Guest guest Posted February 5, 2011 Report Share Posted February 5, 2011 Odilia: You need to schedule a private meeting with your supervisor and let him/her know all of the details, along with the fact that you have had other patient complaints regarding the same issue with the same therapist. At the very least, it is unethical. This type of therapist is the kind that needs to be weeded out of our profession....your manager should take the appropriate steps to remove them from the homecare setting. Pike, PT Help, what to do? Group, I am not sure what to do and need some advice. I am a contract therapy for a home health agency. I called a patient last week to tell them I was coming out to the house and she informed me that another therapist had called that they were on their way out as well. I told her it would take me 20 minutes to get there, and that I could do some paperwork if needed if the other therapist had not finished yet. I arrived 25 minutes later to find that the therapist had already come and gone for the eval. I arrived at the patient house at 12:50. Today I noticed that the therapist had written on his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?) So my question is: is this considered fraud under medicare, the therapist is paid per visit, not sure how the agency is paid and if medicare requires a minimum per visit, but at the very least the patient was done a disservice and the therapist is lying to the agency about how long he is with the patient. I actually had a different patient complaining to me before that this therapist was never staying more than 5 minutes. So where do I go from here? Appreciate any input. Remember I am a therapist there not a manager, so let me know from an employee side what I need to do next. Odilia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2011 Report Share Posted February 5, 2011 An agency I work for has an internal hotline for compliance. While it may seem " right " to start at top (go to therapist.go to supervisor.etc.) this may not be practical in the real world politics. It is a tough call you are facing. If you only go to the therapist. you may find a simple explanation but you may also just hide the problem. If you go to local management, you may cause hurt feelings if complaint is unjustified and it gets back to therapist. I really think the overall problem is billing-staffing policies creeping up in most HH agencies. They prefer to pay per visit for simplicity in their tracking and to encourage the therapist to see huge number of patients. Therapists and managers are so happy to see 12+ HH patients a day but this is simply not possible if you have excess travel and patient issues. The agency can turn a blind-eye to the practice and leave it up to the therapist professional ability but this is avoids the agencies (?) legal and (?) ethical responsibility with billing. If we went back to pay-per-hour, I am sure efficiency would drop . cannot be sure the problem would not occur but it would be less supported by the agency process. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of odiliahome Sent: Friday, February 04, 2011 9:42 PM To: PTManager Subject: Help, what to do? Group, I am not sure what to do and need some advice. I am a contract therapy for a home health agency. I called a patient last week to tell them I was coming out to the house and she informed me that another therapist had called that they were on their way out as well. I told her it would take me 20 minutes to get there, and that I could do some paperwork if needed if the other therapist had not finished yet. I arrived 25 minutes later to find that the therapist had already come and gone for the eval. I arrived at the patient house at 12:50. Today I noticed that the therapist had written on his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?) So my question is: is this considered fraud under medicare, the therapist is paid per visit, not sure how the agency is paid and if medicare requires a minimum per visit, but at the very least the patient was done a disservice and the therapist is lying to the agency about how long he is with the patient. I actually had a different patient complaining to me before that this therapist was never staying more than 5 minutes. So where do I go from here? Appreciate any input. Remember I am a therapist there not a manager, so let me know from an employee side what I need to do next. Odilia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2011 Report Share Posted February 5, 2011 An agency I work for has an internal hotline for compliance. While it may seem " right " to start at top (go to therapist.go to supervisor.etc.) this may not be practical in the real world politics. It is a tough call you are facing. If you only go to the therapist. you may find a simple explanation but you may also just hide the problem. If you go to local management, you may cause hurt feelings if complaint is unjustified and it gets back to therapist. I really think the overall problem is billing-staffing policies creeping up in most HH agencies. They prefer to pay per visit for simplicity in their tracking and to encourage the therapist to see huge number of patients. Therapists and managers are so happy to see 12+ HH patients a day but this is simply not possible if you have excess travel and patient issues. The agency can turn a blind-eye to the practice and leave it up to the therapist professional ability but this is avoids the agencies (?) legal and (?) ethical responsibility with billing. If we went back to pay-per-hour, I am sure efficiency would drop . cannot be sure the problem would not occur but it would be less supported by the agency process. