1. PTA/OTA Reimbursement Cut Takes Effect in 2022

It’s been a year since CMS implemented CO/CQ modifiers for services provided “in whole or in part” to Medicare patients by PTAs and OTAs. In 2022, CMS will be reducing reimbursements by 15% for services with CO/CQ modifiers.

Is your staff struggling to get their tasks done every day? Whether it’s because they can’t do the work or they won’t do the work, productivity is becoming a growing concern in private practices. Chances are this lack of efficiency is hurting your wallet.

What is an insurance referral? 

There are two types of write-offs in medical billing: necessary and unnecessary. Necessary write-offs include contractual obligations, small balance write offs and cash-pay discounts. Unnecessary write-offs occur when billing/administrative mistakes lead to uncollectable money being left on the table. Practice owners and managers who can identify unnecessary write-offs and implement processes to eliminate them can improve the health of the accounts receivable and increase revenue.

Workers compensation claims typically take longer to process compared to commercial insurance claims. It is crucial that your staff submit clean work comp claims with proper documentation in a timely manner. In this article we will discuss the top reasons for work comp denials and how to stop them.

Deciding who will manage your practice’s revenue cycle is not an easy decision and should not be rushed. The first question you should be asking is, “Should I manage my billing in-house or outsource?”  There is no one-size-fits all answer to this question and it largely depends on your individual practice and staff. Today, we are just going to focus on the benefits of outsourcing your rehab therapy billing.

The front desk is often the face of your practice. They are the first and last people to interact with patients. Because this role is so important to the reputation and success of your practice, you need to have the right person for the job. But how can you know you have chosen the right person? Here are the skills our experts look for in a successful front desk specialist: 

Many rehab therapists believe that once they are in-network with an insurance panel, they are an in-network with the insurance indefinitely. This is just one of the common misconceptions of credentialing. The truth is, group and individual providers need to complete recredentialing applications periodically to remain in-network. Let’s take a closer look at recredentialing to avoid unexpected contract termination.

When a healthcare provider gets married and takes their spouses last name, they will update their driver's license, bank accounts, car insurance, etc. With so many crucial areas that need updating, providers might forget to notify the insurance carriers in which their employer participates. Providers must update their professional license and national provider identifier (NPI) with this change, as well as the individual insurance companies.  

The Centers for Medicare and Medicaid Services (CMS) implemented new modifiers that could impact your practice, these are the CQ and CO modifiers. If your practice utilizes physical therapy assistants and/or occupational therapy assistants, you will need to know when and how to apply the CQ and/or CO modifier.