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RE: BCBS of KC

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Heidi

Were these services provided by a PTA?

Kevyn Soupiset, PT, MPT

" Success often comes from taking a misstep in the right direction. "

Progressive Therapy & Sports Medicine

117 W. 6th

Larned, KS 67550

Ph:

Fax

www.progressive-larned.com

<http://www.elocallink.tv/vp6/spon-fcsa_a.php?fvm=1 & sponid=AjUFMg5rVjtUYg== &

v>

http://www.elocallink.tv/vp6/spon-fcsa_a.php?fvm=1 & sponid=AjUFMg5rVjtUYg== & v

From: PTManager [mailto:PTManager ] On Behalf

Of Heidi Harmon

Sent: Friday, January 28, 2011 1:18 PM

To: PTManager

Subject: BCBS of KC

Hello All. Just got my EOB's for the first portions of Jan for patients

billed and the therapy billed allowable was dropped by about $30.00 per hour

allowing only $93.00 per hour for PT. I called the provider rep and waiting

to hear her answer. I am hoping this is a mistake as I would have thought if

they were reducing the allowables by approx $30 per hour I would have heard

about it. Shocked and FRUSTRATED! Has anyone had any of the same issues in

my area or otherwise? This is a game changer for sure! BCBS is 45% of our

business.

Thanks for any input you might have!

Heidi Harmon

Billing Manager

cold laser

What all do you all think of the cold laser? Is it billable? Do you own it?

ease it? Getting good results with?

What say you????

Mark Niles PT, MS, CSCS

rthopedic Specialists PA

niles@... <mailto:niles%40orthospecpa.net>

54-720-7448 x3

54-720-9042 fax

This message, together with any attachments, is intended only for the

ddressee. It may contain information which is legally privileged,

onfidential and exempt from disclosure. If you are not the intended

ecipient, you are hereby notified that any disclosure, copying,

istribution, use, or any action or reliance on this communication is

trictly prohibited. If you have received this e-mail in error, please

otify the sender immediately by telephone ( x3) or by return

-mail and delete the message, along with any attachments

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On

Behalf

f nygaardsabs

ent: Friday, January 28, 2011 9:08 AM

o: PTManager <mailto:PTManager%40yahoogroups.com>

ubject: L-Code Clarification

had a question for the group about L-codes. When reading up on this charge

ode it is my understanding that this code includes the:

) Evaluation

) Fitting of the splint

) Material and supplies

) Any return visits for adjustments/modifications of this splint for

he next 90 days.

If I understand correctly, I am able to charge an orthotic fitting charge on

he day I make the splint and any return visits for the time I do training

ith the patient.

Is this a correct understanding?

always wondered why the price on these codes was so high, but now that I

nderstand it includes any return visits for modification and the initial

valuation I can more clearly can understand.

hanks,

shley Kelley, OTR/L, CLT

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Heidi:

You don't say where you are located, but yes, these cuts were expected and

especially if you are utilizing a PTA. They reduced PT's to 85% of MAP from

90%, they reduced reimbursement for TE, traction, and many other procedures plus

in their infinite wisdom they reduced the amount they will reimburse the PTA to

50% of what they will reimburse the PT! Want a cash based option to add to the

value of your practice? Call me, I have one (-: BCBS was/is 45% of our

business as well.

Ric Baird, MS, PT, ATC

Working. Better. Together.

Interactive Physical Therapy & Fitness

3405 NW Hunters Ridge Terrace

Suite 300

Topeka, KS 66618

(785)246-2300 (P)

(785)246-2301 (F)

Interactive Physical Therapy

1709 SE 29th Street

Suite 300-400

Topeka, KS 66605

(785)266-4600 (P)

(785)266-4601 (F)

www.interactiveptandfitness.com

www.ipt.tsfl.com

Sent from my iPhone

>

> Hello All. Just got my EOB's for the first portions of Jan for patients billed

and the therapy billed allowable was dropped by about $30.00 per hour allowing

only $93.00 per hour for PT. I called the provider rep and waiting to hear her

answer. I am hoping this is a mistake as I would have thought if they were

reducing the allowables by approx $30 per hour I would have heard about it.

