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RE: Re: BCBS Michigan

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Thanks , I figured you would have an answer for me..the BCBS website

also lists 2,547 PTPP and 367 institutional providers (rehab agencies or

CORFs).

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>

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From: PTManager [mailto:PTManager ] On Behalf

Of

Sent: Tuesday, June 05, 2012 1:07 PM

To: PTManager

Subject: Re: BCBS Michigan

I am a Michigan PT

I am a Medicare PTPP

I am a BCBSM Independent Physical Therapist (IPT)

My Practices are also recognized as such

BCBSM pays an IPT on the same fee schedule as a Medicare Rehab Agency or

what BCBSM calls Out Patient Rehab Facility (OPT)

>

> Hi, -

>

> As I recall from an effort to buy a couple of Michigan Rehab Agencies

> several years ago, Michigan BCBS chose to only accept PT/OT/SLP providers

> who were Medicare certified Rehab agencies. Subsequently, there were few

> opportunities for PTPPs.

>

> Things may have changed. Looking forward to seeing you in Tampa later this

> week at the APTA Conference.

>

> Warmest regards,

> Dick

>

> Dr. Hillyer

> Hillyer Consulting

> 700 El Dorado Pkwy W.

> Cape Coral, FL 33914

>

> Mobile

> www.DickHillyer.com <http://www.dickhillyer.com/>

> RHillyer@...

> @RHillyer

> KK4HQE

>

>

> _____

>

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

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

Behalf

> Of Beckley

> Sent: Tuesday, June 05, 2012 10:39 AM

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

> Subject: BCBS Michigan

>

>

>

>

> For traditional BCBS in Michigan, I am interested in knowing if Michigan

> providers are enrolled as rehab agencies or CORFs vs. private practice. I

> know there are a number of Michigan folks on the list.

>

> I am doing some work with NARA (National Association of Rehab Providers

and

> Agencies) and noticed the unusually high number of both rehab agencies and

> CORFs in Michigan on the CMS list that we just obtained. I am curious to

> know if BCBS traditional (not BCN), requires this in their participation

> agreements and contracts, or alternatively reimburses at a differential

for

> one or the other.

>

> Thank You

>

> 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

>

>

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Guest guest

Thanks , I figured you would have an answer for me..the BCBS website

also lists 2,547 PTPP and 367 institutional providers (rehab agencies or

CORFs).

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

Sent: Tuesday, June 05, 2012 1:07 PM

To: PTManager

Subject: Re: BCBS Michigan

I am a Michigan PT

I am a Medicare PTPP

I am a BCBSM Independent Physical Therapist (IPT)

My Practices are also recognized as such

BCBSM pays an IPT on the same fee schedule as a Medicare Rehab Agency or

what BCBSM calls Out Patient Rehab Facility (OPT)

>

> Hi, -

>

> As I recall from an effort to buy a couple of Michigan Rehab Agencies

> several years ago, Michigan BCBS chose to only accept PT/OT/SLP providers

> who were Medicare certified Rehab agencies. Subsequently, there were few

> opportunities for PTPPs.

>

> Things may have changed. Looking forward to seeing you in Tampa later this

> week at the APTA Conference.

>

> Warmest regards,

> Dick

>

> Dr. Hillyer

> Hillyer Consulting

> 700 El Dorado Pkwy W.

> Cape Coral, FL 33914

>

> Mobile

> www.DickHillyer.com <http://www.dickhillyer.com/>

> RHillyer@...

> @RHillyer

> KK4HQE

>

>

> _____

>

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

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

Behalf

> Of Beckley

> Sent: Tuesday, June 05, 2012 10:39 AM

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

> Subject: BCBS Michigan

>

>

>

>

> For traditional BCBS in Michigan, I am interested in knowing if Michigan

> providers are enrolled as rehab agencies or CORFs vs. private practice. I

> know there are a number of Michigan folks on the list.

>

> I am doing some work with NARA (National Association of Rehab Providers

and

> Agencies) and noticed the unusually high number of both rehab agencies and

> CORFs in Michigan on the CMS list that we just obtained. I am curious to

> know if BCBS traditional (not BCN), requires this in their participation

> agreements and contracts, or alternatively reimburses at a differential

for

> one or the other.

>

> Thank You

>

> 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

>

>

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Guest guest

You have made your thoughts known J

The surrounding states all have substantially lower CORFs and rehab agencies

than Michigan, so in doing some research I am trying to isolate potential

reasons. One provider let it be known to me that they have a " facility "

contract with BC that requires them to be a facility type of either.

I do know of instances in which a PTA owns a " facility " and has PTs in

employment. They selected the model for an ownership purpose.

Other Michigan providers - please feel free to chime in..

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

Sent: Tuesday, June 05, 2012 4:28 PM

To: PTManager

Subject: Re: BCBS Michigan

I really can't think of any good reason to be a " facility " private practice

in Michigan. Only justification to me is if the owner is not a licensed

therapist and we all n

Know how I feel about that.

