Medicare Physical Therapy | Day in the Life as a Physical Therapist
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- Опубликовано: 13 авг 2020
- Medicare insurance, along with many other types of insurances is one of the biggest learning curves I have ever experienced. There are so many rules, regulations, processes I have to learn and abide by in order for the company to get paid. One wrong documentation... denied billing.
It's a lot of pressure!
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TIMELINE
2:00 Conflict with insurance
3:25 How medicare physical therapy insurance works
4:50 What happens after you reach the medicare cap
6:30 Case study for Achilles Tendonosis
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Part 5: Treating Physical Therapy Patients • Treating Physical Ther...
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As a former rehab tech, I learned that some PTs will try to fight for more visits and others will try to stretch out their visits before their Medicare benefits renew. Either way, they always try to educate the patient on their injury/condition and assign HEPs to help them recover in the meantime.
Nicrent yup that sounds about right! It’s a hard decision to make sometimes. Because of course we would love to have them forever right? But they can only get approved for what is medically necessary. But even that sometimes is not as easy to distinguish
I’m enjoying these case study videos. Please post them weekly 🙏
Andrew Sasaki THANK YOU! I’ll definitely try to post more of these 🤩
Thats a great story and thanks for sharing! I think I'd fight for them, like some others said, stretching out the frequency of the visits would make the most sense. Too bad they dont have a second insurance to kick in
SeanHeigi You are welcome! Do you like these case studies? Should I do more of them?
I work as a PT aide at South San Francisco and our PT would send the notes to the insurance trying to fight for more visits! But sometimes insurances take a while to get back :( most, if not, all medicare patients get sent an intensive HEP or access to files for their injury!
Kristian Ilustre yes that is very true and that happens a lot of the time here too. If the patient is independent with HEP, then you can DC them with a proper HEP program. But if they are not.. then it’s a harder battle. Thanks for sharing!!!
Lehui Chen have you been able to find any opportunities?
Lehui Chen hello! In terms of work, I guess it’s more added work so that the clinic continues to stay safe for our patients! We still do things hands on with our patients while wearing gloves and washing our hands after every patient!
I actually brought up having volunteers come to our clinic again, but sadly our head PT wants to play it safe and limit the amount of ppl who are in the clinic (2 PTs and 2 aides) since he is on the “older” side.
Lehui Chen I love the way you’re thinking my brotha!
What advice can you give someone that’s going to apply for the PTA program? Love the videos man keep them coming!
Just got into the PTA program here in Honolulu. I’d say treat it as though you were applying to PT school. Get your pre-reqs done and aim for the highest grades and get some observation hours so you have a primer before clinicals
Devon Morquecho just like how iztheillest mentioned below, aim to get high grades. That’s your best chance and be persistent with getting to ur name recognized in their system. Maybe go in person, call, email, etc. thank you so much! I try really hard to keep consistent with you guys!
any updates on this particular patient, outcomes?
That’s a tough conflict and in some ways there’s not a win win. Would be it possible to design a home physical therapy plan for the patient to do on their own? And if it is still bothering the patient they can come in once the year is up ?
Nathan Schmidt definitely the best possibility to do that.. but what if the patient is not compliant with HEP? And every time you have practice exercises in clinic, the patient always requires cuing for positing, technique, and reps? Happens so much more often than you would think, despite constant reminders... what to do then?
Insurances 🤦🏽♀️ pretty much in pharmacy too... why are there so many types of insurances.
Insurance sucks... that’s why if you’re ever going to break free in this profession, you have to go private
i have a question: while being a physiotherapist, do u need to review ur course notes from school regularly so u do not forget anything while working?
Flexin_Vibes great question! I believe you should always try to learn and review periodically. That way you don’t get stale and keep yourself in check. So yes, I find myself reviewing notes and looking things up all the time!! No shame in that!
Fight for the patient 💪😂
David Fletcher HOORAH
Cigna and Medicare sound the worst lol For Cigna, the progress reports every 5 visits! 🤣 and when therapy is going slow the patients might only get 2-3 visits till their next request for auth RIP
SeanHeigi FOR REALLL!!!! So actually I have a little trick for that. When I request for more visits, I tell them I want to see the patient for a longer duration but for a set number of visits. For example, if I want to see the patient 2x a week for a total of 8 visits (that’s 4 weeks right?) I would document “2x a week for 6 weeks (8 total visits)”. That way I can buy some time you know?
Too much politics 😂
Peter Justin Taguinod I hate it so much. Cash based practice all the way!
We’re adding an OT to our practice. Any tips filling out that CMS 855B form?