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5 Bad Coding and Billing Habits - Park Medical Billing

5 Bad Coding and Billing Habits You Need to Break– Right Now!

You’re losing lots of money on your practice and you don’t even know it.

How could you not be aware of thousands of dollars being lost, you say? Surely that kind of money can’t just disappear without you knowing.

The answer: bad habits. Bad coding and billing habits to be exact. A lot of physical therapists fall victim to these habits without their knowledge, and it’s not totally their fault. Most of them have been misinformed or got used to a certain system that they didn’t know has long been outdated.

It’s time to break those bad habits and get your practice the profits it deserves!

Habit 1: Forgetting Assessment and Management Time

There are several components that make up your service time: patient assessment and preparation (Pre-Time), performing the procedure (Intra-Time), and lastly, documentation and discharge (Post-Time). One financially deadly habit that PTs make is forgetting to include all of these components into their assessment and management time.

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Master Healthcare Payer Contract Negotiations - Park Medical Billing

4 Tips for Successful Healthcare Payer Contract Negotiations

Negotiation. It’s tough to do successfully, especially when it’s not something you were trained for.

As a physical therapist you’re trained to treat people and help them live better and healthier lives, not make financial negotiations. But the fact is you can’t continue to do what you’re trained to do without having to negotiate terms of payment first. This negotiation doesn’t mean simply agreeing to whatever the payer says– it’s making sure you get what your time, service and skills are truly worth– and that’s the hard part right there.

Fortunately there are ways to negotiate terms to your benefit. Following these tips and armed with the right facts and figures, successful negotiation can be achieved.

1. Analyze current payer performance and fee schedules

The first thing you need to do in order to negotiate successfully is to analyze your current payers’ performance and fee schedules. Identify the payers with whom you do the most business along with the most common CPT codes you use. Get the number of times you bill each code with each payer, and multiply each number by the proposed payment amounts. Then add up all the totals per payer and divide by the total number of codes billed. This should give you the weighted average for each payer, and a good indication of which contracts are most valuable to you.

Apart from this you could also compare the rates of individual CPT codes and approach payers who pay the least amount about increasing to at least reach the average reimbursement rate for these codes.

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The Basic Principles of Using Modifier 59 in Physical Therapy

For therapists, coding can be complicated. And it gets even more complicated when modifiers enter the picture. Modifiers are tricky things. Used wisely, they can help maximize your revenue. But used erroneously, they can wreak havoc in the form of claim denials and penalties. And if there’s one modifier that

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Physical Therapy Coding Updates

New Physical Therapy Coding Updates for 2017

It’s time again to welcome the new year and with it, changes that will make our practices better than before. Among these changes? Physical Therapy codes.

Recently it was announced that the Physical Therapy Evaluation (97001) and Physical Therapy Re-evaluation (97002) codes have been deleted, and four new codes have been released in their place. These codes will be effective by January 1, 2017.

The new evaluation codes (97161 to 97163) center around services ranging in complexity from low to high, each with a code descriptor specifying required components. To give you an idea of each new code, some of the requirements are stated below:

Code no. 97161 – Physical therapy evaluation: low complexity, requiring the following components:

• A history with no personal factors and/or comorbidities that impact the plan of care;
• An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions;
• A clinical presentation with stable and/or uncomplicated characteristics; and
• Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome.

In this case, usually 20 minutes are spent face-to-face with the patient and/or family.

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