Guest guest Posted August 14, 1999 Report Share Posted August 14, 1999 I work in an Acute Care Hosp, 250 beds. PT's evaluate Elective Hips, Knees and some Scopes 3+ days prior to their surgery. An issue has arisen over the " charge " of this eval. The eval is generally less intensive than a regular Out/pt or Acute eval, however as we only have one chargemaster the only option is to perform an Administrative discount for individual cases. I am aware we could have some other discounts off chargemaster but the aim is to ensure that all patients are treated(charged) equally...right. My question is whether anyone in an Acute care setting has suggestions for setting a " reasonable " fee for said service. I do not want to start encroaching upon price sharing and fee setting, but do want to give the patient a " fair " price for a service which takes between 25-35 mins. Any suggestions? thanks in advance, Lance P.T. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 1999 Report Share Posted August 14, 1999 This appears to be an instructional session involving 30 minutes of exercise. Why not charge two 15 minute exercise charges? Herb Silver,PT Atlanta, GA At 05:18 PM 8/14/99 EDT, you wrote: >I work in an Acute Care Hosp, 250 beds. PT's evaluate Elective Hips, Knees >and some Scopes 3+ days prior to their surgery. An issue has arisen over the > " charge " of this eval. The eval is generally less intensive than a regular >Out/pt or Acute eval, however as we only have one chargemaster the only >option is to perform an Administrative discount for individual cases. I am >aware we could have some other discounts off chargemaster but the aim is to >ensure that all patients are treated(charged) equally...right. > >My question is whether anyone in an Acute care setting has suggestions for >setting a " reasonable " fee for said service. I do not want to start >encroaching upon price sharing and fee setting, but do want to give the >patient a " fair " price for a service which takes between 25-35 mins. > >Any suggestions? > >thanks in advance, > >Lance P.T. > >------------------------------------------------------------------------ > >eGroups.com home: /group/ptmanager > - Simplifying group communications > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 15, 1999 Report Share Posted August 15, 1999 Is the " charge " for this service going to generate real additional money through reimbursement or is it simply a means to track staff productivity? Pre-surgery assessments are a great idea but actual reimbursement is often some flat rate DRG or contracted amount for all of the services tied to the elective surgery regardless of what you charge for a specific activity. I would check with your funders to see if they would pay for this as a separate charge. Do not be surprised to find this service defined as part of the surgery and simply looked at as an expense that is the hospital's problem. If you charge patients a separate fee are you willing to face the PR issue when they find that the cost is not included in the surgery fee? Tom Frederick Knoxville, TN y623@... wrote: > I work in an Acute Care Hosp, 250 beds. PT's evaluate Elective Hips, Knees > and some Scopes 3+ days prior to their surgery. An issue has arisen over the > " charge " of this eval. The eval is generally less intensive than a regular > Out/pt or Acute eval, however as we only have one chargemaster the only > option is to perform an Administrative discount for individual cases. I am > aware we could have some other discounts off chargemaster but the aim is to > ensure that all patients are treated(charged) equally...right. > > My question is whether anyone in an Acute care setting has suggestions for > setting a " reasonable " fee for said service. I do not want to start > encroaching upon price sharing and fee setting, but do want to give the > patient a " fair " price for a service which takes between 25-35 mins. > > Any suggestions? > > thanks in advance, > > Lance P.T. > > ------------------------------------------------------------------------ > > eGroups.com home: /group/ptmanager > - Simplifying group communications Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 15, 1999 Report Share Posted August 15, 1999 We see Ambulatory " Scopes " etc., during their pre-surgical testing for gait training/device fitting. The charge is captured via Pre Surgical testing charges. That becomes a part of the overall charge for the surgery. The TJRs are seen for an educational class pre-operatively, no eval, no treatment education only. There is no charge for this, it is part of our effort to educate our patients, their families and our community. (JCAHO loves it!) L. Gessner,PT Chief Physical Therapist South Nassau Communities Hospital Oceanside, New York Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 15, 1999 Report Share Posted August 15, 1999 One of the issues we had to deal with in our pre-op evaluation and teaching program (which we do for elective joint replacements and back surgeries) was the fact that while most insurers will cover pre-operative lab work, xrays and ekgs, they don't cover things like our services. We still felt that this was an important service to provide, so we chose to look at it from the point of view of reducing costs on managed care patients and as a possible PR advantage, and just looked for the most cost-efficient way to do it. We now do most of our pre-op teaching for these patients in a free class given 2-3 times a month, and include rehab, nursing, and a clinical social worker in the program. en >>> Tom Frederick 