Medicare Script vs Plan of Care..need both?

[Guest guest]

I'm sure this has been asked once or twice before!

If I get a signed plan of care from a physician, do I still need a

script/prescription?  Or is the POC also a prescription?

Thank you!

 

Schweitzer

________________________________

To: PTManager

Sent: Monday, January 16, 2012 1:19 PM

Subject: RE: Therapy pool

 

Gabe - I am sure that your group is probably aware of this, but it should be

at the top of the list:

Under Title III and as part of the 2010 Standards for Accessible Design,

regulations of the Accessible Design for Recreational Facilities will

require all public pools and spas to be outfitted with an ADA compliant

swimming pool lift or sloped entry. The rule extends to places of " public

accommodations " including services establishments which has been defined to

include professional offices of health care providers. This regulation

which has a compliance effective date of March 12, 2012.

J. Beckley, MS, MBA, CHC | President

Beckley & Associates LLC

P | F

<http://nancybeckley.com/> nancybeckley.com |

<http://rehabcomplianceblog.com/> rehabcomplianceblog.com

<http://nancybeckley.com/> Description: Description: Description: Logo for

email signature3

<http://www.linkedin.com/in/nancybeckley> Description: Description:

ZA102637857 Linked In Icon <http://www.twitter.com/nancybeckley>

Description: Description: ZA102637858 Twitter Icon

From: PTManager [mailto:PTManager ] On Behalf

Of Gabe Freyaldenhoven

Sent: Sunday, January 15, 2012 8:20 PM

To: PTManager

Subject: Therapy pool

I have been asked to be part of a focus group that is exploring the

possibility of building an indoor aquatic center for our community. This is

being built my our local city government. My role is to represent the

medical/therapy community regarding the things that would be needed to make

this a usable facility and for the center to be used for therapy or any

other medical purpose. The immediate things that have come to mind are

water accessibility(ramp or lift), temperature, and ensuring the changing

areas are fully accessible. What areas do I need to be aware of when

planning this type of facility? For those of you doing aquatics or that

have been a part of a community center, what are some necessities of a

facility like this and what are some things that have enhanced the usability

of this type of facility?

As always, thanks for your feedback.

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine

[Guest guest]

Hi, -

Assuming that you're talking about outpatient Part B Medicare, not in a

" Rehab Agency " ...

When you do the eval and prepare a Plan of Care (POC), the physician's role

is to certify it.

(Most of them haven't been told this, and would consider me " insubordinate "

for mentioning it! " 8^)

No " prescription " or " orders " are necessary. In fact, according to the new

(2010) APTA Code of Ethics, it is your own professional judgement which

determines what you do. You are expected to communicate with the physician

when necessary, but " following orders " may be now considered by some to be

of questionable ethics:

Principle #3: Physical therapists shall be accountable for making sound

professional judgments.

(Core Values: Excellence, Integrity)

3A. Physical therapists shall demonstrate independent and objective

professional judgment in the patient's/client's best interest in all

practice settings.

3B. Physical therapists shall demonstrate professional judgment informed by

professional standards, evidence (including current literature and

established best practice), practitioner experience, and patient/client

values.

3C. Physical therapists shall make judgments within their scope of practice

and level of expertise and shall communicate with, collaborate with, or

refer to peers or other health care professionals when necessary.

3D. Physical therapists shall not engage in conflicts of interest that

interfere with professional judgment.

3E. Physical therapists shall provide appropriate direction of and

communication with physical therapist assistants and support personnel.

See you AT CSM!

Dick Hillyer

Hillyer, PT,DPT,MBA,MSM

Hillyer Consulting.

Cape Coral, FL 33914

DickHillyer.com

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Schweitzer

Sent: Tuesday, January 17, 2012 8:29 AM

To: PTManager

Subject: Medicare Script vs Plan of Care..need both?

I'm sure this has been asked once or twice before!

If I get a signed plan of care from a physician, do I still need a

script/prescription? Or is the POC also a prescription?

Thank you!

Schweitzer

________________________________

From: Beckley <nancy@...

