is the first—and perhaps most critical—step in the billing process. That means your front office has to be on the ball to obtain and accurately record all eligibility information. Your staff is responsible for determining each patient’s insurance eligibility, including: coinsurance or copay, deductible, benefits cap, where to send the claim, whether the payer requires specialized forms …

  • Can You Ace Our 8-Minute Rule Quiz? Image

    articleJul 21, 2015

    Can You Ace Our 8-Minute Rule Quiz?

    Maybe you thought your days of grinding through word problems ended when you sold that college algebra textbook back to the university bookstore (for less than half of its original price). But if you’re a rehab therapist who treats Medicare patients, you probably have to call upon your math skills—and maybe even the ol’ TI-83 Plus—fairly often, because sometimes Medicare’s 8-minute rule seems more like a complex trigonometric function than a seemingly straightforward billing formula. Think you’ve …

  • Pro-Bono Work: The Good, The Bad, and The Billing Image

    articleJul 20, 2015

    Pro-Bono Work: The Good, The Bad, and The Billing

    We’re all taught at a young age that it’s better to give than to receive. This saying helps children develop perspective, and even as adults, few people would argue against the moral truth of this simple axiom. In fact, I’m betting this statement really speaks to the empathetic nature of rehab therapists. Unfortunately, though, when you’re running a business (for the purposes of this blog, I’m referring to a private practice outpatient therapy clinic), you really need …

  • How Will ICD-10 Affect Direct Access? (And Other Billing Questions) Image

    articleJul 16, 2015

    How Will ICD-10 Affect Direct Access? (And Other Billing Questions)

    In healthcare sectors across the globe, ICD-10 is hardly  a new concept . But in the US, we’ve been hesitant to adopt the updated system since its inception more than 30 years ago. In just a few short months, though, that’s all going to change. If you’ve been watching the news, reading  the WebPT Blog , or talking with your colleagues, you’ve probably gotten the sense that the  ICD-10 delay , debates, and—for some—dread are about to …

  • Wanna Grab a (Free) Slice of Ascend? Image

    articleJul 15, 2015

    Wanna Grab a (Free) Slice of Ascend?

    Wanna Grab a (Free) Slice of Ascend? Ascend 2015 is right around the corner, and we know you’re eager to get to Chi-Town, enjoy a slice of deep-dish pizza, and learn tips from some of the best rehab professionals in the biz. Unfortunately, conferences can cost a pretty penny , which is why we’re treating one lucky winner to the ultimate VIP Ascend package. What do you get if you win? Well, on top of receiving two …

  • Creating the Perfect PT Billing Workflow Image

    articleJul 14, 2015

    Creating the Perfect PT Billing Workflow

    In an ideal world, patients would know their benefits like the back of their hands, we’d have a global payer list, and every claim would be accepted on the first try. But the world is not a perfect place, and there’s only so much you can control. Still, you can do your darndest to get close to the perfect billing workflow. Perfect—or near-perfect—billing begins way before you even create the claim. So, let’s start at the very …

  • Do I Need a New NPI? (And Other NPI Questions) Image

    articleJul 13, 2015

    Do I Need a New NPI? (And Other NPI Questions)

    Are you a HIPAA-covered healthcare provider? If so, take a number—a National Provider Identifier (NPI) number, that is. Because as of May 23, 2007, NPI numbers replace all legacy identifiers—including Unique Physician Identification Numbers (UPIN), Medicaid Provider Numbers, and Medicare Provider Numbers—as the go-to provider identification mechanism in the US healthcare system. But, as with any government-mandated requirement, NPIs have generated quite a few questions over the years. Here are some of the most common ones (along …

  • Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks Image

    articleJul 9, 2015

    Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks

    Hello, readers. Over the past several weeks, I’ve enjoyed answering a number of your questions regarding billing for PT services, so I’m excited to address the topic right here on the WebPT Blog. On June 19, 2015, the Office of the Inspector General (OIG) released a report involving an outpatient private practice physical therapy provider. In case you weren’t aware, the OIG—which is part of the US Department of Health and Human Services (HHS)—is basically the CMS …

  • Counting the Clock: 7 Must-Know Facts about Billable PT Treatment Time Image

    articleJul 8, 2015

    Counting the Clock: 7 Must-Know Facts about Billable PT Treatment Time

    In the classic 1993 legal flick The Firm, Gene Hackman’s veteran attorney character advises a rookie associate (played by a young and dashingly handsome Tom Cruise) to bill for any hours he spends “even thinking about a client”—whether he’s “stuck in traffic or shaving or sitting on a park bench.” Unfortunately, the rules governing billable time in rehab therapy are not as, shall we say, open to interpretation. In fact, billing for every single minute of a …

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