Re: PT Aide/Tech Performing Group Therapy for Medicare Patients

[Guest guest]

Group " therapy " suggests therapy is being provided and therapy is a skilled

service. PT Aides are not skilled providers. With respect, why do these

questions keep arising from our professionals?

Alan Petrazzi, MPT, MPM

Rehab Director

Pittsburgh, PA

[Guest guest]

Dear Alan,

Thank you for your response and I agree with your opinion. I am not a PT.

I am a consultant and have a third party billing company. I have a

particularly challenging new client that does not share the same interpretation

of CMS guidelines and rules as I do. I had sincerely hoped that posing some

of his challenges on list serve would enlightening him and provide him

with a viewpoint other than mine.

I couldn't agree more with your summation, " Why do these questions keep

arising from our professionals? " My observation, after 20 years of providing

practice management consulting and billing services to physicians and

therapists, is that a small number of physicians and therapists would rather

elicit the advice of another physician or therapist with regard to what

constitutes " correct coding and billing " for a procedure than to investigate

and

adhere to what constitutes " correct coding and billing " for a procedure of

a third party payer. This causes a big problem when the physician or

therapist being asked for advice has no understanding or appreciation for third

party payer guidelines and rules.

As long as therapist keep asking these type of questions, I will have a

job. That's the upside.

Thanks again to PT List Serve and to their participants.

Vickie

D. Cavitt, President

Rehab Billing Specialists, L.L.C.

600 Guilbeau Road, Suite A

Lafayette, LA 70506

In a message dated 9/26/2011 8:09:25 P.M. Central Daylight Time,

alanpetrazzi@... writes:

Group " therapy " suggests therapy is being provided and therapy is a skilled

service. PT Aides are not skilled providers. With respect, why do these

questions keep arising from our professionals?

Alan Petrazzi, MPT, MPM

Rehab Director

Pittsburgh, PA

[Non-text portions of this message have been removed]

[Guest guest]

In my humble opinion, the reason PT practioners keep asking this question

is to find someone who agrees that the best way to make more money is to

have technicians " extend " their ability to bill more units per day.

Unfortunately this question gets amended to it like a bill going through

Congress. In this case practioners like to add the argument that as

autonomous practioners we have the right (not privilege) to decide what is

best for each patient. As long as these two items (autonomy and billing for

work done by technician's) are intrinsically linked, this question will be

debated.

Steve Marcum PT

Outpatient Physical Therapy

Lexington , KY

Sent from my Windows Phone

[Guest guest]

Alan asks " ...why do these questions keep arising from our professionals? "

Because, in contradiction to the desires and needs of therapists and patients,

the entirety of our practice--even the very definition of it--is controlled by

power-wielding third parties. In this hyper-controlled world, isn't it only

natural and right that when told to go jump in a lake, questions arise like how

deep we must sink, and how long we must stay under?

Interpretation of rules has become massive business for good

reason--interpretation is the last hope for those whose professional judgment

has been obviated. Government, insurance, government insurance... Rules and

regulations have become so well embedded into our practices today (indeed into

every aspect of our lives) that to some, compliance has overtaken humaneness as

our highest ethic. (Heck, we've become so inured to tethers that we even spend

good money to hire additional controllers, like the Joint Commission!)

Some undoubtedly are thinking now " It is certainly not professional to call the

work of aides 'physical therapy' " . But that is an ostensible statement,

meaningful only in the context of world totally buttoned up by third-party

rules. What if the impossible happened and you found yourself suddenly able to

design treatment programs with only the desires and needs of your patients in

mind? And what if you discovered then that you could, for mere pennies, conduct

valuable therapeutic activities with staff sporting little education and

training, and that patients were happy to have the option to pay minimally for

it? It won't happen of course, until we decide that we can live without all

those " free " third-party " benefits, " but it's a pleasant dream...

Dave Milano, PT, Rehabilitation Director

Laurel Health System

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Alan Petrazzi

Sent: Monday, September 26, 2011 9:00 PM

To: PTManager ; PTManager

Subject: Re: PT Aide/Tech Performing Group Therapy for Medicare

Patients

Group " therapy " suggests therapy is being provided and therapy is a skilled

service. PT Aides are not skilled providers. With respect, why do these

questions keep arising from our professionals?

Alan Petrazzi, MPT, MPM

Rehab Director

Pittsburgh, PA

[Guest guest]

Dave--You voice my sentiments. Very soon cheap care is coming and we should

be ready to provide and make a profit..another dream?

Hiten Dave' PT

> **

>

>

> Alan asks " ...why do these questions keep arising from our professionals? "

>

> Because, in contradiction to the desires and needs of therapists and

> patients, the entirety of our practice--even the very definition of it--is

> controlled by power-wielding third parties. In this hyper-controlled world,

> isn't it only natural and right that when told to go jump in a lake,

> questions arise like how deep we must sink, and how long we must stay under?

>

> Interpretation of rules has become massive business for good

> reason--interpretation is the last hope for those whose professional

> judgment has been obviated. Government, insurance, government insurance...

> Rules and regulations have become so well embedded into our practices today

> (indeed into every aspect of our lives) that to some, compliance has

> overtaken humaneness as our highest ethic. (Heck, we've become so inured to

> tethers that we even spend good money to hire additional controllers, like

> the Joint Commission!)

>

> Some undoubtedly are thinking now " It is certainly not professional to call

> the work of aides 'physical therapy' " . But that is an ostensible statement,

> meaningful only in the context of world totally buttoned up by third-party

> rules. What if the impossible happened and you found yourself suddenly able

> to design treatment programs with only the desires and needs of your

> patients in mind? And what if you discovered then that you could, for mere

> pennies, conduct valuable therapeutic activities with staff sporting little

> education and training, and that patients were happy to have the option to

> pay minimally for it? It won't happen of course, until we decide that we can

> live without all those " free " third-party " benefits, " but it's a pleasant

> dream...

>

> Dave Milano, PT, Rehabilitation Director

> Laurel Health System

>

> ________________________________

> From: PTManager [mailto:PTManager ] On

> Behalf Of Alan Petrazzi

> Sent: Monday, September 26, 2011 9:00 PM

> To: PTManager ; PTManager

> Subject: Re: PT Aide/Tech Performing Group Therapy for Medicare

> Patients

>

>

> Group " therapy " suggests therapy is being provided and therapy is a skilled

> service. PT Aides are not skilled providers. With respect, why do these

> questions keep arising from our professionals?

>

> Alan Petrazzi, MPT, MPM

> Rehab Director

> Pittsburgh, PA

>

>