Practice Management team plays key role at PPS conference

Connie Ziccarelli, COO & Director of Managed Care Operations; and Kevin Svoboda, PT & Director of Work Injury Program Initiative and Clinical Competencies, were honored to represent our clinics at the annual Private Practice Section conference of the APTA in November. Connie is a seasoned Administration member of the PPS, with 12 years experience, and serves as a co-chair and member of the Administrative Council. 

Our providers' Medicare claim error rate is less than one percent and it continues to lead the industry. According to APTA-endorsed industry experts, the national physical therapy Medicare claim error rate average is 24 to 26 percent.

Jodi Woodward, Director of Medical Billing, applauds our providers and Practice Management team for continuing to meet this incredible standard. The Pre-Bill Audit System is one facet of this success. Using that system, each piece of claim documentation that gets sent to Medicare is reviewed by an in-house auditor and biller that specialize in Medicare. 

Account specialists also review each line of a Medicare claim for the proper coding and modifiers. Providers contribute when they send compliant, accurate and timely documentation showing the medical necessity for physical therapy services. This allows for accurate billings to Medicare. »»» Read more

The Work Injury Program Initiative has increased workman's compensation billables by 353% in our Illinois market. After ongoing consultation with the Practice Management team, Jon DeBord, PT & Local Clinic Owner and Director, empowered a key player on his staff, Scott Salisbury, DPT, to manage his clinics' workman's compensation program.

The Practice Management team is proactively working to ensure all clinics stay up to date on changes in Medicare and Medicaid rules. Connie Ziccarelli, COO & Director of Managed Care Operations; Kevin Svoboda, PT & Director of Clinical Competencies and Emily Monson, PT & Local Clinic Director and Owner, Clear Lake Physical Therapy, formed a committee and created multiple webinar series on Medicare compliance, Medicaid documentation and how to successfully secure reimbursement from large insurance companies.

"There are constant changes with Medicare regulations which are found on the Medicare website, within our professional journals and on our profession's website, which most licensed therapists are already reading in order to protect their professional viability," Kevin said. "We try to refresh them on these changes and collaborate on how to implement these expectations into their practice."

Kevin acknowledged that therapists might be anxious about Medicare's Recovery Audit Contractor system. The goal of the webinar series, however, is to proactively refresh the clinic staff on rule changes and increase the likelihood of passing if it is audited. In fact, because of clarification and reinforcement in the webinar series, two clinics have passed random Medicare compliance audits 100%.

Connie, Kevin and the Practice Management team also have presented webinars on how to document for Medicaid at the local and regional level. These refreshers were created to ensure each patient visit is documented correctly and authorized by Medicaid. Lastly, Connie and Kevin presented a webinar on how to apply successful principles of documentation and reimbursement to large insurance companies. Clinics have access to the webinar material and a dedicated team of compliance experts at any time.

Spine and Sport PT & Aquatics landed an opportunity with an international food ingredient and pharmaceutical company to provide on-site injury prevention and consulting services. 

The partnership came through collaboration with Fred Shonkwiler, MPT & Local Clinic Owner and Director, Spine & Sport Physical Therapy; and Kevin Svoboda, PT & Director, Work Injury Program Initiative. The partnership is helping increase Fred's market share in the workman's compensation segment of the market in northwest Missouri. »»» Read more

The Practice Management Team - consisting of Connie Ziccarelli, COO & Director of Managed Care Operations; Catherine Saaski, Director of Patient Accounts and Jodi Woodward, Director of Medical Billing - will launch a program in 2011 designed to lessen impact on the environment.

The Go Green initiative will encourage patients to sign up for electronic statements, and opt out of receiving paper statements. Patients also can pay their bill online, rather than by mail. 

The move is designed to lessen the amount of paper patients use when conducting their clinic transactions, as well as provide more ease and convenience. It's estimated that thousands of trees are used every month to make millions of paper billing statements for healthcare services. 

The service will be as secure and easy as online banking and will be available for every partnered clinic. Look for more details on the program in the near future.

» FSA, HRA or HSA funds can no longer be used to purchase OTC medicine and drugs unless a medicine or drug is prescribed. A "prescription" means a written or electronic order for a medicine or drug that meets the legal requirements of a prescription in the state in which the medical expense is incurred and that is issued by an individual who is legally authorized to issue a prescription in that state.

» You can continue to use your FSA, HRA or HSA funds to purchase OTC items that are not considered a medicine or drug. Please note that insulin remains an eligible expense with or without a prescription.

» Any FSA enrollee who used a debit card in 2010 should use the same card in 2011, as it will reload.

» Updated Employee Handbooks will be distributed the week of Jan. 3, 2011. The Section 14 acknowledgement form should be signed and returned by Feb. 1.

With an eye toward continuing education, Practice Management leaders organized several learning sessions and proficiency exams for technological advancement. The programs served as a refresher and also as continuing education for any staff that may have needed their skills fine-tuned. 

Jodi Woodward, Director of Medical Billing, applauded her team for its enthusiasm.

"It's really nice because we have people with all different skill sets when it comes to technology," she said. "It gave us an opportunity to know that our entire team is proficient and can independently operate with these industry programs."

One great patient visit led to an up spike in direct referrals for Skyline Physical Therapy. After treating a patient who works at a local supermarket chain in Arizona, Michelle Bambenek, DPT & Local Clinic Director, saw an increase in direct referrals for workman's compensation patients. 

The company said that most importantly, it liked the way Michelle and Skyline Physical Therapy communicated proactively with it and the insurance company. It also said it respected the patient's physical therapy program and the way the patient was treated. This partnership is ongoing and has great potential for future growth with other industrial rehabilitation patients. »»» Read more