Guest guest Posted June 8, 2012 Report Share Posted June 8, 2012 Group: I recently started helping a lady that performs hippotherapy with children. How would we bill for this service? We will be working with doctors plus private insurance and Medicaid. I currently work in a hospital based outpatient department and not sure how to do this on a private basis. Huffman P.T., M.S., A.T.,C. ville, IL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2012 Report Share Posted June 12, 2012 We don't bill specifically for Mat-therapy, Bicycle-therapy or Swiss Ball-therapy, but use these tools in the application of skilled PT interventions for ROM, exercise, balance training, etc. How is using a horse as a modality to achieve these ends any different if the PT is still performing the skilled intervention with the same focus? I am presuming billing Therex, Ther Activities, or some such. Just curious. Most of the horses I know are busy creating new clients for me, but I know there are saintly individuals in hippotherapy circles who are helping with great therapy. Anne MPT ville, CA > > Please keep in mind the vast majority of insurance carriers do not > knowingly reimburse for hippotherapy as many consider it > investigational and experimental. The key word in the previous > sentence is knowingly. Most likely, you will be reimbursed for your > therapy services since most of your claims never get reviewed. The > thing to think about is what would happen if some of your claims were > reviewed and documentation showed you did hippotherapy? Would you get > reimbursed if on a pre-pay audit or keep the money if on a post-pay audit? > > Rick Gawenda, PT > President > Gawenda Seminars & Consulting, Inc. > www.gawendaseminars.com > > Follow Gawenda Seminars & Consulting, Inc on Facebook > > Register for the June 19, 2012 webinar conference: " ICD-9 Coding, > Medicare Therapy Cap, CCI Edits & Modifiers Used in Outpatient Therapy " at > https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1886 > > > > From: Trevor Huffman <trevor.huffman@... > <mailto:trevor.huffman%40passavanthospital.com>> > Subject: Hippotherapy > To: " 'PTManager > <mailto:%27PTManager%40yahoogroups.com>' " <PTManager > <mailto:PTManager%40yahoogroups.com>> > Date: Friday, June 8, 2012, 2:06 PM > > > > Group: > > I recently started helping a lady that performs hippotherapy with > children. How would we bill for this service? We will be working with > doctors plus private insurance and Medicaid. I currently work in a > hospital based outpatient department and not sure how to do this on a > private basis. > > Huffman P.T., M.S., A.T.,C. > > ville, IL > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2012 Report Share Posted June 12, 2012 We don't bill specifically for Mat-therapy, Bicycle-therapy or Swiss Ball-therapy, but use these tools in the application of skilled PT interventions for ROM, exercise, balance training, etc. How is using a horse as a modality to achieve these ends any different if the PT is still performing the skilled intervention with the same focus? I am presuming billing Therex, Ther Activities, or some such. Just curious. Most of the horses I know are busy creating new clients for me, but I know there are saintly individuals in hippotherapy circles who are helping with great therapy. Anne MPT ville, CA > > Please keep in mind the vast majority of insurance carriers do not > knowingly reimburse for hippotherapy as many consider it > investigational and experimental. The key word in the previous > sentence is knowingly. Most likely, you will be reimbursed for your > therapy services since most of your claims never get reviewed. The > thing to think about is what would happen if some of your claims were > reviewed and documentation showed you did hippotherapy? Would you get > reimbursed if on a pre-pay audit or keep the money if on a post-pay audit? > > Rick Gawenda, PT > President > Gawenda Seminars & Consulting, Inc. > www.gawendaseminars.com > > Follow Gawenda Seminars & Consulting, Inc on Facebook > > Register for the June 19, 2012 webinar conference: " ICD-9 Coding, > Medicare Therapy Cap, CCI Edits & Modifiers Used in Outpatient Therapy " at > https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1886 > > > > From: Trevor Huffman <trevor.huffman@... > <mailto:trevor.huffman%40passavanthospital.com>> > Subject: