Re: Re: Medicares Advanced Beneficiary Notice

[Guest guest]

Hi Group!

 

ABNs have 3 options: Option 1 states we will bill MC.  MC will likely pay and

probably ask for a refund years from now making billing the patient that far

in the future unlikely. 

This seems quite unfair to the provider. 

Patients would want Option 1 checked if: 1) they hope to not pay for the

service  2) they need an EOB to bill secondary on their own.

 

What does a provider do here?

 

Thank you!

Schweitzer

Florida

 

 

 

To: PTManager

Sent: Wednesday, May 16, 2012 4:16 PM

Subject: Re: Web PT

 

I tried PracticeFusion for my cash-based practice (I have another, seperate

practice that bills insurance for which I use A2C Clinical Controller).

I dropped PracticeFusion because I had to type everything in. I called to ask if

they could accept images and that was not available yet. I can't remember if

scanned pages (PDFs) were available at the time or not.

With PracticeFusion, you get what you pay for - its free. But, it doesn't do

much yet for PTs.

Tim , PT

www.PhysicalTherapyDiagnosis.com

>

>

> I have signed up for Practice Fusion but have not started using it. Jackie -

Any recommendations on setting it up for PT? If you want, please contact me via

phone. I would love any suggestions you would have.

>

> I feel paying for the exorbitant fee associated with EMR systems is not

justified for the systems out there. We have stayed with the paper system and

scan everything in via a Fuji dual-sided scanner to create our final records. My

team and I have found it faster and easier than the current EMR systems

available.

>

> Be Well!

>

>

> Sasha Digges, Jr. PT, ATC, CSCS

>

>

>

> PEAK Physical Therapy

> & Sports Rehabilitation

> 344 McLaws Circle

> burg, VA. 23185

> Phone:

> Fax:

> Website: www.ineedpeakpt.com

> Twitter: SashaDiggesPT

>

>

>

[Guest guest]

Hi Group!

 

ABNs have 3 options: Option 1 states we will bill MC.  MC will likely pay and

probably ask for a refund years from now making billing the patient that far

in the future unlikely. 

This seems quite unfair to the provider. 

Patients would want Option 1 checked if: 1) they hope to not pay for the

service  2) they need an EOB to bill secondary on their own.

 

What does a provider do here?

 

Thank you!

Schweitzer

Florida

 

 

 

To: PTManager

Sent: Wednesday, May 16, 2012 4:16 PM

Subject: Re: Web PT

 

I tried PracticeFusion for my cash-based practice (I have another, seperate

practice that bills insurance for which I use A2C Clinical Controller).

I dropped PracticeFusion because I had to type everything in. I called to ask if

they could accept images and that was not available yet. I can't remember if

scanned pages (PDFs) were available at the time or not.

With PracticeFusion, you get what you pay for - its free. But, it doesn't do

much yet for PTs.

Tim , PT

www.PhysicalTherapyDiagnosis.com

>

>

> I have signed up for Practice Fusion but have not started using it. Jackie -

Any recommendations on setting it up for PT? If you want, please contact me via

phone. I would love any suggestions you would have.

>

> I feel paying for the exorbitant fee associated with EMR systems is not

justified for the systems out there. We have stayed with the paper system and

scan everything in via a Fuji dual-sided scanner to create our final records. My

team and I have found it faster and easier than the current EMR systems

available.

>

> Be Well!

>

>

> Sasha Digges, Jr. PT, ATC, CSCS

>

>

>

> PEAK Physical Therapy

> & Sports Rehabilitation

> 344 McLaws Circle

> burg, VA. 23185

> Phone:

> Fax:

> Website: www.ineedpeakpt.com

> Twitter: SashaDiggesPT

>

>

>

[Guest guest]

Hi ,

I believe you are interpreting this incorrectly. Medicare has a prompt

pay law so if you submit a claim for the service you list on the ABN, you

will know in a reasonable amount of time whether they will pay or not.

The refund would then be to the patient not to Medicare.

Option one is pretty clear. The person checking this is stating that they

understand that the listed service may not be reimbursed by Medicare and

that they will pay out -of-pocket for that service. If you submit the

claim to Medicare and they do pay for that service, then you are agreeing

to refund the cost of service to the patient.

This also allows clinics to continue to request payment at time of service.

M Howell, PT, MPT

IPTA Payment Specialist

Meridian, ID

thowell@...>

Hi Group!

>  

> ABNs have 3 options: Option 1 states we will bill MC.  MC will likely

> pay and probably ask for a refund years from now making billing the

> patient that far in the future unlikely.  This seems quite unfair to

> the provider. 

