Outsourced Medical Billing for Small Practices in the USA

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Introduction to Outsourced Medical Billing Running a small medical practice in the United States can feel like juggling flaming torches while riding a unicycle. You’re expected to provide high-quality patient care, manage staff, keep up with regulations, and still make sure the practice remains profitable. One of the biggest hidden challenges? Medical billing. This is where outsourced medical billing for small practices in the USA has emerged as a game-changing solution. Medical billing isn’t just about sending claims and waiting for payments. It’s a complex, ever-evolving process that requires precision, compliance, and constant updates. For small practices with limited staff and resources, managing billing in-house often leads to delays, errors, and lost revenue. Outsourcing medical billing allows providers to hand over this burden to specialized professionals who live and breathe revenue cycle management. In today’s healthcare environment, where reimbursements are shrinking and regu...
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Common Outpatient Rehabilitation Therapy CERT Errors

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Billing Part B Outpatient Therapy Services

Outpatient rehabilitation therapy includes Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) services. Medicare covers outpatient PT, OT, and SLP services when:

  • A physician or Non-Physician Practitioner (NPP) certifies the “treatment plan,” called the Plan of Care (POC), ensuring:
    • A patient needs therapy services 
    • POC is: 
      • Established by a physician, NPP, our qualified therapist provides services 
      • Reviewed periodically by a physician or NPP 
    • A patient gets services under physician care 
  • POC certifying the provider’s name and NPI is on the claim 
  • Providers meet medical necessity, documentation, and coding requirements

where, 

  • CERT: Comprehensive Error Rate Testing
  • A physician is a Doctor of Medicine, osteopathy, podiatric medicine, and optometry (only for low vision rehabilitation). 
  • NPP includes a Physician Assistant (PA), Clinical Nurse Specialist (CNS), or Nurse Practitioner (NP). 
  • A qualified Therapist includes a PT, OT, or SLP who meets regulatory qualifications as applicable, including state licensure or certification.

Common Outpatient Rehabilitation Therapy CERT Errors

  • Missing certification and recertification(s): Physician’s, NPP’s, or therapist’s dated signature(s) approving the POC. Prevention: Confirm physician or NPP certified the POC (and recertified it when appropriate) with their signature and date.
  • Missing signature: Physician, NPP, or therapist who developed the POC and established treatment plan date. Prevention: Ensure you add your dated signature and professional identification (for example, PT, OT).

To learn more about Common Outpatient Rehabilitation Therapy CERT Errors, click here: https://bit.ly/3qSdiEY Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

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