RE: billing time

[Guest guest]

Hi, Leonard -

These days, Medicare reimbursement is according to how much time the

*patient* received therapist services, with a multiplier for the relative

value of the service, non-clinical practice expense, and malpractice

expense. Then, it's adjusted for geographic area.

Non-Medicare payors vary, but many base their payment on... Medicare.

In the inpatient acute care environment, reimbursement is according to a

" case rate " formula in which patients are grouped according to diagnosis.

" Charges " or " billing " are somewhat irrelevant there. As an example, my

wife had an appendectomy a month ago, and Medicare paid (and the hospital

accepted) about $4,100 in payment for a $17,300 " charge " .

Reviewing patient records is very important, but not billable or

collectible.

Hope that helps,

Dr. Dick Hillyer

Dr. W. Hillyer

Lee Therapist Group, LLC

Hillyer Consulting

700 El Dorado Pkwy W.

Cape Coral, FL 33914

Home

Office

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_____

From: PTManager [mailto:PTManager ] On Behalf

Of Leonard Paladino

Sent: Tuesday, October 21, 2008 5:36 PM

To: PTManager

Subject: billing time

I understand that chart review time is part of the evaluation process,

hence built into the evaluation charge. Is any of the chart review time

prior to TREATMENT time considered billable time ? This had been

suggested to me previously, but I do not have references or

confirmation. I'm considering this as it relates to acute care setting

where medical status can obviously change quickly, and treating

therapists spend significant time reviewing chart to identify these

changes and determine appropriateness/safety of therapy intervention.

Any input appreciated, including references.

Leonard Paladino, PT

Team Leader of Rehabilitation Services

Delnor-Community Hospital

Geneva, IL 60134

leonard.paladino@ <mailto:leonard.paladino%40delnor.com> delnor.com

<mailto:leonard.paladino@ <mailto:leonard.paladino%40delnor.com> delnor.com>