We recently published an article on how to make your documentation defensible. Therapists must also understand what constitutes a medically necessary claim. CMS defines a medically necessary service or supply as:
“needed to prevent, diagnose, or treat an [...]
The healthcare insurance industry today is moving toward value-based payments. Auditing systems are being used to ensure that clinics are strictly following CPT (Current Procedural Terminology) and National Correct Coding Initiative (NCCI) rules. To protect [...]
On January 1st, 2017, the Centers for Medicare and Medicaid Services (CMS) made changes in order to improve its payment for quality programs. It combined several programs into one Merit-based Incentive Payment System (MIPS). We touched on the basics of these [...]
To receive payment from any insurer for occupational or physical therapy services, the documentation must accurately report medically necessary service. It must also support the charges submitted on the claim.
Medicare, however, has some other rules that [...]
Every year, patient deductibles and out-of-pocket expenses increase. This means that it's even more imperative that patient balance collection is at the forefront of every therapist’s mind. This segment of your payments can constitute at least 20% of your [...]
Cancellations and no-shows invariably depress clinic profitability. A "cancellation" is an appointment that is cancelled prior to scheduled treatment time. A "no-show" is when a patient fails to report for treatment without notice.
Depending on the type of [...]
Keeping patients healthy is a physical therapist’s number one priority, but a physical therapy owner’s priority is the bottom line. There are five essential accounts receivable metrics to monitor as part of your revenue cycle management best practices. [...]