08/15/99 11:29AM >>> Is the " charge " for this service going to generate real additional money through reimbursement or is it simply a means to track staff productivity? Pre-surgery assessments are a great idea but actual reimbursement is often some flat rate DRG or contracted amount for all of the services tied to the elective surgery regardless of what you charge for a specific activity. I would check with your funders to see if they would pay for this as a separate charge. Do not be surprised to find this service defined as part of the surgery and simply looked at as an expense that is the hospital's problem. If you charge patients a separate fee are you willing to face the PR issue when they find that the cost is not included in the surgery fee? Tom Frederick Knoxville, TN y623@... wrote: > I work in an Acute Care Hosp, 250 beds. PT's evaluate Elective Hips, Knees > and some Scopes 3+ days prior to their surgery. An issue has arisen over the > " charge " of this eval. The eval is generally less intensive than a regular > Out/pt or Acute eval, however as we only have one chargemaster the only > option is to perform an Administrative discount for individual cases. I am > aware we could have some other discounts off chargemaster but the aim is to > ensure that all patients are treated(charged) equally...right. > > My question is whether anyone in an Acute care setting has suggestions for > setting a " reasonable " fee for said service. I do not want to start > encroaching upon price sharing and fee setting, but do want to give the > patient a " fair " price for a service which takes between 25-35 mins. > > Any suggestions? > > thanks in advance, > > Lance P.T. > > ------------------------------------------------------------------------ > > eGroups.com home: /group/ptmanager > - Simplifying group communications ------------------------------------------------------------------------ eGroups.com home: /group/ptmanager - Simplifying group communications Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 1999 Report Share Posted August 16, 1999 This thread raises some issues that some of my colleagues and I have have discussed in the past. 1. Preop teaching, back schools and other educational activities are treatment or more accurately interventions. Ref. Guide to Physical Therapist Practice. 2. Physical therapists can not provide interventions without doing an examination and evaluation of the patient. Ref. Standards of Practice 3. Physical therapists can not delegate interventions to supportive personnel (PTA, Aides, etc.) unless they have examined and evaluated the patient first. Ref. Standards of Practice Additional references are: Code of Ethics, Guide to Professional Conduct, State Practice Acts and State Regulations. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 1999 Report Share Posted August 16, 1999 Tom: Good point. Since the majority of hip and knee replacements are Medicare beneficiaries and the surgery falls under the respective DRG for their inpatient stay; our facility has elected NOT to (attempt) to bill for this as a separate service. (It may not even be " legal " ) It is gratis, done as a service, in the hope (we have not been providing pre-op instruction long enough to know if we are actually improving outcomes) that we are decreasing LOS, increasing function, and improving patient satisfaction (i.e. " outcomes " ) Thanks, Trager, PT Rehabilitation Services Manager Kaweah Delta Health Care District Visalia, CA. Re: PreSurgery Evals Is the " charge " for this service going to generate real additional money through reimbursement or is it simply a means to track staff productivity? Pre-surgery assessments are a great idea but actual reimbursement is often some flat rate DRG or contracted amount for all of the services tied to the elective surgery regardless of what you charge for a specific activity. I would check with your funders to see if they would pay for this as a separate charge. Do not be surprised to find this service defined as part of the surgery and simply looked at as an expense that is the hospital's problem. If you charge patients a separate fee are you willing to face the PR issue when they find that the cost is not included in the surgery fee? Tom Frederick Knoxville, TN y623@... wrote: > I work in an Acute Care Hosp, 250 beds. PT's evaluate Elective Hips, Knees > and some Scopes 3+ days prior to their surgery. An issue has arisen over the > " charge " of this eval. The eval is generally less intensive than a regular > Out/pt or Acute eval, however as we only have one chargemaster the only > option is to perform an Administrative discount for individual cases. I am > aware we could have some other discounts off chargemaster but the aim is to > ensure that all patients are treated(charged) equally...right. > > My question is whether anyone in an Acute care setting has suggestions for > setting a " reasonable " fee for said service. I do not want to start > encroaching upon price sharing and fee setting, but do want to give the > patient a " fair " price for a service which takes between 25-35 mins. > > Any suggestions? > > thanks in advance, > > Lance P.T. > > ------------------------------------------------------------------------ > > eGroups.com home: /group/ptmanager > - Simplifying group communications ------------------------------------------------------------------------ eGroups.com home: /group/ptmanager - Simplifying group communications Quote Link to comment Share on other sites More sharing options...
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