<mailto:nancy%40bloomingdaleconsulting.com> >

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

Sent: Monday, January 16, 2012 1:19 PM

Subject: RE: Therapy pool

Gabe - I am sure that your group is probably aware of this, but it should be

at the top of the list:

Under Title III and as part of the 2010 Standards for Accessible Design,

regulations of the Accessible Design for Recreational Facilities will

require all public pools and spas to be outfitted with an ADA compliant

swimming pool lift or sloped entry. The rule extends to places of " public

accommodations " including services establishments which has been defined to

include professional offices of health care providers. This regulation

which has a compliance effective date of March 12, 2012.

J. Beckley, MS, MBA, CHC | President

Beckley & Associates LLC

P | F

<http://nancybeckley.com/> nancybeckley.com |

<http://rehabcomplianceblog.com/> rehabcomplianceblog.com

<http://nancybeckley.com/> Description: Description: Description: Logo for

email signature3

<http://www.linkedin.com/in/nancybeckley> Description: Description:

ZA102637857 Linked In Icon <http://www.twitter.com/nancybeckley>

Description: Description: ZA102637858 Twitter Icon

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

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

Behalf

Of Gabe Freyaldenhoven

Sent: Sunday, January 15, 2012 8:20 PM

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

Subject: Therapy pool

I have been asked to be part of a focus group that is exploring the

possibility of building an indoor aquatic center for our community. This is

being built my our local city government. My role is to represent the

medical/therapy community regarding the things that would be needed to make

this a usable facility and for the center to be used for therapy or any

other medical purpose. The immediate things that have come to mind are

water accessibility(ramp or lift), temperature, and ensuring the changing

areas are fully accessible. What areas do I need to be aware of when

planning this type of facility? For those of you doing aquatics or that

have been a part of a community center, what are some necessities of a

facility like this and what are some things that have enhanced the usability

of this type of facility?

As always, thanks for your feedback.

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine

[Guest guest]

Hi, -

Assuming that you're talking about outpatient Part B Medicare, not in a

" Rehab Agency " ...

When you do the eval and prepare a Plan of Care (POC), the physician's role

is to certify it.

(Most of them haven't been told this, and would consider me " insubordinate "

for mentioning it! " 8^)

No " prescription " or " orders " are necessary. In fact, according to the new

(2010) APTA Code of Ethics, it is your own professional judgement which

determines what you do. You are expected to communicate with the physician

when necessary, but " following orders " may be now considered by some to be

of questionable ethics:

Principle #3: Physical therapists shall be accountable for making sound

professional judgments.

(Core Values: Excellence, Integrity)

3A. Physical therapists shall demonstrate independent and objective

professional judgment in the patient's/client's best interest in all

practice settings.

3B. Physical therapists shall demonstrate professional judgment informed by

professional standards, evidence (including current literature and

established best practice), practitioner experience, and patient/client

values.

3C. Physical therapists shall make judgments within their scope of practice

and level of expertise and shall communicate with, collaborate with, or

refer to peers or other health care professionals when necessary.

3D. Physical therapists shall not engage in conflicts of interest that

interfere with professional judgment.

3E. Physical therapists shall provide appropriate direction of and

communication with physical therapist assistants and support personnel.

See you AT CSM!

Dick Hillyer

Hillyer, PT,DPT,MBA,MSM

Hillyer Consulting.

Cape Coral, FL 33914

DickHillyer.com

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Schweitzer

Sent: Tuesday, January 17, 2012 8:29 AM

To: PTManager

Subject: Medicare Script vs Plan of Care..need both?

I'm sure this has been asked once or twice before!

If I get a signed plan of care from a physician, do I still need a

script/prescription? Or is the POC also a prescription?

Thank you!

Schweitzer

________________________________

From: Beckley <nancy@...

<mailto:nancy%40bloomingdaleconsulting.com> >

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

Sent: Monday, January 16, 2012 1:19 PM

Subject: RE: Therapy pool

Gabe - I am sure that your group is probably aware of this, but it should be

at the top of the list:

Under Title III and as part of the 2010 Standards for Accessible Design,

regulations of the Accessible Design for Recreational Facilities will

require all public pools and spas to be outfitted with an ADA compliant

swimming pool lift or sloped entry. The rule extends to places of " public

accommodations " including services establishments which has been defined to

include professional offices of health care providers. This regulation

which has a compliance effective date of March 12, 2012.