Shocked and FRUSTRATED! Has anyone had any of the same issues in my area or

otherwise? This is a game changer for sure! BCBS is 45% of our business.

>

> Thanks for any input you might have!

>

> Heidi Harmon

> Billing Manager

>

> cold laser

>

> What all do you all think of the cold laser? Is it billable? Do you own it?

> ease it? Getting good results with?

> What say you????

>

> Mark Niles PT, MS, CSCS

> rthopedic Specialists PA

> niles@...

> 54-720-7448 x3

> 54-720-9042 fax

> This message, together with any attachments, is intended only for the

> ddressee. It may contain information which is legally privileged,

> onfidential and exempt from disclosure. If you are not the intended

> ecipient, you are hereby notified that any disclosure, copying,

> istribution, use, or any action or reliance on this communication is

> trictly prohibited. If you have received this e-mail in error, please

> otify the sender immediately by telephone ( x3) or by return

> -mail and delete the message, along with any attachments

>

> From: PTManager [mailto:PTManager ] On Behalf

> f nygaardsabs

> ent: Friday, January 28, 2011 9:08 AM

> o: PTManager

> ubject: L-Code Clarification

>

>

>

> had a question for the group about L-codes. When reading up on this charge

> ode it is my understanding that this code includes the:

> ) Evaluation

> ) Fitting of the splint

> ) Material and supplies

> ) Any return visits for adjustments/modifications of this splint for

> he next 90 days.

> If I understand correctly, I am able to charge an orthotic fitting charge on

> he day I make the splint and any return visits for the time I do training

> ith the patient.

> Is this a correct understanding?

> always wondered why the price on these codes was so high, but now that I

> nderstand it includes any return visits for modification and the initial

> valuation I can more clearly can understand.

> hanks,

> shley Kelley, OTR/L, CLT

>

>

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Share on other sites

Heidi:

You don't say where you are located, but yes, these cuts were expected and

especially if you are utilizing a PTA. They reduced PT's to 85% of MAP from

90%, they reduced reimbursement for TE, traction, and many other procedures plus

in their infinite wisdom they reduced the amount they will reimburse the PTA to

50% of what they will reimburse the PT! Want a cash based option to add to the

value of your practice? Call me, I have one (-: BCBS was/is 45% of our

business as well.

Ric Baird, MS, PT, ATC

Working. Better. Together.

Interactive Physical Therapy & Fitness

3405 NW Hunters Ridge Terrace

Suite 300

Topeka, KS 66618

(785)246-2300 (P)

(785)246-2301 (F)

Interactive Physical Therapy

1709 SE 29th Street

Suite 300-400

Topeka, KS 66605

(785)266-4600 (P)

(785)266-4601 (F)

www.interactiveptandfitness.com

www.ipt.tsfl.com

Sent from my iPhone

>

> Hello All. Just got my EOB's for the first portions of Jan for patients billed

and the therapy billed allowable was dropped by about $30.00 per hour allowing

only $93.00 per hour for PT. I called the provider rep and waiting to hear her

answer. I am hoping this is a mistake as I would have thought if they were

reducing the allowables by approx $30 per hour I would have heard about it.

Shocked and FRUSTRATED! Has anyone had any of the same issues in my area or

otherwise? This is a game changer for sure! BCBS is 45% of our business.

>

> Thanks for any input you might have!

>

> Heidi Harmon

> Billing Manager

>

> cold laser

>

> What all do you all think of the cold laser? Is it billable? Do you own it?

> ease it? Getting good results with?

> What say you????

>

> Mark Niles PT, MS, CSCS

> rthopedic Specialists PA

> niles@...