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of odiliahome Sent: Friday, February 04, 2011 9:42 PM To: PTManager Subject: Help, what to do? Group, I am not sure what to do and need some advice. I am a contract therapy for a home health agency. I called a patient last week to tell them I was coming out to the house and she informed me that another therapist had called that they were on their way out as well. I told her it would take me 20 minutes to get there, and that I could do some paperwork if needed if the other therapist had not finished yet. I arrived 25 minutes later to find that the therapist had already come and gone for the eval. I arrived at the patient house at 12:50. Today I noticed that the therapist had written on his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?) So my question is: is this considered fraud under medicare, the therapist is paid per visit, not sure how the agency is paid and if medicare requires a minimum per visit, but at the very least the patient was done a disservice and the therapist is lying to the agency about how long he is with the patient. I actually had a different patient complaining to me before that this therapist was never staying more than 5 minutes. So where do I go from here? Appreciate any input. Remember I am a therapist there not a manager, so let me know from an employee side what I need to do next. Odilia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2011 Report Share Posted February 5, 2011 Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week! My heart goes out to you in your dilemma, just as it did to our colleague, Marcey. Without knowing which state you are in, you are saying that the other therapist claimed a 45 minute visit during the 25 minutes you were en route. If you were in Florida, you would be subject to FL-456, the law which enables FL-486, the practice act. FL 456 clearly says that we are " mandated reporters " of such activities. You may want to check with your state PT Association office to see whether you are subject to a similar law. Dr. Dick Hillyer, PT,DPT,MBA,MSM _____ From: PTManager [mailto:PTManager ] On Behalf Of pikede@... Sent: Saturday, February 05, 2011 7:40 AM To: PTManager Subject: Re: Help, what to do? Odilia: You need to schedule a private meeting with your supervisor and let him/her know all of the details, along with the fact that you have had other patient complaints regarding the same issue with the same therapist. At the very least, it is unethical. This type of therapist is the kind that needs to be weeded out of our profession....your manager should take the appropriate steps to remove them from the homecare setting. Pike, PT Help, what to do? Group, I am not sure what to do and need some advice. I am a contract therapy for a home health agency. I called a patient last week to tell them I was coming out to the house and she informed me that another therapist had called that they were on their way out as well. I told her it would take me 20 minutes to get there, and that I could do some paperwork if needed if the other therapist had not finished yet. I arrived 25 minutes later to find that the therapist had already come and gone for the eval. I arrived at the patient house at 12:50. Today I noticed that the therapist had written on his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?) So my question is: is this considered fraud under medicare, the therapist is paid per visit, not sure how the agency is paid and if medicare requires a minimum per visit, but at the very least the patient was done a disservice and the therapist is lying to the agency about how long he is with the patient. I actually had a different patient complaining to me before that this therapist was never staying more than 5 minutes. So where do I go from here? Appreciate any input. Remember I am a therapist there not a manager, so let me know from an employee side what I need to do next. Odilia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 I do feel that there must be some caution taken in what the patient reports as the times. I can understand that if there is a repeated pattern of complaints, it should be followed through. I was reported to a referring Dr. as only spending 15 minutes per session with the patient throughout the 5 weeks of treatment which was far from the truth. The patient's daughter was upset that I was discharging her mother from treatment and thus was trying to get an additional referral to another therapist or agency when the patient had clearly reached their maximum potential. I believe that caution has to be taken in accusing someone of wrongful reporting of times. , PT Florida > > > Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week! > My heart goes out to you in your dilemma, just as it did to our colleague, > Marcey. > > Without knowing which state you are in, you are saying that the other > therapist claimed a 45 minute visit during the 25 minutes you were en > route. > If you were in Florida, you would be subject to FL-456, the law which > enables FL-486, the practice act. FL 456 clearly says that we are " mandated > reporters " of such activities. You may want to check with your state PT > Association office to see whether you are subject to a similar law. > > Dr. Dick Hillyer, PT,DPT,MBA,MSM > > > _____ > > From: PTManager [mailto:PTManager ] On > Behalf > Of pikede@... > Sent: Saturday, February 05, 2011 7:40 AM > To: PTManager > Subject: Re: Help, what to do? > > Odilia: > You need to schedule a private meeting with your supervisor and let him/her > know all of the