Private Practice Policies and Ethics

[Guest guest]

Hi Group,

Many issues related to ethics have been addressed here and I want to

get some feedback on some disturbing trends I have noticed.

I have been a PT for many years, mostly in one state. In recent years

I have focused more in the outpatient setting in PT-owned PP, and

also Home Health. I am at a stage in my life where I have neither the

desire nor resources to open my own practice. Due to problems with

the ethics of some previous employers, I became an independent

contractor. This allowed me to move on quickly if I didn't like how a

practice was being run.

What I have found recently is so discouraging! Three practices were

overlapping Medicare patients and charging separately (not a " group

therapy " charge) even when there was no unattended (ie. E-stim)

treatments. They " justified " this by stating that this took into

account no-shows/cancellations. One even said they would try to get

some MC patients in a few minutes early and have others stay a few

minutes late so it " all worked out " . I am no mathematician, but no

matter how you slice it, there are only 60 minutes in an hour. If you

rob from to pay , it is my belief that you bill those

minutes to not . And putting someone on a stationary bike

or Nu-step and charging for ther ex while treating another patient? I

am unaware of any " unattended " ther ex code. Another clinic was

billing ther ex and aquatic for the same minutes. Yet another wanted

me to bill attended for unattended treatments in order to pay off

the " exorbitant cost " of the equipment (I refused and never came back

after that initial day).

I am not " holier than thou " but feel that integrity is important. I

hear about the declining reimbursements PP owners receive and am

aware of the higher wages, costs of benefits etc. Is what I'm seeing

with PTPP based more out of sheer survival rather than simply greed?

When I do rough estimates of average per hour reimbursements and

average hourly overhead (wages/benefiits/rent/utils/supplies etc.),

it sure seems so. I love our profession and it saddens me that

seemingly good PTs are cutting corners and/or making compromises. I

am having a crisis of conscience and don't know if I can remain in

this field if I cannot work in a way that is consistent with my state

practice act, APTA, Medicare rules.

I look forward to the feedback from this group and respect your

opinions.

Thanks ahead of time for your thoughts and insights.

DA, PT