Re: Using the Guide to Physical Therapist Practice

[Guest guest]

We use the practice guide when a payer is questioning payment. We send the

pertinent pages to the insurance company with the info we want them to pay

" special " attention too underlined in yellow. The payments do not come faster

but we have had success in getting paid, atleast. I think with the guide

helps cut down subsequent paper work and mailings (seems like we have less

doing it this way).

None of the insurers have asked about the guide

I've gone through it as thoroughly as I have time for and have actually copied

the pages we use the most often so I don't have to thumb through it each time.

We keep them in protectors in a notebook for easy access.

Carol Ristau PT

Resolution Therapies

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[Guest guest]

I do use it some - for explanation, justification to non-PT personnel, often.

I will use it as a reference more as I have time to read it more in depth.

Congratulations on the coverage of this/your new endeavor (The PT Manager) in

the most recent Eli Rehab Report. Nice coverage for you! In the same issue

there was coverage regarding HCFA permitting FIs to withhold payment from

providers based on " suspicion of fraud " . What do you think of this? Sounds

like a bit of a witch hunt to me but I don't know the particulars.

Thanks for providing this service. It's been quite helpful already.

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[Guest guest]

Please do share with us her response. Ah, the wonders of email.

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[Guest guest]

Guffaw!

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[Guest guest]

coverage regarding HCFA permitting FIs to withhold payment from

>providers based on " suspicion of fraud " . What do you think of this? Sounds

>like a bit of a witch hunt to me but I don't know the particulars.

Withholding payment due to suspicion of fraud reminds me of the times my

wife asks me to " come to the refrigerator and smell this, Do you think this

food has gone bad? " - I have never figured out how to respond to those

requests.

In the best case scenario, I may end up eating something that looks or

seems suspicious. Yum yum!! In the worst case scenario, I get a close up

encounter with rotting food. I wish there was a third option.

BTW, my wife subscribes to this list - so I expect a clever retort from her.

R. Kovacek, MSA, PT

KovacekManagementServices, Inc.

The FOCUS Group, Inc.

20225 Danbury Lane

Harper Woods, MI 48225

Fax

Email Pkovacek@...

<http://www.theFOCUSgroup.net>

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[Guest guest]

I think she will share it with you herself. <grin??>

At 03:53 PM 7/7/1998 -0400, you wrote:

>Please do share with us her response. Ah, the wonders of email.

>

>

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>

R. Kovacek, MSA, PT

KovacekManagementServices, Inc.

The FOCUS Group, Inc.

20225 Danbury Lane

Harper Woods, MI 48225

Fax

Email Pkovacek@...

<http://www.theFOCUSgroup.net>

Join PT Manager list serv --

To subscribe, send an empty message to ptmanager-subscribe@...

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[Guest guest]

In a message dated 98-07-07 10:11:14 EDT, you write:

<< Have you used it? How?

Most definitely. I have utilized this as further evidence in contradicting

insurance companies claims of " our computer says. . . . . is the standard of

care " . I have also used this to bolster my arguments of what I perceive as

'medically necessary care'. This provides greater credibility to my

" opinions " as this is a consensus document by experts in our field.

Have you read it? How thoroughly?

Part I has been out for a lot longer than that--and I had read that section

before. I've read most of the M/S, Neuro, Integ. as they are most pertinent

to my clinic's populus. And I must admit, I have just glazed over the

cardiopulmonary section. I just dipped and dabbled in this section--more for

curiosity sake than anything. Also, was kind of quickly looking for anything

that would be pertinent in my Professional Level Resucuer CPR classses that I

teach to introduce PT rehabilitation as an FYI item. Haven't really looked

tho'.

Have payers asked about it or have you shared it with them?

Once they were aware that it existed, yes they do ask. I have 3 or 4

meetings in the next couple of weeks with a couple case manager dept. heads to

review the document and show them how it can be of use to them.

Any suggestions for others in using these documents well?

I also used this as a resource item with a colleague that was doing a lecture

on scoliosis treatments for a seminar. They found it to be helpful in

information that should be disseminated about 'what to expect from PT " and

were 'comforted' by the fact that info that was given based on the guide was

truly the basis from which PTs should be working, rather than just her

opinion.

Hope this is helpful.

Peg Grey

>>

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[Guest guest]

Hi --the last 2 days of information you have sent has been very

valuable--thanks again for the service. In response to how I use the Guide to

PT Practice:

I use it more frequently over time--

As a resource when setting up Outcomes Management Systems for clients

and as a resource for teaching Administration and Management course to PT and

PTA students.

It has also served well to compose case studies for courses.

Annette Herrick

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