Hippotherapy > To: " 'PTManager > <mailto:%27PTManager%40yahoogroups.com>' " <PTManager > <mailto:PTManager%40yahoogroups.com>> > Date: Friday, June 8, 2012, 2:06 PM > > > > Group: > > I recently started helping a lady that performs hippotherapy with > children. How would we bill for this service? We will be working with > doctors plus private insurance and Medicaid. I currently work in a > hospital based outpatient department and not sure how to do this on a > private basis. > > Huffman P.T., M.S., A.T.,C. > > ville, IL > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2012 Report Share Posted June 12, 2012 Because some insurance carriers will say the tool, in this case, the horse, is not a proven tool in the realm of therapy. It is a grey area that is up for interpretation upon an audit by the insurance carrier. Just things to think about. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. http://www.gawendaseminars.com > We don't bill specifically for Mat-therapy, Bicycle-therapy or Swiss > Ball-therapy, but use these tools in the application of skilled PT > interventions for ROM, exercise, balance training, etc. How is using a > horse as a modality to achieve these ends any different if the PT is > still performing the skilled intervention with the same focus? > I am presuming billing Therex, Ther Activities, or some such. Just curious. > Most of the horses I know are busy creating new clients for me, but I > know there are saintly individuals in hippotherapy circles who are > helping with great therapy. > > Anne MPT > ville, CA > > > > > > Please keep in mind the vast majority of insurance carriers do not > > knowingly reimburse for hippotherapy as many consider it > > investigational and experimental. The key word in the previous > > sentence is knowingly. Most likely, you will be reimbursed for your > > therapy services since most of your claims never get reviewed. The > > thing to think about is what would happen if some of your claims were > > reviewed and documentation showed you did hippotherapy? Would you get > > reimbursed if on a pre-pay audit or keep the money if on a post-pay audit? > > > > Rick Gawenda, PT > > President > > Gawenda Seminars & Consulting, Inc. > > www.gawendaseminars.com > > > > Follow Gawenda Seminars & Consulting, Inc on Facebook > > > > Register for the June 19, 2012 webinar conference: " ICD-9 Coding, > > Medicare Therapy Cap, CCI Edits & Modifiers Used in Outpatient Therapy " at > > https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1886 > > > > > > > > From: Trevor Huffman <trevor.huffman@... > > <mailto:trevor.huffman%40passavanthospital.com>> > > Subject: Hippotherapy > > To: " 'PTManager > > <mailto:%27PTManager%40yahoogroups.com>' " <PTManager > > <mailto:PTManager%40yahoogroups.com>> > > Date: Friday, June 8, 2012, 2:06 PM > > > > > > > > Group: > > > > I recently started helping a lady that performs hippotherapy with > > children. How would we bill for this service? We will be working with > > doctors plus private insurance and Medicaid. I currently work in a > > hospital based outpatient department and not sure how to do this on a > > private basis. > > > > Huffman P.T., M.S., A.T.,C. > > > > ville, IL > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2012 Report Share Posted June 12, 2012 Because some insurance carriers will say the tool, in this case, the horse, is not a proven tool in the realm of therapy. It is a grey area that is up for interpretation upon an audit by the insurance carrier. Just things to think about. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. http://www.gawendaseminars.com > We don't bill specifically for Mat-therapy, Bicycle-therapy or Swiss > Ball-therapy, but use these tools in the application of skilled PT > interventions for ROM, exercise, balance training, etc. How is using a > horse as a modality to achieve these ends any different if the PT is > still performing the skilled intervention with the same focus? > I am presuming billing Therex, Ther Activities, or some such. Just curious. > Most of the horses I know are busy creating new clients for me, but I > know there are saintly individuals in hippotherapy circles who are > helping with great therapy. > > Anne MPT > ville, CA > > > > > > Please keep in mind the vast majority of insurance carriers do not > > knowingly reimburse