> >

> > Hi, -

> >

> > As I recall from an effort to buy a couple of Michigan Rehab Agencies

> > several years ago, Michigan BCBS chose to only accept PT/OT/SLP

providers

> > who were Medicare certified Rehab agencies. Subsequently, there were few

> > opportunities for PTPPs.

> >

> > Things may have changed. Looking forward to seeing you in Tampa later

this

> > week at the APTA Conference.

> >

> > Warmest regards,

> > Dick

> >

> > Dr. Hillyer

> > Hillyer Consulting

> > 700 El Dorado Pkwy W.

> > Cape Coral, FL 33914

> >

> > Mobile

> > www.DickHillyer.com <http://www.dickhillyer.com/>

> > RHillyer@

> > @RHillyer

> > KK4HQE

> >

> >

> > _____

> >

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

<mailto:PTManager%40yahoogroups.com>

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

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

> Behalf

> > Of Beckley

> > Sent: Tuesday, June 05, 2012 10:39 AM

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

<mailto:PTManager%40yahoogroups.com>

> > Subject: BCBS Michigan

> >

> >

> >

> >

> > For traditional BCBS in Michigan, I am interested in knowing if Michigan

> > providers are enrolled as rehab agencies or CORFs vs. private practice.

I

> > know there are a number of Michigan folks on the list.

> >

> > I am doing some work with NARA (National Association of Rehab Providers

> and

> > Agencies) and noticed the unusually high number of both rehab agencies

and

> > CORFs in Michigan on the CMS list that we just obtained. I am curious to

> > know if BCBS traditional (not BCN), requires this in their participation

> > agreements and contracts, or alternatively reimburses at a differential

> for

> > one or the other.

> >

> > Thank You

> >

> > 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

> >

> >

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Guest guest

If you want to be a Medicaid provider due to pediatrics, that is one reason to

become an ORF or CORF. PTs in private practice can only be reimbursed by

Medicaid for coinsurance and deductible amounts only from Medicare.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

http://www.gawendaseminars.com

On Jun 5, 2012, at 5:38 PM, " Beckley "

wrote:

> You have made your thoughts known J

>

> The surrounding states all have substantially lower CORFs and rehab agencies

> than Michigan, so in doing some research I am trying to isolate potential

> reasons. One provider let it be known to me that they have a " facility "

> contract with BC that requires them to be a facility type of either.

>

> I do know of instances in which a PTA owns a " facility " and has PTs in

> employment. They selected the model for an ownership purpose.

>

> Other Michigan providers - please feel free to chime in..

>

> 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

> Sent: Tuesday, June 05, 2012 4:28 PM

> To: PTManager

> Subject: Re: BCBS Michigan

>

> I really can't think of any good reason to be a " facility " private practice

> in Michigan. Only justification to me is if the owner is not a licensed

> therapist and we all n

> Know how I feel about that.

>

>

>

>

> > >

> > > Hi, -

> > >

> > > As I recall from an effort to buy a couple of Michigan Rehab Agencies

> > > several years ago, Michigan BCBS chose to only accept PT/OT/SLP

> providers

> > > who were Medicare certified Rehab agencies. Subsequently, there were few

> > > opportunities for PTPPs.

> > >

> > > Things may have changed. Looking forward to seeing you in Tampa later

> this

> > > week at the APTA Conference.

> > >

> > > Warmest regards,

> > > Dick

> > >

> > > Dr. Hillyer

> > > Hillyer Consulting

> > > 700 El Dorado Pkwy W.

> > > Cape Coral, FL 33914

> > >

> > > Mobile

> > > www.DickHillyer.com <http://www.dickhillyer.com/>

> > > RHillyer@

> > > @RHillyer

> > > KK4HQE

> > >

> > >

> > > _____

> > >

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

> <mailto:PTManager%40yahoogroups.com>

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

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

> > Behalf

> > > Of Beckley

> > > Sent: Tuesday, June 05, 2012 10:39 AM

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

> <mailto:PTManager%40yahoogroups.com>

> > > Subject: BCBS Michigan

> > >

> > >

> > >

> > >

> > > For traditional BCBS in Michigan, I am interested in knowing if Michigan

> > > providers are enrolled as rehab agencies or CORFs vs. private practice.

> I

> > > know there are a number of Michigan folks on the list.

> > >

> > > I am doing some work with NARA (National Association of Rehab Providers

> > and

> > > Agencies) and noticed the unusually high number of both rehab agencies

> and

> > > CORFs in Michigan on the CMS list that we just obtained. I am curious to

> > > know if BCBS traditional (not BCN), requires this in their participation

> > > agreements and contracts, or alternatively reimburses at a differential

> > for

> > > one or the other.

> > >

> > > Thank You

> > >

> > > 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

> > >

> > >

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