details, along with the fact that you have had other > patient > complaints regarding the same issue with the same therapist. At the very > least, it is unethical. This type of therapist is the kind that needs to be > weeded out of our profession....your manager should take the appropriate > steps to remove them from the homecare setting. > Pike, PT > > Help, what to do? > > Group, > > I am not sure what to do and need some advice. > > I am a contract therapy for a home health agency. I called a patient last > week to tell them I was coming out to the house and she informed me that > another therapist had called that they were on their way out as well. I > told > her it would take me 20 minutes to get there, and that I could do some > paperwork if needed if the other therapist had not finished yet. I arrived > 25 minutes later to find that the therapist had already come and gone for > the eval. I arrived at the patient house at 12:50. Today I noticed that the > therapist had written on his eval that he was there from 5:18 to 6 PM, > which > is a lie (or fraud?) > > So my question is: is this considered fraud under medicare, the therapist > is > paid per visit, not sure how the agency is paid and if medicare requires a > minimum per visit, but at the very least the patient was done a disservice > and the therapist is lying to the agency about how long he is with the > patient. I actually had a different patient complaining to me before that > this therapist was never staying more than 5 minutes. > > So where do I go from here? > > Appreciate any input. Remember I am a therapist there not a manager, so let > me know from an employee side what I need to do next. > > Odilia > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 I do feel that there must be some caution taken in what the patient reports as the times. I can understand that if there is a repeated pattern of complaints, it should be followed through. I was reported to a referring Dr. as only spending 15 minutes per session with the patient throughout the 5 weeks of treatment which was far from the truth. The patient's daughter was upset that I was discharging her mother from treatment and thus was trying to get an additional referral to another therapist or agency when the patient had clearly reached their maximum potential. I believe that caution has to be taken in accusing someone of wrongful reporting of times. , PT Florida > > > Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week! > My heart goes out to you in your dilemma, just as it did to our colleague, > Marcey. > > Without knowing which state you are in, you are saying that the other > therapist claimed a 45 minute visit during the 25 minutes you were en > route. > If you were in Florida, you would be subject to FL-456, the law which > enables FL-486, the practice act. FL 456 clearly says that we are " mandated > reporters " of such activities. You may want to check with your state PT > Association office to see whether you are subject to a similar law. > > Dr. Dick Hillyer, PT,DPT,MBA,MSM > > > _____ > > From: PTManager [mailto:PTManager ] On > Behalf > Of pikede@... > Sent: Saturday, February 05, 2011 7:40 AM > To: PTManager > Subject: Re: Help, what to do? > > Odilia: > You need to schedule a private meeting with your supervisor and let him/her > know all of the details, along with the fact that you have had other > patient > complaints regarding the same issue with the same therapist. At the very > least, it is unethical. This type of therapist is the kind that needs to be > weeded out of our profession....your manager should take the appropriate > steps to remove them from the homecare setting. > Pike, PT > > Help, what to do? > > Group, > > I am not sure what to do and need some advice. > > I am a contract therapy for a home health agency. I called a patient last > week to tell them I was coming out to the house and she informed me that > another therapist had called that they were on their way out as well. I > told > her it would take me 20 minutes to get there, and that I could do some > paperwork if needed if the other therapist had not finished yet. I arrived > 25 minutes later to find that the therapist had already come and gone for > the eval. I arrived at the patient house at 12:50. Today I noticed that the > therapist had written on his eval that he was there from 5:18 to 6 PM, > which > is a lie (or fraud?) > > So my question is: is this considered fraud under medicare, the therapist > is > paid per visit, not sure how the agency is paid and if medicare requires a > minimum per visit, but at the very least the patient was done a disservice > and the therapist is lying to the agency about how long he is with the > patient. I actually had a different patient complaining to me before that > this therapist was never staying more than 5 minutes. > > So where do I go from here? > > Appreciate any input. Remember I am a therapist there not a manager, so let > me know from an employee side what I need to do next. > > Odilia > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 - Excellent point! We all need to be certain we've documented accurately for what we've done. Dr. Dick Hilyer, PT,DPT,MBA,MSM _____ From: PTManager [mailto:PTManager ] On Behalf Of Goodger Sent: Sunday, February 06, 2011 1:28 PM To: PTManager Subject: Re: Help, what to do? I do feel that there must be some caution taken in what the patient reports as the times. I can understand that if there is a repeated pattern of complaints, it should be followed through. I was reported to a referring Dr. as only spending 15 minutes per session with the patient throughout the 5 