RE: Co-Pays

[Guest guest]

Dear Anonymous PT:

I probably missed the discussion that may have prompted your post. In any rate,

here is my 2 cents.

I would presume, although blindly, as I can’t speak for others, that the idea

of lowering co-pays is not to be connected to a lower overall reimbursement by

our part.

If you look at the whole picture of billing and collecting in the private

practice sector of physiotherapy, and I am sure you did, co-pays are going up at

the same time reimbursement is going down.

It is nothing but a very disingenuous, however extremely effective tactic from

the part of corporate insurance to disincentive the use of services by their

members. In the majority of the cases in my practice, I have to bill under

specialist, which requires a specialist co-pay by the part of the patient.

Multiply that to 2-3X / week and even for a couple of weeks you can see how many

patients would rather wait, or maybe opt for surgery at very worst –

considering the little clout PT pulls against physicians next to the public

(next to anybody, really) and the generalized ignorance about what PT is and

what we do (or how and why we do it).

The higher co-pay ABSOLUTELY does hurt the private practice. Regardless of

whatever it does for one’s ego, utilization is where the math brings it all to

a halt: a typical patient would see, say, a neurologist from once to 3 times

(unnecessarily, if I may say!) in the course of a typical lumbar radiculopathy

for example. With a co-pay of 50.00 = 50.00 - 150.00. PT 3X/wk for 3 Wks =

450.00 in co-pays. A big disincentive to the patient.

The problem CONTINUES to lie on the devaluation of what we provide, easily done

considering there is absolutely no public demand to see THE physiotherapist. Its

really at the physician’s discretion to refer for the gross reality (no need

to mention for matter of this discussion that we do see occasionally direct

access patients – BY THE WAY, there is no worse PR nightmare than to utilize

the term direct access, as the public looks at us like a-deer-in-the-headlights

). Its all news to the patient and they have no true expectation of they will

see or get (and we could add to that the fact that indeed, the pt could end up

experiencing a gamut of different “physical therapiesâ€, from the HP,

massage, US on down the road to Reiki or Acupressure plus some myofascial

“releaseâ€, OR the patient could end up lucky in a more scientific approach

to his or her problem. But I digress. The issue is not (or it should not be)

to lower co-pays to devalue our services, but for the insurance company to take

greater burden in the physiotherapist payment formula.

If that is not what the matter is, then we are talking about an ego issue, and

if so, keeping co-pays high will only hurt the bottom line in one’s practice,

no matter which way you look.

My opinion anyway.

Respectfully;

Armin Loges, PT

PS.: no need for anonymity: sometimes we bark but we never bite.

Piece!

From: Kovacek

Sent: Tuesday, March 08, 2011 3:00 PM

To: PTManager

Subject: Co-Pays

I have been asked to post this for a member of PTManager who does not wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty* service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by others.

PT and CHT in private practice.

[Guest guest]

Dear Anonymous PT:

I probably missed the discussion that may have prompted your post. In any rate,

here is my 2 cents.

I would presume, although blindly, as I can’t speak for others, that the idea

of lowering co-pays is not to be connected to a lower overall reimbursement by

our part.

If you look at the whole picture of billing and collecting in the private

practice sector of physiotherapy, and I am sure you did, co-pays are going up at

the same time reimbursement is going down.

It is nothing but a very disingenuous, however extremely effective tactic from

the part of corporate insurance to disincentive the use of services by their

members. In the majority of the cases in my practice, I have to bill under

specialist, which requires a specialist co-pay by the part of the patient.

Multiply that to 2-3X / week and even for a couple of weeks you can see how many

patients would rather wait, or maybe opt for surgery at very worst –

considering the little clout PT pulls against physicians next to the public

(next to anybody, really) and the generalized ignorance about what PT is and

what we do (or how and why we do it).

The higher co-pay ABSOLUTELY does hurt the private practice. Regardless of

whatever it does for one’s ego, utilization is where the math brings it all to

a halt: a typical patient would see, say, a neurologist from once to 3 times

(unnecessarily, if I may say!) in the course of a typical lumbar radiculopathy

for example. With a co-pay of 50.00 = 50.00 - 150.00. PT 3X/wk for 3 Wks =

450.00 in co-pays. A big disincentive to the patient.

The problem CONTINUES to lie on the devaluation of what we provide, easily done

considering there is absolutely no public demand to see THE physiotherapist. Its

really at the physician’s discretion to refer for the gross reality (no need

to mention for matter of this discussion that we do see occasionally direct

access patients – BY THE WAY, there is no worse PR nightmare than to utilize

the term direct access, as the public looks at us like a-deer-in-the-headlights

). Its all news to the patient and they have no true expectation of they will

see or get (and we could add to that the fact that indeed, the pt could end up

experiencing a gamut of different “physical therapiesâ€, from the HP,

massage, US on down the road to Reiki or Acupressure plus some myofascial

“releaseâ€, OR the patient could end up lucky in a more scientific approach

to his or her problem. But I digress. The issue is not (or it should not be)

to lower co-pays to devalue our services, but for the insurance company to take

greater burden in the physiotherapist payment formula.

If that is not what the matter is, then we are talking about an ego issue, and

if so, keeping co-pays high will only hurt the bottom line in one’s practice,

no matter which way you look.

My opinion anyway.

Respectfully;

Armin Loges, PT

PS.: no need for anonymity: sometimes we bark but we never bite.

Piece!

From: Kovacek

Sent: Tuesday, March 08, 2011 3:00 PM

To: PTManager

Subject: Co-Pays

I have been asked to post this for a member of PTManager who does not wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty* service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by others.

PT and CHT in private practice.

[Guest guest]

Dear Anonymous PT:

I probably missed the discussion that may have prompted your post. In any rate,

here is my 2 cents.

I would presume, although blindly, as I can’t speak for others, that the idea

of lowering co-pays is not to be connected to a lower overall reimbursement by

our part.

If you look at the whole picture of billing and collecting in the private

practice sector of physiotherapy, and I am sure you did, co-pays are going up at

the same time reimbursement is going down.

It is nothing but a very disingenuous, however extremely effective tactic from

the part of corporate insurance to disincentive the use of services by their

members. In the majority of the cases in my practice, I have to bill under

specialist, which requires a specialist co-pay by the part of the patient.

Multiply that to 2-3X / week and even for a couple of weeks you can see how many

patients would rather wait, or maybe opt for surgery at very worst –

considering the little clout PT pulls against physicians next to the public

(next to anybody, really) and the generalized ignorance about what PT is and

what we do (or how and why we do it).

The higher co-pay ABSOLUTELY does hurt the private practice. Regardless of

whatever it does for one’s ego, utilization is where the math brings it all to

a halt: a typical patient would see, say, a neurologist from once to 3 times

(unnecessarily, if I may say!) in the course of a typical lumbar radiculopathy

for example. With a co-pay of 50.00 = 50.00 - 150.00. PT 3X/wk for 3 Wks =

450.00 in co-pays. A big disincentive to the patient.

The problem CONTINUES to lie on the devaluation of what we provide, easily done

considering there is absolutely no public demand to see THE physiotherapist. Its

really at the physician’s discretion to refer for the gross reality (no need

to mention for matter of this discussion that we do see occasionally direct

access patients – BY THE WAY, there is no worse PR nightmare than to utilize

the term direct access, as the public looks at us like a-deer-in-the-headlights

). Its all news to the patient and they have no true expectation of they will

see or get (and we could add to that the fact that indeed, the pt could end up

experiencing a gamut of different “physical therapiesâ€, from the HP,

massage, US on down the road to Reiki or Acupressure plus some myofascial

“releaseâ€, OR the patient could end up lucky in a more scientific approach

to his or her problem. But I digress. The issue is not (or it should not be)

to lower co-pays to devalue our services, but for the insurance company to take

greater burden in the physiotherapist payment formula.

If that is not what the matter is, then we are talking about an ego issue, and

if so, keeping co-pays high will only hurt the bottom line in one’s practice,

no matter which way you look.

My opinion anyway.

Respectfully;

Armin Loges, PT

PS.: no need for anonymity: sometimes we bark but we never bite.

Piece!

From: Kovacek

Sent: Tuesday, March 08, 2011 3:00 PM

To: PTManager

Subject: Co-Pays

I have been asked to post this for a member of PTManager who does not wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty* service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by others.

PT and CHT in private practice.

[Guest guest]

I agree with you, Tom.

The sad thing is that the insurance companies are actually passing on

more of the financial responsibility to the patient by increasing

copays, which is a deterrent to patients using our PT services. It's

interesting, if you look at some of the EOBs (which patients do bring in

to show us), it is amazing what is happening. I'm not going to use real

numbers here, but the scenario is very real- let's say BCBS, one of the

big offenders, reimburses us $21 per unit and we bill two units for a

particular visit. That's $42 reimbursement for that particular visit.

And guess what- the patient's copay is $40. So BCBS only pays $2 for

that visit. The patients see this on their EOB and are often quite

shocked.

The sad thing part deux is that if the copays are legislated to be

lower, what is to stop the insurance companies from lowering their

actual reimbursement (theirs + the patient's responsibility)? So in the

scenario above, BCBS lowers the patient copay to $20.... what if BCBS

decides that their reimbursement responsibility is still going to be $2?

Overall reimbursement to us is even lower. Yes, maybe you'd get more

volume if the copays were lower, but would we actually still be

profitable? Something to think about.

Regards,

Meryl Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

I agree with you, Tom.

The sad thing is that the insurance companies are actually passing on

more of the financial responsibility to the patient by increasing

copays, which is a deterrent to patients using our PT services. It's

interesting, if you look at some of the EOBs (which patients do bring in

to show us), it is amazing what is happening. I'm not going to use real

numbers here, but the scenario is very real- let's say BCBS, one of the

big offenders, reimburses us $21 per unit and we bill two units for a

particular visit. That's $42 reimbursement for that particular visit.

And guess what- the patient's copay is $40. So BCBS only pays $2 for

that visit. The patients see this on their EOB and are often quite

shocked.

The sad thing part deux is that if the copays are legislated to be

lower, what is to stop the insurance companies from lowering their

actual reimbursement (theirs + the patient's responsibility)? So in the

scenario above, BCBS lowers the patient copay to $20.... what if BCBS

decides that their reimbursement responsibility is still going to be $2?

Overall reimbursement to us is even lower. Yes, maybe you'd get more

volume if the copays were lower, but would we actually still be

profitable? Something to think about.

Regards,

Meryl Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

I agree with you, Tom.

The sad thing is that the insurance companies are actually passing on

more of the financial responsibility to the patient by increasing

copays, which is a deterrent to patients using our PT services. It's

interesting, if you look at some of the EOBs (which patients do bring in

to show us), it is amazing what is happening. I'm not going to use real

numbers here, but the scenario is very real- let's say BCBS, one of the

big offenders, reimburses us $21 per unit and we bill two units for a

particular visit. That's $42 reimbursement for that particular visit.

And guess what- the patient's copay is $40. So BCBS only pays $2 for

that visit. The patients see this on their EOB and are often quite

shocked.

The sad thing part deux is that if the copays are legislated to be

lower, what is to stop the insurance companies from lowering their

actual reimbursement (theirs + the patient's responsibility)? So in the

scenario above, BCBS lowers the patient copay to $20.... what if BCBS

decides that their reimbursement responsibility is still going to be $2?

Overall reimbursement to us is even lower. Yes, maybe you'd get more

volume if the copays were lower, but would we actually still be

profitable? Something to think about.

Regards,

Meryl Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

The key is to have a payment specialist lobbying against that and at the

same time offering cost saving ideas like reducing fraud and abuse and true

research based utilization review. We have the tools to offer to help

insurances , when they are willing, to save time and money in other ways

besides lowered reimbursement.

Past that it still is up to our collective ability to come together and

stand against cuts that are no appropriate.

That said, we do have to be open to compromise in this economy and be

willing to tighten our belts a bit in good faith where it is appropriate

(and there are still cases out there that meet that criteria) while still

lobbying for getting paid fairly. That is why we can offer a better way to

charge co-pays and a system which doesn't pass the buck down the line ie

gets people the care they need now at a reasonable cost versus waiting until

the problem leads to the need to access higher cost services.

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Tuesday, March 08, 2011 2:39 PM

To: PTManager

Subject: RE: Co-Pays

I agree with you, Tom.

The sad thing is that the insurance companies are actually passing on

more of the financial responsibility to the patient by increasing

copays, which is a deterrent to patients using our PT services. It's

interesting, if you look at some of the EOBs (which patients do bring in

to show us), it is amazing what is happening. I'm not going to use real

numbers here, but the scenario is very real- let's say BCBS, one of the

big offenders, reimburses us $21 per unit and we bill two units for a

particular visit. That's $42 reimbursement for that particular visit.

And guess what- the patient's copay is $40. So BCBS only pays $2 for

that visit. The patients see this on their EOB and are often quite

shocked.

The sad thing part deux is that if the copays are legislated to be

lower, what is to stop the insurance companies from lowering their

actual reimbursement (theirs + the patient's responsibility)? So in the

scenario above, BCBS lowers the patient copay to $20.... what if BCBS

decides that their reimbursement responsibility is still going to be $2?

Overall reimbursement to us is even lower. Yes, maybe you'd get more

volume if the copays were lower, but would we actually still be

profitable? Something to think about.

Regards,

Meryl Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

The key is to have a payment specialist lobbying against that and at the

same time offering cost saving ideas like reducing fraud and abuse and true

research based utilization review. We have the tools to offer to help

insurances , when they are willing, to save time and money in other ways

besides lowered reimbursement.

Past that it still is up to our collective ability to come together and

stand against cuts that are no appropriate.

That said, we do have to be open to compromise in this economy and be

willing to tighten our belts a bit in good faith where it is appropriate

(and there are still cases out there that meet that criteria) while still

lobbying for getting paid fairly. That is why we can offer a better way to

charge co-pays and a system which doesn't pass the buck down the line ie

gets people the care they need now at a reasonable cost versus waiting until

the problem leads to the need to access higher cost services.

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Tuesday, March 08, 2011 2:39 PM

To: PTManager

Subject: RE: Co-Pays

I agree with you, Tom.

The sad thing is that the insurance companies are actually passing on

more of the financial responsibility to the patient by increasing

copays, which is a deterrent to patients using our PT services. It's

interesting, if you look at some of the EOBs (which patients do bring in

to show us), it is amazing what is happening. I'm not going to use real

numbers here, but the scenario is very real- let's say BCBS, one of the

big offenders, reimburses us $21 per unit and we bill two units for a

particular visit. That's $42 reimbursement for that particular visit.

And guess what- the patient's copay is $40. So BCBS only pays $2 for

that visit. The patients see this on their EOB and are often quite

shocked.

The sad thing part deux is that if the copays are legislated to be

lower, what is to stop the insurance companies from lowering their

actual reimbursement (theirs + the patient's responsibility)? So in the

scenario above, BCBS lowers the patient copay to $20.... what if BCBS

decides that their reimbursement responsibility is still going to be $2?

Overall reimbursement to us is even lower. Yes, maybe you'd get more

volume if the copays were lower, but would we actually still be

profitable? Something to think about.

Regards,

Meryl Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

The key is to have a payment specialist lobbying against that and at the

same time offering cost saving ideas like reducing fraud and abuse and true

research based utilization review. We have the tools to offer to help

insurances , when they are willing, to save time and money in other ways

besides lowered reimbursement.

Past that it still is up to our collective ability to come together and

stand against cuts that are no appropriate.

That said, we do have to be open to compromise in this economy and be

willing to tighten our belts a bit in good faith where it is appropriate

(and there are still cases out there that meet that criteria) while still

lobbying for getting paid fairly. That is why we can offer a better way to

charge co-pays and a system which doesn't pass the buck down the line ie

gets people the care they need now at a reasonable cost versus waiting until

the problem leads to the need to access higher cost services.

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended

recipient. If you are not the intended recipient of the email or any of its

attachments, please be advised that you have received this email in error

and that any use, dissemination, distribution, forwarding, printing or

copying of this email or any attached files is strictly prohibited. If you

have received this email in error, please immediately purge it and all

attachments and notify the sender by reply email.

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Tuesday, March 08, 2011 2:39 PM

To: PTManager

Subject: RE: Co-Pays

I agree with you, Tom.

The sad thing is that the insurance companies are actually passing on

more of the financial responsibility to the patient by increasing

copays, which is a deterrent to patients using our PT services. It's

interesting, if you look at some of the EOBs (which patients do bring in

to show us), it is amazing what is happening. I'm not going to use real

numbers here, but the scenario is very real- let's say BCBS, one of the

big offenders, reimburses us $21 per unit and we bill two units for a

particular visit. That's $42 reimbursement for that particular visit.

And guess what- the patient's copay is $40. So BCBS only pays $2 for

that visit. The patients see this on their EOB and are often quite

shocked.

The sad thing part deux is that if the copays are legislated to be

lower, what is to stop the insurance companies from lowering their

actual reimbursement (theirs + the patient's responsibility)? So in the

scenario above, BCBS lowers the patient copay to $20.... what if BCBS

decides that their reimbursement responsibility is still going to be $2?

Overall reimbursement to us is even lower. Yes, maybe you'd get more

volume if the copays were lower, but would we actually still be

profitable? Something to think about.

Regards,

Meryl Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

A " specialist " designation is created for medical MD specialists. As they cost

the insurance company more, they want the patient to pay more of the bill. It is

not a recognition of status. Co-pays are a barrier to access and In my mind

fraud as they are being used. To have someone buy an insurance policy that says

they are " covered " for PT services, only to have that insurer cover $2 of an

already deflated charge is ridiculus. whats more we have seen instances where

the co-pay exceeds the amount of the insured benefit, so in essence they have

bought coverage and received nothing for their purchase. Is there a risk that

they lower payment, sure, but do we know people are not getting care because of

these co-pays not only for PT but for medical care, absolutely.

In New York we have had Legislation for 2 years to limit the co-pay to 20% of

the benefit amount. Other states are following our lead. We have a

responsibility to our patients to advocate for them, this is but one way we can

do that.

Jim Dunleavy PT, MS

Past President NYPTA

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

A " specialist " designation is created for medical MD specialists. As they cost

the insurance company more, they want the patient to pay more of the bill. It is

not a recognition of status. Co-pays are a barrier to access and In my mind

fraud as they are being used. To have someone buy an insurance policy that says

they are " covered " for PT services, only to have that insurer cover $2 of an

already deflated charge is ridiculus. whats more we have seen instances where

the co-pay exceeds the amount of the insured benefit, so in essence they have

bought coverage and received nothing for their purchase. Is there a risk that

they lower payment, sure, but do we know people are not getting care because of

these co-pays not only for PT but for medical care, absolutely.

In New York we have had Legislation for 2 years to limit the co-pay to 20% of

the benefit amount. Other states are following our lead. We have a

responsibility to our patients to advocate for them, this is but one way we can

do that.

Jim Dunleavy PT, MS

Past President NYPTA

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

A " specialist " designation is created for medical MD specialists. As they cost

the insurance company more, they want the patient to pay more of the bill. It is

not a recognition of status. Co-pays are a barrier to access and In my mind

fraud as they are being used. To have someone buy an insurance policy that says

they are " covered " for PT services, only to have that insurer cover $2 of an

already deflated charge is ridiculus. whats more we have seen instances where

the co-pay exceeds the amount of the insured benefit, so in essence they have

bought coverage and received nothing for their purchase. Is there a risk that

they lower payment, sure, but do we know people are not getting care because of

these co-pays not only for PT but for medical care, absolutely.

In New York we have had Legislation for 2 years to limit the co-pay to 20% of

the benefit amount. Other states are following our lead. We have a

responsibility to our patients to advocate for them, this is but one way we can

do that.

Jim Dunleavy PT, MS

Past President NYPTA

Co-Pays

I have been asked to post this for a member of PTManager who does not

wish

to be identified

*****************************

Dear Group,

I am a private practice physical therapist.

I am disappointed to hear that so many private practice owners and so

many

therapists are advocating for a decrease in PT copays.

I have been through many years of schooling and provide a *specialty*

service.

AT's, MD's, DO's and/or Chiro's do not have my education or my skill

level

in providing care.

I take great pride in the care I provide and believe that I should be

charging a *specialist co-pay*.

First, we need to value ourselves....then only can we be valued by

others.

PT and CHT in private practice.

[Guest guest]

Would like to ask members, how do you manage your productivity, when staff

spends time reviewing documentation, prior to treatments, consulting with MD on

previous status, with nursing etc, just to find, patient is not in room, or on

his/her way out to a test.

Any advice, suggestion, recommendation is greatly appreciate it!

Have a great weekend!

L., PT

[Guest guest]

Would like to ask members, how do you manage your productivity, when staff

spends time reviewing documentation, prior to treatments, consulting with MD on

previous status, with nursing etc, just to find, patient is not in room, or on

his/her way out to a test.

Any advice, suggestion, recommendation is greatly appreciate it!

Have a great weekend!

L., PT

[Guest guest]

We build an extra 'unit' into the evaluation to account for all the extra time.

For example, a patient is charged for 2 units but the therapist gets credit for

3 units. We've also sought feedback from staff on what they do to help be more

productive as a way to learn from each other. The other thing is we tell staff

to go to a patient room first. It can save a lot of time. In your example, the

therapist that does that three times in a day could have almost seen another

treatment if the pt room was the first stop.

Lauffer, PT

________________________________

From: PTManager [PTManager ] On Behalf Of Leonor

[diazlm@...]

Sent: Friday, March 18, 2011 1:03 PM

To: PTManager

Subject: Re: Co-Pays

Would like to ask members, how do you manage your productivity, when staff

spends time reviewing documentation, prior to treatments, consulting with MD on

previous status, with nursing etc, just to find, patient is not in room, or on

his/her way out to a test.

Any advice, suggestion, recommendation is greatly appreciate it!

Have a great weekend!

L., PT