> Patients would want Option 1 checked if: 1) they hope to not pay for the

> service  2) they need an EOB to bill secondary on their own.  

> What does a provider do here?

>  

> Thank you!

> Schweitzer

> Florida

>  

>  

>  

>

> To: PTManager

> Sent: Wednesday, May 16, 2012 4:16 PM

> Subject: Re: Web PT

>

>

>  

> I tried PracticeFusion for my cash-based practice (I have another,

> seperate practice that bills insurance for which I use A2C Clinical

> Controller).

>

> I dropped PracticeFusion because I had to type everything in. I called

> to ask if they could accept images and that was not available yet. I

> can't remember if scanned pages (PDFs) were available at the time or

> not.

>

> With PracticeFusion, you get what you pay for - its free. But, it

> doesn't do much yet for PTs.

>

> Tim , PT

> www.PhysicalTherapyDiagnosis.com

>

>

>>

>>

>> I have signed up for Practice Fusion but have not started using it.

>> Jackie - Any recommendations on setting it up for PT? If you want,

>> please contact me via phone. I would love any suggestions you would

>> have.

>>

>> I feel paying for the exorbitant fee associated with EMR systems is

>> not justified for the systems out there. We have stayed with the paper

>> system and scan everything in via a Fuji dual-sided scanner to create

>> our final records. My team and I have found it faster and easier than

>> the current EMR systems available.

>>

>> Be Well!

>>

>>

>> Sasha Digges, Jr. PT, ATC, CSCS

>>

>>

>>

>> PEAK Physical Therapy

>> & Sports Rehabilitation

>> 344 McLaws Circle

>> burg, VA. 23185

>> Phone:

>> Fax:

>> Website: www.ineedpeakpt.com

>> Twitter: SashaDiggesPT

>>

>>

>>

[Guest guest]

When the Medicare patient signs the ABN and chooses Option number 1, the patient

is saying they want the service, but also want the Medicare program billed to

see what happens. When you bill the service you expect Medicare to deny, besides

applying the appropriate therapy modifier such as GP, GO, or GN, you also need

to append the GA modifier to that code on the claim form. The GA modifier

indicates to your Medicare contractor that you expect them to deny the service

and you had the patient sign an ABN. Once the patient signs the ABN, you can

collect your fee from the patient at time of service. If the Medicare program

ends up paying you, you must accept Medicare payment and refund the patient

their payment minus any co-insurance or deductible that is their responsibility.

If you feel the Medicare program paid you in error, you can always contact them

and try and work it out that way as well.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

http://www.gawendaseminars.com

> Hi Group!

>

> ABNs have 3 options: Option 1 states we will bill MC. MC will likely pay and

probably ask for a refund years from now making billing the patient that far in

the future unlikely.

> This seems quite unfair to the provider.

> Patients would want Option 1 checked if: 1) they hope to not pay for the

service 2) they need an EOB to bill secondary on their own.

>

> What does a provider do here?

>

> Thank you!

> Schweitzer

> Florida

>

>

>

>

> To: PTManager

> Sent: Wednesday, May 16, 2012 4:16 PM

> Subject: Re: Web PT

>

>

> I tried PracticeFusion for my cash-based practice (I have another, seperate

practice that bills insurance for which I use A2C Clinical Controller).

>

> I dropped PracticeFusion because I had to type everything in. I called to ask

if they could accept images and that was not available yet. I can't remember if

scanned pages (PDFs) were available at the time or not.

>

> With PracticeFusion, you get what you pay for - its free. But, it doesn't do

much yet for PTs.

>

> Tim , PT

> www.PhysicalTherapyDiagnosis.com

>

>

> >

> >

> > I have signed up for Practice Fusion but have not started using it. Jackie -

Any recommendations on setting it up for PT? If you want, please contact me via

phone. I would love any suggestions you would have.

> >

> > I feel paying for the exorbitant fee associated with EMR systems is not

justified for the systems out there. We have stayed with the paper system and

scan everything in via a Fuji dual-sided scanner to create our final records. My

team and I have found it faster and easier than the current EMR systems

available.

> >

> > Be Well!

> >

> >

> > Sasha Digges, Jr. PT, ATC, CSCS

> >

> >

> >

> > PEAK Physical Therapy

> > & Sports Rehabilitation

> > 344 McLaws Circle

> > burg, VA. 23185

> > Phone:

> > Fax:

> > Website: www.ineedpeakpt.com

> > Twitter: SashaDiggesPT

> >

> >

> >