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Dilemma of Florida PTs

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Dear Fellow PTManager subscribers,

There has been a great deal of recent discussion and questions

regarding the current differences between many Florida rehab providers

and Blue Cross/Blue Shield of Florida over the issue of focused medical

reviews and delayed payments.

As editor of Eli’s Rehab Report, I have been a member of this

list since its inception, and I have followed these and other

discussions with great interest.

In its most recent issue, Eli's Rehab Report details the

dilemmas faced by several PT providers in Florida. In many cases,

providers say they have never had a single run-in with Medicare, but now

find themselves under a 100 focused medical review, leaving them with

little or no cash flow, and facing the likelihood of shutting their

doors. Furthermore, they insist their claims are being branded as " not

medically necessary, " without additional clarification and guidance from

BCBSF. Now, these providers insist that " BCBSF is out of control, and

nobody's watching over them, " leaving them no choice but to pursue a

class-action lawsuit.

BCBSF representatives, however, insist they are not trying to

shut anyone down. The problem, they contend, is that claims " need to

paint a picture so that we can tell what's going on. " Unfortunately,

they say that most providers are too vague in their documentation,

leaving reviewers no other option but to deny the claims. Consequently,

too many denied claims and the provider goes under review.

This is an issue that I will continue to cover in the future,

with several articles planned for the next issue as well, including

BCBSF's suggestions for improving documentation.

This is just one of the many topics covered recently in Eli's

Rehab Report, including:

• Is the market weakening for rehab providers who want to sell

their practices?

• Why do rehab providers need to become quality salespeople,

and what skills do they possess that make them naturals at selling?

• Does NovaCare’s recent announcement that it will consider

“strategic alternatives,” which may include selling off one or more of

its operating divisions, indicate that it’s getting too big? If so, why

isn’t HealthSouth facing a similar predicament?

• Will the delay in consolidated billing actually create new

problems for providers if HCFA starts to pay SNFs under a prospective

payment system without consolidated billing.

If anyone has any questions, please feel free to call or e-mail

me.

Sincerely,

Cary Boshamer

Editor, Eli's Rehab Report

caryb@...

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Cary,

I read your notice on PT manager. I am a owner of an ORF in south florida and

have found the exact problem occurring in my practice. Until just two months

ago, I had virtually no problem with reimbursement or ADR's. Since June 98, I

am under a 10% ADR rate. Meaning per billing period 10% of my patients

medical records fall under the " Additional Documentatin Required " list. This

means no cash flow at present on those cases, and I expect (although I have ot

yet heard about my cases) them to be denied because " not medically necessary "

I base this on what my billing company's other clients are experiencing and

what you have described. I feel that the Blues have only a few options to

click on their computers and Not Meidcally Necessary is the easiest one to

push. This is BS! We both know that now skilled people are reading these

charts, how sensible is that? Also, Medicare and their payment to the Blues

is on a different timeline. As the year comes to a close, the blues probably

sense their payments from medicare will diminish, so they will " cut "

disbursement to the providers to save cash. Who know if that is what is

really happening, but I am not happy. I would be very interested in hearing

from you RE: documentation or any other idaeas for stoppint his nonsense fro

the blues.

hope to hear from you

Witt

wittpt@...

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