Guest guest Posted June 27, 2000 Report Share Posted June 27, 2000 Nice job, Ken. I have thought for quite a while that the APTA should have a specialization process for us " generalists " for whom treating in whatever setting, whichever patient has become a challenging, rewarding way of (professional)life. Thanks for your words. PT Clinical Coordinator of PT Sheltering Arms Richmond, VA Fwd: Coverage Issues I'm utilizing energy conservation techniques. Ken > We have had many discussions on this listserve about the problems > associated with " Reimbursement driving Practice " , rather > than " Practice driving Reimbursement " . We all bemoan how this > decreases the quality of patient care and leads to ethical and > potential legal problems with delivering care. I certainly agree > with these points and share these concerns. > > Having said all of this, I find it incredibly ironic when I hear > people discuss " coverage " issues in facilities and practices. The > issue almost always concerns " How are we going to assure continuity > of care for patients when their therapist is not around? " The > undercurrent to this discussion is actually: How is the > facility/practice going to assure continuity since they are the ones > billing? In other words, it is " their " problem. > > This makes me absolutely crazy! I recall a conversation that I once > had with a Rehabilitation department about Weather Emergencies, and > what the policy would be for employees who could not make it to > work. When I was asked how the employees who did make it would be > treated in comparison to those who did not, I asked the following > question: " How will we assure that the patients would be treated? " > > I was greeted with quizzical looks. They reiterated their question > about what the policy would be, and I then reiterated my > question: " How will we assure that the patients would be treated? " > As their frustration continued to mount (as your may be now!) I > simply said that if we did not answer my question first, we would > never get to their question. > > The point is that we are responsible for assuring the proper > treatment, and continuity of care for our patients. If we are more > concerned about our time off concerns than our patients, then we > should not be taken seriously as " professionals " . The plan of care > for a patient must be developed according to the identified clinical > needs of the patient. If we develop this plan based on " coverage " > issues, we are shirking our professional, ethical, and legal > responsibilities. This is what is meant by " Reimbursement driving > Practice " . > > If we persist in allowing therapists to be Outpatient Specialists, > Inpatient Specialists, Subacute Specialists, etc. we are reinforcing > Reimbursement driving Practice. I refuse to believe that a therapist > seeing a patient today, does not know how to treat the patient > tomorrow after they have been transferred. It is the setting which > had changed, not the patient! Just because these settings are > regulated and reimbursed differently does not mean we can not, or > should not, see the patient through. > > That is where we need to get ourselves! > That is " Practice driving Reimbursement " ! > > Ken Mailly, PT > Mailly & Inglett Consulting > Wayne, NJ > Director of Government Affairs/Professional Affairs Representative > NJ Chapter, APTA > --- End forwarded message --- > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > > Coming Soon - Rehab Pro - The New Way...A Better Way to Rehab Success! > LAMP Summit 2000. July 23-25, 2000 Register at . > > Visit our EStore at www.RehabBusiness.com [This message contained attachments] ________________________________________________________________________ ________________________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 28, 2000 Report Share Posted June 28, 2000 " The onus is not on APTA to educate us, it is on me to learn as the professional clinician. " What a thought, Ken! I'd submit that the APTA actually IS us. Despite the experience that some of us may have had with paternalistic social institutions, we ourselves are at least 80% responsible for our own destinies. When we cluster together in an affinity group such as the APTA, we actually contribute to what that becomes, not so much the other way around. This is good: We strengthen our own support structures that way. Some of what the group is, also rubs off on us, but to a lesser extent. So, (if I may plug my old employer, the US Army Medical Department) ... " Beee Alll That Youuu Cannn Beee! " Dick Hillyer, PT, TLK Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 Ken, I agree that a patient's continuity of care and appropriate care plan are extremely important. But you cannot ignore the reimbursement and business end of our profession these days. Therapists must be aware of coverage restrictions in order to provide the most appropriate and efficient therapy for their patients. The purse strings have tightened significantly as a result of the BBA of 1997. In order to succeed in our profession these days, we must continue to search for " best practice " techniques. They may need to be developed for an HMO patient authorized for 4 visits s/p ACL reconstruction and one authorized for 24 visits. Unfortunately, all insurances are not created equal. Clinics may have a little lattitude for charity, but it is limited. We must keep the business aspect of our profession in the forefront. The key is to be able to balance efficient business techniques with quality care so our practicies may survive these difficult times. I look forward to any feedback. Bob Rohack, PT Rehab Supervisor Bethesda Memorial Hospital, Boynton Bch, FL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 Bob: I will challenge you, however, that if you are able to successfully rehab the patient with the ACL repair using 4 total visits - then why would you need 24 just because 24 are authorized? If we do one in 4 visits - then all should be tried in 4 visits. Just my $0.02... Ed Flickinger, PT, MBA ROHACK007@... wrote: > Ken, I agree that a patient's continuity of care and appropriate care plan > are extremely important. But you cannot ignore the reimbursement and > business end of our