J. Beckley, MS, MBA, CHC | President

Beckley & Associates LLC

P | F

<http://nancybeckley.com/> nancybeckley.com |

<http://rehabcomplianceblog.com/> rehabcomplianceblog.com

<http://nancybeckley.com/> Description: Description: Description: Logo for

email signature3

<http://www.linkedin.com/in/nancybeckley> Description: Description:

ZA102637857 Linked In Icon <http://www.twitter.com/nancybeckley>

Description: Description: ZA102637858 Twitter Icon

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

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

Behalf

Of Gabe Freyaldenhoven

Sent: Sunday, January 15, 2012 8:20 PM

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

Subject: Therapy pool

I have been asked to be part of a focus group that is exploring the

possibility of building an indoor aquatic center for our community. This is

being built my our local city government. My role is to represent the

medical/therapy community regarding the things that would be needed to make

this a usable facility and for the center to be used for therapy or any

other medical purpose. The immediate things that have come to mind are

water accessibility(ramp or lift), temperature, and ensuring the changing

areas are fully accessible. What areas do I need to be aware of when

planning this type of facility? For those of you doing aquatics or that

have been a part of a community center, what are some necessities of a

facility like this and what are some things that have enhanced the usability

of this type of facility?

As always, thanks for your feedback.

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine

[Guest guest]

Hi, -

Assuming that you're talking about outpatient Part B Medicare, not in a

" Rehab Agency " ...

When you do the eval and prepare a Plan of Care (POC), the physician's role

is to certify it.

(Most of them haven't been told this, and would consider me " insubordinate "

for mentioning it! " 8^)

No " prescription " or " orders " are necessary. In fact, according to the new

(2010) APTA Code of Ethics, it is your own professional judgement which

determines what you do. You are expected to communicate with the physician

when necessary, but " following orders " may be now considered by some to be

of questionable ethics:

Principle #3: Physical therapists shall be accountable for making sound

professional judgments.

(Core Values: Excellence, Integrity)

3A. Physical therapists shall demonstrate independent and objective

professional judgment in the patient's/client's best interest in all

practice settings.

3B. Physical therapists shall demonstrate professional judgment informed by

professional standards, evidence (including current literature and

established best practice), practitioner experience, and patient/client

values.

3C. Physical therapists shall make judgments within their scope of practice

and level of expertise and shall communicate with, collaborate with, or

refer to peers or other health care professionals when necessary.

3D. Physical therapists shall not engage in conflicts of interest that

interfere with professional judgment.

3E. Physical therapists shall provide appropriate direction of and

communication with physical therapist assistants and support personnel.

See you AT CSM!

Dick Hillyer

Hillyer, PT,DPT,MBA,MSM

Hillyer Consulting.

Cape Coral, FL 33914

DickHillyer.com

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Schweitzer

Sent: Tuesday, January 17, 2012 8:29 AM

To: PTManager

Subject: Medicare Script vs Plan of Care..need both?

I'm sure this has been asked once or twice before!

If I get a signed plan of care from a physician, do I still need a

script/prescription? Or is the POC also a prescription?

Thank you!

Schweitzer

________________________________

From: Beckley <nancy@...

<mailto:nancy%40bloomingdaleconsulting.com> >

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

Sent: Monday, January 16, 2012 1:19 PM

Subject: RE: Therapy pool

Gabe - I am sure that your group is probably aware of this, but it should be

at the top of the list:

Under Title III and as part of the 2010 Standards for Accessible Design,

regulations of the Accessible Design for Recreational Facilities will

require all public pools and spas to be outfitted with an ADA compliant

swimming pool lift or sloped entry. The rule extends to places of " public

accommodations " including services establishments which has been defined to

include professional offices of health care providers. This regulation

which has a compliance effective date of March 12, 2012.