weeks of treatment which was far from the truth. The patient's daughter was upset that I was discharging her mother from treatment and thus was trying to get an additional referral to another therapist or agency when the patient had clearly reached their maximum potential. I believe that caution has to be taken in accusing someone of wrongful reporting of times. , PT Florida On Sat, Feb 5, 2011 at 6:53 PM, Dick Hillyer <RHillyer@... <mailto:RHillyer%40comcast.net> > wrote: > > > Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week! > My heart goes out to you in your dilemma, just as it did to our colleague, > Marcey. > > Without knowing which state you are in, you are saying that the other > therapist claimed a 45 minute visit during the 25 minutes you were en > route. > If you were in Florida, you would be subject to FL-456, the law which > enables FL-486, the practice act. FL 456 clearly says that we are " mandated > reporters " of such activities. You may want to check with your state PT > Association office to see whether you are subject to a similar law. > > Dr. Dick Hillyer, PT,DPT,MBA,MSM > > > _____ > > From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On > Behalf > Of pikede@... <mailto:pikede%40lakeshore.net> > Sent: Saturday, February 05, 2011 7:40 AM > To: PTManager <mailto:PTManager%40yahoogroups.com> > Subject: Re: Help, what to do? > > Odilia: > You need to schedule a private meeting with your supervisor and let him/her > know all of the details, along with the fact that you have had other > patient > complaints regarding the same issue with the same therapist. At the very > least, it is unethical. This type of therapist is the kind that needs to be > weeded out of our profession....your manager should take the appropriate > steps to remove them from the homecare setting. > Pike, PT > > Help, what to do? > > Group, > > I am not sure what to do and need some advice. > > I am a contract therapy for a home health agency. I called a patient last > week to tell them I was coming out to the house and she informed me that > another therapist had called that they were on their way out as well. I > told > her it would take me 20 minutes to get there, and that I could do some > paperwork if needed if the other therapist had not finished yet. I arrived > 25 minutes later to find that the therapist had already come and gone for > the eval. I arrived at the patient house at 12:50. Today I noticed that the > therapist had written on his eval that he was there from 5:18 to 6 PM, > which > is a lie (or fraud?) > > So my question is: is this considered fraud under medicare, the therapist > is > paid per visit, not sure how the agency is paid and if medicare requires a > minimum per visit, but at the very least the patient was done a disservice > and the therapist is lying to the agency about how long he is with the > patient. I actually had a different patient complaining to me before that > this therapist was never staying more than 5 minutes. > > So where do I go from here? > > Appreciate any input. Remember I am a therapist there not a manager, so let > me know from an employee side what I need to do next. > > Odilia > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 - Excellent point! We all need to be certain we've documented accurately for what we've done. Dr. Dick Hilyer, PT,DPT,MBA,MSM _____ From: PTManager [mailto:PTManager ] On Behalf Of Goodger Sent: Sunday, February 06, 2011 1:28 PM To: PTManager Subject: Re: Help, what to do? I do feel that there must be some caution taken in what the patient reports as the times. I can understand that if there is a repeated pattern of complaints, it should be followed through. I was reported to a referring Dr. as only spending 15 minutes per session with the patient throughout the 5 weeks of treatment which was far from the truth. The patient's daughter was upset that I was discharging her mother from treatment and thus was trying to get an additional referral to another therapist or agency when the patient had clearly reached their maximum potential. I believe that caution has to be taken in accusing someone of wrongful reporting of times. , PT Florida On Sat, Feb 5, 2011 at 6:53 PM, Dick Hillyer <RHillyer@... <mailto:RHillyer%40comcast.net> > wrote: > > > Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week! > My heart goes out to you in your dilemma, just as it did to our colleague, > Marcey. > > Without knowing which state you are in, you are saying that the other > therapist claimed a 45 minute visit during the 25 minutes you were en > route. > If you were in Florida, you would be subject to FL-456, the law which > enables FL-486, the practice act. FL 456 clearly says that we are " mandated > reporters " of such activities. You may want to check with your state PT > Association office to see whether you are subject to a similar law. > > Dr. Dick Hillyer, PT,DPT,MBA,MSM > > > _____ > > From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On > Behalf > Of pikede@... <mailto:pikede%40lakeshore.net> > Sent: Saturday, February 05, 2011 7:40 AM > To: PTManager <mailto:PTManager%40yahoogroups.com> > Subject: Re: Help, what to do? > > Odilia: > You need to schedule a private meeting with your supervisor and let him/her > know all of the details, along with the fact that you have had other > patient > complaints regarding the same issue with the same therapist. At the very > least, it is unethical. This type of therapist is the kind that needs to be > weeded out of our profession....your manager should take the appropriate > steps to remove them from the homecare setting. > Pike, PT > > Help, what to do? > > Group, > > I am not sure what to do and need some advice. > > I am a contract therapy for a home health agency. I called a patient last > week to tell them I was coming out to the house and she informed me that > another therapist had called that they were on their way out as well. I > told > her it would take me 20 minutes to get there, and that I could do some > paperwork if needed if the other therapist had not finished yet. I arrived > 25 minutes later to find that the therapist had already come and gone for > the eval. I arrived at the patient house at 12:50. Today I noticed that the > therapist had written on his eval that he was there from 5:18 to 6 PM, > which > is a lie (or fraud?) > > So my question is: is this considered fraud under medicare, the therapist > is > paid per visit, not sure how the agency is paid and if medicare requires a > minimum per visit, but at the very least the patient was done a disservice > and the therapist is lying to the agency about how long he is with the > patient. I actually had a different patient complaining to me before that > this therapist was never staying more than 5 minutes. > > So where do I go from here? > > Appreciate any input. Remember I am a therapist there not a manager, so let > me know from an employee side what I need to do next. > > Odilia > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2011 Report Share Posted February 7, 2011 Odilia, I am not really familiar with home health computer documentation, but I wonder if the time the therapist was in the home may have been documented much later after all of that therapists visits were completed for that day and he then did his computer documentation: hence the " 6:00 pm " time instead of the 12:25-12:50 time he was actually there. I am not sure if home health is like I am in outpatient, and I document any time I get a chance, which may be after I am done for the day at 6:00 or 7:00 pm. Just a thought. Seems like an awfully short eval and treat for a patient though. Matt Dvorak, PT Yankton, SD ________________________________ From: PTManager on behalf of odiliahome Sent: Fri 2/4/2011 9:42 PM To: PTManager Subject: Help, what to do? Group, I am not sure what to do and need some advice. I am a contract therapy for a home health agency. I called a patient last week to tell them I was coming out to the house and she informed me that another therapist had called that they were on their way out as well. I told her it would take me 20 minutes to get there, and that I could do some paperwork if needed if the other therapist had not finished yet. I arrived 25 minutes later to find that the therapist had already come and gone for the eval. I arrived at the patient house at 12:50. Today I noticed that the therapist had written on his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?) So my question is: is this considered fraud under medicare, the therapist is paid per visit, not sure how the agency is paid and if medicare requires a minimum per visit, but at the very least the patient was done a disservice and the therapist is lying to the agency about how long he is with the patient. I actually had a different patient complaining to me before that this therapist was never staying more than 5 minutes. So where do I go from here? Appreciate any input. Remember I am a therapist there not a manager, so let me know from an employee side what I need to do next. Odilia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2011 Report Share Posted February 7, 2011 Odilia, I am not really familiar with home health computer documentation, but I wonder if the time the therapist was in the home may have been documented much later after all of that therapists visits were completed for that day and he then did his computer documentation: hence the " 6:00 pm " time instead of the 12:25-12:50 time he was actually there. I am not sure if home health is like I am in outpatient, and I document any time I get a chance, which may be after I am done for the day at 6:00 or 7:00 pm. Just a thought. Seems like an awfully short eval and treat for a patient though. Matt Dvorak, PT Yankton, SD ________________________________ From: PTManager on behalf of odiliahome Sent: Fri 2/4/2011 9:42 PM To: PTManager Subject: Help, what to do? Group, I am not sure what to do and need some advice. I am a contract therapy for a home health agency. I called a patient last week to tell them I was coming out to the house and she informed me that another therapist had called that they were on their way out as well. I told her it would take me 20 minutes to get there, and that I could do some paperwork if needed if the other therapist had not finished yet. I arrived 25 minutes later to find that the therapist had already come and gone for the eval. I arrived at the patient house at 12:50. Today I noticed that the therapist had written on his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?) So my question is: is this considered fraud under medicare, the therapist is paid per visit, not sure how the agency is paid and if medicare requires a minimum per visit, but at the very least the patient was done a disservice and the therapist is lying to the agency about how long he is with the patient. I actually had a different patient complaining to me before that this therapist was never staying more than 5 minutes. So where do I go from here? Appreciate any input. Remember I am a therapist there not a manager, so let me know from an employee side what I need to do next. Odilia Quote Link to comment Share on other sites More sharing options...
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