Guest guest Posted January 31, 2011 Report Share Posted January 31, 2011 Welcome to the club.... Horizon reduced rates in NJ in March 2005, to a $58.00 cap no matter what you do including multiple body parts. Oh by the way, I almost forgot that they also do not reimburse extra for evaluations or reevaluations. Needless to say I have dropped out and have observed many of my colleagues struggle and at times close because they accept such low reimbursement because they think it is more important to stay busy!!!! It was 30% of my practice and I now accept patients out of network. Yes I have fewer patients but generating the same amount and going home at 8pm instead of 10pm is a plus. Here in New Jersey we have a group of approx. 150 private practice owners that have organized a group to deal directly with issues that affect private practitioners. The New Jersey Society of Independent Physical Therapists (NJSIPT) and we have introduced legislation that will mandate that Insurance companies reimburse a minimum of 140% of the Medicare fee schedule. One has to question where the floor of reimbursement is, as perceived by the Insurance companies. I say it is a big fat zero. As PTs continue to sign these outrageous contracts the insurance companies will continue to lower their reimbursement. Did you ever research what the insurance companies' executives bring in every year? I have and it is outrageous. Think twice before you sign unless you want to deliver inferior services or step over that redline that may be considered fraud. Barry Barry G. Inglett, P.T., CHT, Cert.MDT Wayne Physical Therapy & Spine Center Tel. Fax www.waynept.com Mailly & Inglett Consulting, LLC www.njptAid.biz Mailly Inglett & Barmak Consulting www.maillyinglettbarmak.com cold laser > > What all do you all think of the cold laser? Is it billable? Do you own it? > ease it? Getting good results with? > What say you???? > > Mark Niles PT, MS, CSCS > rthopedic Specialists PA > niles@... > 54-720-7448 x3 > 54-720-9042 fax > This message, together with any attachments, is intended only for the > ddressee. It may contain information which is legally privileged, > onfidential and exempt from disclosure. If you are not the intended > ecipient, you are hereby notified that any disclosure, copying, > istribution, use, or any action or reliance on this communication is > trictly prohibited. If you have received this e-mail in error, please > otify the sender immediately by telephone ( x3) or by return > -mail and delete the message, along with any attachments > > From: PTManager [mailto:PTManager ] On Behalf > f nygaardsabs > ent: Friday, January 28, 2011 9:08 AM > o: PTManager > ubject: L-Code Clarification > > > > had a question for the group about L-codes. When reading up on this charge > ode it is my understanding that this code includes the: > ) Evaluation > ) Fitting of the splint > ) Material and supplies > ) Any return visits for adjustments/modifications of this splint for > he next 90 days. > If I understand correctly, I am able to charge an orthotic fitting charge on > he day I make the splint and any return visits for the time I do training > ith the patient. > Is this a correct understanding? > always wondered why the price on these codes was so high, but now that I > nderstand it includes any return visits for modification and the initial > valuation I can more clearly can understand. > hanks, > shley Kelley, OTR/L, CLT > > Quote Link to comment Share on other sites More sharing options...
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