J. Beckley, MS, MBA, CHC | President

Beckley & Associates LLC

P | F

<http://nancybeckley.com/> nancybeckley.com |

<http://rehabcomplianceblog.com/> rehabcomplianceblog.com

<http://nancybeckley.com/> Description: Description: Description: Logo for

email signature3

<http://www.linkedin.com/in/nancybeckley> Description: Description:

ZA102637857 Linked In Icon <http://www.twitter.com/nancybeckley>

Description: Description: ZA102637858 Twitter Icon

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

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

Behalf

Of Gabe Freyaldenhoven

Sent: Sunday, January 15, 2012 8:20 PM

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

Subject: Therapy pool

I have been asked to be part of a focus group that is exploring the

possibility of building an indoor aquatic center for our community. This is

being built my our local city government. My role is to represent the

medical/therapy community regarding the things that would be needed to make

this a usable facility and for the center to be used for therapy or any

other medical purpose. The immediate things that have come to mind are

water accessibility(ramp or lift), temperature, and ensuring the changing

areas are fully accessible. What areas do I need to be aware of when

planning this type of facility? For those of you doing aquatics or that

have been a part of a community center, what are some necessities of a

facility like this and what are some things that have enhanced the usability

of this type of facility?

As always, thanks for your feedback.

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine

[Guest guest]

Hi ,

The answer depend on state law. In some states, a physician/provider

referral/prescription/order may be required.

For Medicare Part B, it depends on where you practice. The recent changes in

the Hospital Condition of Participation now requires a physician order for

hospital outpatient Part B patients in addition to the plan of care.

There are no regulations defining what an “order†is that I am aware of and

I would need others to help on that.

There are specific regulations on what a plan of care needs to have in it, who

can prepare it, who can sign it and when it needs to be signed. Per anything

that I am aware of, a plan of care for Medicare is NOT a

referral/prescription/order and vice versa.

Unfortunately, one of the biggest problems that I continue to hear is physicians

that send a referral then refuse or get upset when you send them a plan of care

to sign – stating that they already sent the referral and that is all that is

needed. We all have to carefully educate them (I have sent regulations to

office managers to confirm what is needed) because, bottom-line you will be

denied payment if you don’t have the signed plan of care (if that case is

reviewed at any point by Medicare (or a RAC) and now if you do not have a

physician order that is timed and dated (for Hospital Outpatient Part .

M.Howell, P.T., M.P.T.

IPTA Payment Specialist

Meridian, Idaho

thowell@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended recipient.

If you are not the intended recipient of the email or any of its attachments,

please be advised that you have received this email in error and that any use,

dissemination, distribution, forwarding, printing or copying of this email or

any attached files is strictly prohibited. If you have received this email in

error, please immediately purge it and all attachments and notify the sender by

reply email.

From: PTManager [mailto:PTManager ] On Behalf Of

Schweitzer

Sent: Tuesday, January 17, 2012 6:29 AM

To: PTManager

Subject: Medicare Script vs Plan of Care..need both?

I'm sure this has been asked once or twice before!

If I get a signed plan of care from a physician, do I still need a

script/prescription? Or is the POC also a prescription?

Thank you!

Schweitzer

________________________________

From: Beckley <nancy@...

<mailto:nancy%40bloomingdaleconsulting.com> >

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

Sent: Monday, January 16, 2012 1:19 PM

Subject: RE: Therapy pool

Gabe - I am sure that your group is probably aware of this, but it should be

at the top of the list:

Under Title III and as part of the 2010 Standards for Accessible Design,

regulations of the Accessible Design for Recreational Facilities will

require all public pools and spas to be outfitted with an ADA compliant

swimming pool lift or sloped entry. The rule extends to places of " public

accommodations " including services establishments which has been defined to

include professional offices of health care providers. This regulation

which has a compliance effective date of March 12, 2012.

J. Beckley, MS, MBA, CHC | President

Beckley & Associates LLC

P | F

<http://nancybeckley.com/> nancybeckley.com |

<http://rehabcomplianceblog.com/> rehabcomplianceblog.com

<http://nancybeckley.com/> Description: Description: Description: Logo for

email signature3

<http://www.linkedin.com/in/nancybeckley> Description: Description:

ZA102637857 Linked In Icon <http://www.twitter.com/nancybeckley>

Description: Description: ZA102637858 Twitter Icon

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

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

Behalf

Of Gabe Freyaldenhoven

Sent: Sunday, January 15, 2012 8:20 PM

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

Subject: Therapy pool

I have been asked to be part of a focus group that is exploring the

possibility of building an indoor aquatic center for our community. This is

being built my our local city government. My role is to represent the

medical/therapy community regarding the things that would be needed to make

this a usable facility and for the center to be used for therapy or any

other medical purpose. The immediate things that have come to mind are

water accessibility(ramp or lift), temperature, and ensuring the changing

areas are fully accessible. What areas do I need to be aware of when

planning this type of facility? For those of you doing aquatics or that

have been a part of a community center, what are some necessities of a

facility like this and what are some things that have enhanced the usability

of this type of facility?