> 54-720-7448 x3

> 54-720-9042 fax

> This message, together with any attachments, is intended only for the

> ddressee. It may contain information which is legally privileged,

> onfidential and exempt from disclosure. If you are not the intended

> ecipient, you are hereby notified that any disclosure, copying,

> istribution, use, or any action or reliance on this communication is

> trictly prohibited. If you have received this e-mail in error, please

> otify the sender immediately by telephone ( x3) or by return

> -mail and delete the message, along with any attachments

>

> From: PTManager [mailto:PTManager ] On Behalf

> f nygaardsabs

> ent: Friday, January 28, 2011 9:08 AM

> o: PTManager

> ubject: L-Code Clarification

>

>

>

> had a question for the group about L-codes. When reading up on this charge

> ode it is my understanding that this code includes the:

> ) Evaluation

> ) Fitting of the splint

> ) Material and supplies

> ) Any return visits for adjustments/modifications of this splint for

> he next 90 days.

> If I understand correctly, I am able to charge an orthotic fitting charge on

> he day I make the splint and any return visits for the time I do training

> ith the patient.

> Is this a correct understanding?

> always wondered why the price on these codes was so high, but now that I

> nderstand it includes any return visits for modification and the initial

> valuation I can more clearly can understand.

> hanks,

> shley Kelley, OTR/L, CLT

>

>

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Share on other sites

No...PT Treated

RE: BCBS of KC

Heidi

Were these services provided by a PTA?

Kevyn Soupiset, PT, MPT

" Success often comes from taking a misstep in the right direction. "

Progressive Therapy & Sports Medicine

117 W. 6th

Larned, KS 67550

Ph:

Fax

www.progressive-larned.com

http://www.elocallink.tv/vp6/spon-fcsa_a.php?fvm=1 & sponid=AjUFMg5rVjtUYg== &

>

ttp://www.elocallink.tv/vp6/spon-fcsa_a.php?fvm=1 & sponid=AjUFMg5rVjtUYg== & v

From: PTManager [mailto:PTManager ] On Behalf

f Heidi Harmon

ent: Friday, January 28, 2011 1:18 PM

o: PTManager

ubject: BCBS of KC

ello All. Just got my EOB's for the first portions of Jan for patients

illed and the therapy billed allowable was dropped by about $30.00 per hour

llowing only $93.00 per hour for PT. I called the provider rep and waiting

o hear her answer. I am hoping this is a mistake as I would have thought if

hey were reducing the allowables by approx $30 per hour I would have heard

bout it. Shocked and FRUSTRATED! Has anyone had any of the same issues in

y area or otherwise? This is a game changer for sure! BCBS is 45% of our

usiness.

Thanks for any input you might have!

Heidi Harmon

illing Manager

-----Original Message-----

rom: Mark Niles <mniles@... <mailto:mniles%40orthospecpa.net> >

o: PTManager <mailto:PTManager%40yahoogroups.com>

ent: Fri, Jan 28, 2011 12:16 pm

ubject: cold laser

What all do you all think of the cold laser? Is it billable? Do you own it?

ase it? Getting good results with?

hat say you????

Mark Niles PT, MS, CSCS

thopedic Specialists PA

iles@... <mailto:niles%40orthospecpa.net>

4-720-7448 x3

4-720-9042 fax

his message, together with any attachments, is intended only for the

dressee. It may contain information which is legally privileged,

nfidential and exempt from disclosure. If you are not the intended

cipient, you are hereby notified that any disclosure, copying,

stribution, use, or any action or reliance on this communication is

rictly prohibited. If you have received this e-mail in error, please

tify the sender immediately by telephone ( x3) or by return

mail and delete the message, along with any attachments

From: PTManager <mailto:PTManager%40yahoogroups.com>

mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On

ehalf

nygaardsabs

nt: Friday, January 28, 2011 9:08 AM

: PTManager <mailto:PTManager%40yahoogroups.com>

bject: L-Code Clarification

had a question for the group about L-codes. When reading up on this charge

de it is my understanding that this code includes the:

Evaluation

Fitting of the splint

Material and supplies

Any return visits for adjustments/modifications of this splint for

e next 90 days.

f I understand correctly, I am able to charge an orthotic fitting charge on

e day I make the splint and any return visits for the time I do training

th the patient.

s this a correct understanding?

lways wondered why the price on these codes was so high, but now that I

derstand it includes any return visits for modification and the initial

aluation I can more clearly can understand.

anks,

hley Kelley, OTR/L, CLT

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