for hippotherapy as many consider it > > investigational and experimental. The key word in the previous > > sentence is knowingly. Most likely, you will be reimbursed for your > > therapy services since most of your claims never get reviewed. The > > thing to think about is what would happen if some of your claims were > > reviewed and documentation showed you did hippotherapy? Would you get > > reimbursed if on a pre-pay audit or keep the money if on a post-pay audit? > > > > Rick Gawenda, PT > > President > > Gawenda Seminars & Consulting, Inc. > > www.gawendaseminars.com > > > > Follow Gawenda Seminars & Consulting, Inc on Facebook > > > > Register for the June 19, 2012 webinar conference: " ICD-9 Coding, > > Medicare Therapy Cap, CCI Edits & Modifiers Used in Outpatient Therapy " at > > https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1886 > > > > > > > > From: Trevor Huffman <trevor.huffman@... > > <mailto:trevor.huffman%40passavanthospital.com>> > > Subject: Hippotherapy > > To: " 'PTManager > > <mailto:%27PTManager%40yahoogroups.com>' " <PTManager > > <mailto:PTManager%40yahoogroups.com>> > > Date: Friday, June 8, 2012, 2:06 PM > > > > > > > > Group: > > > > I recently started helping a lady that performs hippotherapy with > > children. How would we bill for this service? We will be working with > > doctors plus private insurance and Medicaid. I currently work in a > > hospital based outpatient department and not sure how to do this on a > > private basis. > > > > Huffman P.T., M.S., A.T.,C. > > > > ville, IL > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2012 Report Share Posted June 12, 2012 Because some insurance carriers will say the tool, in this case, the horse, is not a proven tool in the realm of therapy. It is a grey area that is up for interpretation upon an audit by the insurance carrier. Just things to think about. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. http://www.gawendaseminars.com > We don't bill specifically for Mat-therapy, Bicycle-therapy or Swiss > Ball-therapy, but use these tools in the application of skilled PT > interventions for ROM, exercise, balance training, etc. How is using a > horse as a modality to achieve these ends any different if the PT is > still performing the skilled intervention with the same focus? > I am presuming billing Therex, Ther Activities, or some such. Just curious. > Most of the horses I know are busy creating new clients for me, but I > know there are saintly individuals in hippotherapy circles who are > helping with great therapy. > > Anne MPT > ville, CA > > > > > > Please keep in mind the vast majority of insurance carriers do not > > knowingly reimburse for hippotherapy as many consider it > > investigational and experimental. The key word in the previous > > sentence is knowingly. Most likely, you will be reimbursed for your > > therapy services since most of your claims never get reviewed. The > > thing to think about is what would happen if some of your claims were > > reviewed and documentation showed you did hippotherapy? Would you get > > reimbursed if on a pre-pay audit or keep the money if on a post-pay audit? > > > > Rick Gawenda, PT > > President > > Gawenda Seminars & Consulting, Inc. > > www.gawendaseminars.com > > > > Follow Gawenda Seminars & Consulting, Inc on Facebook > > > > Register for the June 19, 2012 webinar conference: " ICD-9 Coding, > > Medicare Therapy Cap, CCI Edits & Modifiers Used in Outpatient Therapy " at > > https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1886 > > > > > > > > From: Trevor Huffman <trevor.huffman@... > > <mailto:trevor.huffman%40passavanthospital.com>> > > Subject: Hippotherapy > > To: " 'PTManager > > <mailto:%27PTManager%40yahoogroups.com>' " <PTManager > > <mailto:PTManager%40yahoogroups.com>> > > Date: Friday, June 8, 2012, 2:06 PM > > > > > > > > Group: > > > > I recently started helping a lady that performs hippotherapy with > > children. How would we bill for this service? We will be working with > > doctors plus private insurance and Medicaid. I currently work in a > > hospital based outpatient department and not sure how to do this on a > > private basis. > > > > Huffman P.T., M.S., A.T.,C. > > > > ville, IL > > > > Quote Link to comment Share on other sites More sharing options...
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