profession these days. Therapists must be aware of > coverage restrictions in order to provide the most appropriate and efficient > therapy for their patients. The purse strings have tightened significantly > as a result of the BBA of 1997. In order to succeed in our profession these > days, we must continue to search for " best practice " techniques. They may > need to be developed for an HMO patient authorized for 4 visits s/p ACL > reconstruction and one authorized for 24 visits. Unfortunately, all > insurances are not created equal. Clinics may have a little lattitude for > charity, but it is limited. We must keep the business aspect of our > profession in the forefront. > > The key is to be able to balance efficient business techniques with > quality care so our practicies may survive these difficult times. > > I look forward to any feedback. > > Bob Rohack, PT > Rehab Supervisor > Bethesda Memorial Hospital, Boynton Bch, FL > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details > LAMP Summit 2000. July 23-25, 2000 Register at . > Visit our EStore at www.RehabBusiness.com Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2000 Report Share Posted July 16, 2000 In a message dated 07/15/2000 3:13:37 PM Central Daylight Time, ROHACK007@... writes: << The key is to be able to balance efficient business techniques with quality care so our practicies may survive these difficult times.>> Bob; Very eloquently stated! Successful practices will need to partner with their business office staff and spend more time learning what is going on. The weakest component of any clinic is not in the treatment area. Unless time is spent to learn and facilitate the front office, practices will continue to struggle and some will fail. Therapists have continuing education opportunities, but front office staff still suffer from the stereotype that the best front office staff is one that accepts minumum wage and understands the success of a practice hinges on the quality of therapy provided. I realize that my statements are controversial, but until practitioners devote as much attention to the business side of their practice, they will continue to suffer financially. Okay, I'm out of the pulpit this Sunday morning. Jim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2000 Report Share Posted July 16, 2000 Bob & Jim: You're both quite correct! If a practice fails the cause is not likely to be poor treatment or patient management skills but inadequate knowledge of practice management and the critical importance of the " front desk " . Elmer Platz, PT 418 Route 515 Vernon, NJ 07462-3027 fax http://www.platzpt.com " Every man owes part of his time and money to the business or industry in which he is engaged. No man has the moral right to withhold his support from an organization that is striving to improve conditions within his sphere. " President Theodore Roosevelt Re: Coverage Issues In a message dated 07/15/2000 3:13:37 PM Central Daylight Time, ROHACK007@... writes: << The key is to be able to balance efficient business techniques with quality care so our practicies may survive these difficult times.>> Bob; Very eloquently stated! Successful practices will need to partner with their business office staff and spend more time learning what is going on. The weakest component of any clinic is not in the treatment area. Unless time is spent to learn and facilitate the front office, practices will continue to struggle and some will fail. Therapists have continuing education opportunities, but front office staff still suffer from the stereotype that the best front office staff is one that accepts minumum wage and understands the success of a practice hinges on the quality of therapy provided. I realize that my statements are controversial, but until practitioners devote as much attention to the business side of their practice, they will continue to suffer financially. Okay, I'm out of the pulpit this Sunday morning. Jim Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2000 Report Share Posted July 17, 2000 In a message dated 7/15/2000 8:08:42 PM Central Daylight Time, flickingerpt@... writes: << if you are able to successfully rehab the patient with the ACL repair using 4 total visits - >> Just a thought here. I don't want anyone acting on this as I need to contact a patent attorney in order finalize this concept. In order to accomodate the HMO's I would propose a " Jiffy Lube " concept. Providers would purchase old automotive garages and open up the treatment bays. Since time and money are at a premium (emphasis added-tongue in cheek), patients could drive their car into the bay. For HMO patients we could apply ice or heat (whichever the tech feels is most appropriate). By accepting the credit card at the time of drive through, insurers could pay for services at the time of the treatment. I'm still working on how to treat the HMO patient if they need anything other than a Hot/Cold pack though. Any ideas? With a concept like this, I am sure I can drive therapists out of business very soon. A. Nonmus Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2000 Report Share Posted July 17, 2000 > I'm still working on how to treat the HMO patient if they need anything other > than a Hot/Cold pack though. Any ideas? > yes. treatment could consist of watching a video and taking a test. the pt would also be given an HEP: a pamplet with glossy pictures. the 2nd session would just be a follow up to make sure the pt still has the pamplet. A total of two sessions and the pt would not even have to get out of his car. By the way, the fact that the pt stays in his car may help reduce general liability costs to the business. Mike Hickey, PT Re: Coverage Issues > In a message dated 7/15/2000 8:08:42 PM Central Daylight Time, > flickingerpt@... writes: > > << if you are able to successfully rehab the patient with the ACL repair > using 4 total visits - >> > > Just a thought here. I don't want anyone acting on this as I need to contact > a patent attorney in order finalize this concept. In order to accomodate the > HMO's I would propose a " Jiffy Lube " concept. Providers would purchase old > automotive garages and open up the treatment bays. Since time and money are > at a premium (emphasis added-tongue in cheek), patients could drive their car > into the bay. For HMO patients we could apply ice or heat (whichever the > tech feels is most appropriate). By accepting the credit card at the time of > drive through, insurers could pay for services at the time of the treatment. > I'm still working on how to treat the HMO patient if they need anything other > than a Hot/Cold pack though. Any ideas? > > With a concept like this, I am sure I can drive therapists out of business > very soon. > A. Nonmus > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details > LAMP Summit 2000. July 23-25, 2000 Register at . > Visit our EStore at www.RehabBusiness.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2000 Report Share Posted July 17, 2000 Since you have quoted one small, incomplete line of my original post - would you mind explaining your point? And properly identify yourself so that I know to whom I am speaking. Thanks. Ed Flickinger, PT, MBA JHall49629@... wrote: > In a message dated 7/15/2000 8:08:42 PM Central Daylight Time, > flickingerpt@... writes: > > << if you are able to successfully rehab the patient with the ACL repair > using 4 total visits - >> > > Just a thought here. I don't want anyone acting on this as I need to contact > a patent attorney in order finalize this concept. In order to accomodate the > HMO's I would propose a " Jiffy Lube " concept. Providers would purchase old > automotive garages and open up the treatment bays. Since time and money are > at a premium (emphasis added-tongue in cheek), patients could drive their car > into the bay. For HMO patients we could apply ice or heat (whichever the > tech feels is most appropriate). By accepting the credit card at the time of > drive through, insurers could pay for services at the time of the treatment. > I'm still working on how to treat the HMO patient if they need anything other > than a Hot/Cold pack though. Any ideas? > > With a concept like this, I am sure I can drive therapists out of business > very soon. > A. Nonmus > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details > LAMP Summit 2000. July 23-25, 2000 Register at . > Visit our EStore at www.RehabBusiness.com Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 18, 2000 Report Share Posted July 18, 2000 Ahh, drive through PT. Now we're talking! Helene Rosen >>> " Mike Hickey " 07/17/00 07:09PM >>> > I'm still working on how to treat the HMO patient if they need anything other > than a Hot/Cold pack though. Any ideas? > yes. treatment could consist of watching a video and taking a test. the pt would also be given an HEP: a pamplet with glossy pictures. the 2nd session would just be a follow up to make sure the pt still has the pamplet. A total of two sessions and the pt would not even have to get out of his car. By the way, the fact that the pt stays in his car may help reduce general liability costs to the business. Mike Hickey, PT Re: Coverage Issues > In a message dated 7/15/2000 8:08:42 PM Central Daylight Time, > flickingerpt@... writes: > > << if you are able to successfully rehab the patient with the ACL repair > using 4 total visits - >> > > Just a thought here. I don't want anyone acting on this as I need to contact > a patent attorney in order finalize this concept. In order to accomodate the > HMO's I would propose a " Jiffy Lube " concept. Providers would purchase old > automotive garages and open up the treatment bays. Since time and money are > at a premium (emphasis added-tongue in cheek), patients could drive their car > into the bay. For HMO patients we could apply ice or heat (whichever the > tech feels is most appropriate). By accepting the credit card at the time of > drive through, insurers could pay for services at the time of the treatment. > I'm still working on how to treat the HMO patient if they need anything other > than a Hot/Cold pack though. Any ideas? > > With a concept like this, I am sure I can drive therapists out of business > very soon. > A. Nonmus > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details > LAMP Summit 2000. July 23-25, 2000 Register at . > Visit our EStore at www.RehabBusiness.com > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details (800) 540-0774 LAMP Summit 2000. July 23-25, 2000 Register at . Visit our EStore at www.RehabBusiness.com ! ! ! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 20, 2000 Report Share Posted July 20, 2000 Bob, Jim, & Elmer -- AMEN! Dick Hillyer Re: Coverage Issues > > > In a message dated 07/15/2000 3:13:37 PM Central Daylight Time, > ROHACK007@... writes: > > << The key is to be able to balance efficient business techniques with > quality care so our practicies may survive these difficult times.>> > > Bob; > > Very eloquently stated! Successful practices will need to partner with > their > business office staff and spend more time learning what is going on. The > weakest component of any clinic is not in the treatment area. Unless time > is > spent to learn and facilitate the front office, practices will continue to > struggle and some will fail. Therapists have continuing education > opportunities, but front office staff still suffer from the stereotype that > the best front office staff is one that accepts minumum wage and understands > the success of a practice hinges on the quality of therapy provided. I > realize that my statements are controversial, but until practitioners devote > as much attention to the business side of their practice, they will continue > to suffer financially. > > Okay, I'm out of the pulpit this Sunday morning. > Jim > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - > Rochester Michigan. Register at today. > Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details > > LAMP Summit 2000. July 23-25, 2000 Register at . > Visit our EStore at www.RehabBusiness.com > > > > > > Coming September 22,2000 - Helene Fearon on Coding and Reimbursement - Rochester Michigan. Register at today. > Rehab Pro - The New Way...A Better Way to Rehab Success! Call for details > LAMP Summit 2000. July 23-25, 2000 Register at . > Visit our EStore at www.RehabBusiness.com > > > Quote Link to comment Share on other sites More sharing options...
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