HCPro.com: Briefings on Outpatient Rehab: Reimbursement and Regulations

Ever-changing reimbursement policies and government regulations affects your facility's ability to stay in compliance. Briefings on Outpatient Rehab Reimbursement & Regulations reports on these changes and offers suggestions on how best to cope with them.

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September 2008 (Volume 13, Issue 9)	view entire issue

PQRI update: The 2007 bonuses have arrived
Healthcare providers who participated in the 2007 Physician Quality Reporting Initiative (PQRI) received a total of more than $36 million in bonus payments, CMS announced in July. Providers who participated in the PQRI, a voluntary program that gives incentive payments to providers who report certain quality measures determined by CMS, should have received their bonuses by August. The average bonus for an individual professional was $600, and the largest payment, which went to a physician group practice, totaled more than $205,700, according to CMS.

Treating autism: More states require insurance coverage
The services provided by PTs, OTs, and SLPs are often critical for people with autism spectrum disorders (ASD), a group of developmental disabilities marked by impairment in communication and social interaction. However, many insurance companies have historically denied payment for these services.

Make your electronic records comply with HIPAA standards
If you’ve decided to start using electronic records at your practice, you’ve probably spent hours researching which software program to purchase and thinking about how to train your staff. But how much time have you dedicated to making sure the protected health information (PHI) that will be stored in those records is secure?

BRRR coding corner
Editor’s note: Rick Gawenda, PT, director of rehabilitation services at Detroit Receiving Hospital and owner of Gawenda Seminars (www.gawendaseminars.com) in Ypsilanti, MI, answered the coding questions below. Submit questions to Associate Editor Emily Beaver at ebeaver@hcpro.com.

Delegating tasks and billing appropriately
When it comes to working with aides, most therapists have two questions: “What can aides do?” and “Can I bill for those services?” The answers depend on several variables—what state you practice in, what payer you are billing, and your own professional judgment, says Rick Gawenda, PT, director of rehabilitation services at Detroit Receiving Hospital and owner of Gawenda Seminars in Ypsilanti, MI. Being aware of the requirements of your state practice act, payers’ policies, and professional standards will help you determine how to work with aides and when to bill for their services.

BRRR Q&A
Editor’s note: Nancy J. Beckley, MS, MBA, CHC, president of Bloomingdale Consulting Group in Brandon, FL, answered the questions below. Please submit questions to Associate Editor Emily Beaver at ebeaver@hcpro.com.

Other recently-published articles from Briefings on Outpatient Rehab: Reimbursement and Regulations:

CMS delays Recovery Audit Contractor program

Tracking productivity: Looking beyond billable units

Know the rules for rehab services in home health setting

Waiving coinsurance may be appropriate at times

BRRR coding corner

Rehab providers should take economy concerns seriously; caution suggested

SLP shortage results in higher salary and benefit demands

Compliance officers crucial to long-term success

Avoid entering a corporate integrity agreement

BRRR Q&A

Medicare changes give more SLPs option to go private in 2009

Manage your facility’s front office well for good first impressions and a successful practice

Don’t let backend operations be your facility’s downfall

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