As always, thanks for your feedback.

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine

[Guest guest]

Hi ,

The answer depend on state law. In some states, a physician/provider

referral/prescription/order may be required.

For Medicare Part B, it depends on where you practice. The recent changes in

the Hospital Condition of Participation now requires a physician order for

hospital outpatient Part B patients in addition to the plan of care.

There are no regulations defining what an “order†is that I am aware of and

I would need others to help on that.

There are specific regulations on what a plan of care needs to have in it, who

can prepare it, who can sign it and when it needs to be signed. Per anything

that I am aware of, a plan of care for Medicare is NOT a

referral/prescription/order and vice versa.

Unfortunately, one of the biggest problems that I continue to hear is physicians

that send a referral then refuse or get upset when you send them a plan of care

to sign – stating that they already sent the referral and that is all that is

needed. We all have to carefully educate them (I have sent regulations to

office managers to confirm what is needed) because, bottom-line you will be

denied payment if you don’t have the signed plan of care (if that case is

reviewed at any point by Medicare (or a RAC) and now if you do not have a

physician order that is timed and dated (for Hospital Outpatient Part .

M.Howell, P.T., M.P.T.

IPTA Payment Specialist

Meridian, Idaho

thowell@...

This email and any files transmitted with it may contain PRIVILEGED or

CONFIDENTIAL information and may be read or used only by the intended recipient.

If you are not the intended recipient of the email or any of its attachments,

please be advised that you have received this email in error and that any use,

dissemination, distribution, forwarding, printing or copying of this email or

any attached files is strictly prohibited. If you have received this email in

error, please immediately purge it and all attachments and notify the sender by

reply email.

From: PTManager [mailto:PTManager ] On Behalf Of

Schweitzer

Sent: Tuesday, January 17, 2012 6:29 AM

To: PTManager

Subject: Medicare Script vs Plan of Care..need both?

I'm sure this has been asked once or twice before!

If I get a signed plan of care from a physician, do I still need a

script/prescription? Or is the POC also a prescription?

Thank you!

Schweitzer

________________________________

From: Beckley <nancy@...

<mailto:nancy%40bloomingdaleconsulting.com> >

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

Sent: Monday, January 16, 2012 1:19 PM

Subject: RE: Therapy pool

Gabe - I am sure that your group is probably aware of this, but it should be

at the top of the list:

Under Title III and as part of the 2010 Standards for Accessible Design,

regulations of the Accessible Design for Recreational Facilities will

require all public pools and spas to be outfitted with an ADA compliant

swimming pool lift or sloped entry. The rule extends to places of " public

accommodations " including services establishments which has been defined to

include professional offices of health care providers. This regulation

which has a compliance effective date of March 12, 2012.

J. Beckley, MS, MBA, CHC | President

Beckley & Associates LLC

P | F

<http://nancybeckley.com/> nancybeckley.com |

<http://rehabcomplianceblog.com/> rehabcomplianceblog.com

<http://nancybeckley.com/> Description: Description: Description: Logo for

email signature3

<http://www.linkedin.com/in/nancybeckley> Description: Description:

ZA102637857 Linked In Icon <http://www.twitter.com/nancybeckley>

Description: Description: ZA102637858 Twitter Icon

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

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

Behalf

Of Gabe Freyaldenhoven

Sent: Sunday, January 15, 2012 8:20 PM

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

Subject: Therapy pool

I have been asked to be part of a focus group that is exploring the

possibility of building an indoor aquatic center for our community. This is

being built my our local city government. My role is to represent the

medical/therapy community regarding the things that would be needed to make

this a usable facility and for the center to be used for therapy or any

other medical purpose. The immediate things that have come to mind are

water accessibility(ramp or lift), temperature, and ensuring the changing

areas are fully accessible. What areas do I need to be aware of when

planning this type of facility? For those of you doing aquatics or that

have been a part of a community center, what are some necessities of a

facility like this and what are some things that have enhanced the usability

of this type of facility?

As always, thanks for your feedback.

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine