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Accurate Documentation
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4 Tips to Achieving Successfully Negotiated Payer Contracts

Negotiation. It’s tough to do successfully, especially when it’s not something you were trained for.

As a physical therapist you’re trained to treat people and help them live better and healthier lives, not make financial negotiations. But the fact is you can’t continue to do what you’re trained to do without having to negotiate terms of payment first. This negotiation doesn’t mean simply agreeing to whatever the payer says– it’s making sure you get what your time, service and skills are truly worth– and that’s the hard part right there.

Fortunately there are ways to negotiate terms to your benefit. Following these tips and armed with the right facts and figures, successful negotiation can be achieved.

1. Analyze current payer performance and fee schedules

The first thing you need to do in order to negotiate successfully is to analyze your current payers’ performance and fee schedules. Identify the payers with whom you do the most business along with the most common CPT codes you use. Get the number of times you bill each code with each payer, and multiply each number by the proposed payment amounts. Then add up all the totals per payer and divide by the total number of codes billed. This should give you the weighted average for each payer, and a good indication of which contracts are most valuable to you.

Apart from this you could also compare the rates of individual CPT codes and approach payers who pay the least amount about increasing to at least reach the average reimbursement rate for these codes.

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Physical Therapy Coding Updates
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New Physical Therapy Coding Updates for 2017

It’s time again to welcome the new year and with it, changes that will make our practices better than before. Among these changes? Physical Therapy codes.

Recently it was announced that the Physical Therapy Evaluation (97001) and Physical Therapy Re-evaluation (97002) codes have been deleted, and four new codes have been released in their place. These codes will be effective by January 1, 2017.

The new evaluation codes (97161 to 97163) center around services ranging in complexity from low to high, each with a code descriptor specifying required components. To give you an idea of each new code, some of the requirements are stated below:

Code no. 97161 – Physical therapy evaluation: low complexity, requiring the following components:

• A history with no personal factors and/or comorbidities that impact the plan of care;
• An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions;
• A clinical presentation with stable and/or uncomplicated characteristics; and
• Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome.

In this case, usually 20 minutes are spent face-to-face with the patient and/or family.

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medical billing technology
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Why Trust Medical Billing Technology Today

Technology has penetrated practically every field and industry, and medical billing is no exception.

From training to application, technology has become part and parcel of medical billing and coding. There are online medical billing courses, virtual patient databases and electronic means of communicating with and billing patients. Yet some practices still feel apprehensive about embracing technology when it comes to billing, and their concerns would not be unfounded.

Common Concerns with Technology

The biggest and most common concern over the use of medical billing technology is security. In recent years, we’ve heard of numerous cases of hackers breaking into secure company databases, resulting in hundreds of sensitive and highly valuable client information being exposed to the public or going into the wrong hands.

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