Fix ASC Billing Margins to Protect Surgical Revenue

-
Image
Fix ASC Billing Margins to Restore Financial Stability Ambulatory Surgery Centers (ASCs) are under increasing financial pressure. Rising supply costs, staffing challenges, payer reimbursement cuts, and complex billing rules are steadily shrinking profitability. When billing inefficiencies exist, even high surgical volume cannot protect ASC billing margins. Fixing ASC billing margins requires more than increasing case volume. It demands accurate coding, clean claims, payer compliance, and a disciplined revenue cycle strategy. Without these elements in place, revenue leakage becomes inevitable. Why ASC Billing Margins Are Declining ASC billing margins are declining across the U.S. healthcare system due to a combination of operational and reimbursement-related factors. Many of these issues remain hidden until cash flow is already impacted. Key contributors include: Underreported procedures and implants Incorrect CPT, HCPCS, and modifier usage Missed or delayed pre-authorizations ...
Post a Comment

Getting Paid for Telehealth Physical Therapy

-

 

gettingpaidfortelehealthphysicaltherapy.jpg

Basics of Telehealth Physical Therapy

Medicare covers three types of telehealth physical therapy services i.e., telehealth services, e-visits, and virtual check-ins. But physical therapist still needs to follow a few basic practices for getting paid for telehealth physical therapy, let’s discuss them. During the c, the federal government has broadened access to telehealth services including physical therapy. With revised billing guidelines, all beneficiaries can now connect with their healthcare providers online, and providers will get the same reimbursement for these services as they would for in-person sessions.

Verification of Identity

Given that in the telehealth clinical setting, the beneficiary and therapist are not in the same location and may not have established a prior in-person relationship, it is critical, at least initially, that the identities of the physical therapy providers and beneficiaries be verified. Photo identification is recommended for both the beneficiary and all parties who may be involved in the delivery of care to the beneficiary. The photo identification, at minimum, should include the name of the individual; however, personal information such as address or driver’s license number. 

Informed Consent 

Just as PTs must follow state law requirements and professional best practices for acquiring informed consent for in-person encounters, the same requirements should be followed for the delivery of physical therapy services via telehealth technologies. Given the unique nature of the provision of services through telehealth, there are some special considerations including: 

  • Consent to be photographed, recorded, or videotaped and consent to the storage of the encounter data, if applicable. Disclosure should be made as to how long data will be stored. 
  • Consent procedures should include a hold harmless clause for medical or other information lost because of technology failures. Beneficiaries should be informed of the possibility of failure of the technologies used to provide telehealth services.

Standards of Care 

It is the responsibility of the PT to ensure the standard of care required both professionally and legally per the Practice Act is met. As such, it is incumbent upon the PT to determine which beneficiaries and therapeutic interventions are appropriate for the utilization of technology as a component of, or instead of, in-person provision of physical therapy care.

Physical therapy providers shall be guided by professional discipline, the best available evidence, and any existing clinical practice guidelines when practicing via telehealth. Physical therapy interventions and/or referrals/consultations made using technology will be held to the same standards of care as those in traditional (in-person) settings.

To learn more about Getting Paid for Telehealth Physical Therapy, click here: https://bit.ly/3S0BZdJ, Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

Comments

Post a Comment

Popular posts from this blog

How to Reduce Days in A/R with Smart Denial Management Strategies

-
Image
 Timely reimbursement is the lifeblood of a financially healthy medical practice. Yet, increasing Days in Accounts Receivable (A/R) continues to be one of the most pressing revenue cycle issues for healthcare providers. One of the major culprits behind this issue? Denials. In this blog, we explore how strategic denial management not only reduces days in A/R but also improves cash flow and strengthens your bottom line. Understanding Days in A/R Days in A/R refers to the average number of days it takes for a practice to collect payments due after services have been provided. Industry benchmarks typically suggest keeping A/R days under 35. Anything higher signals inefficiencies - and likely unresolved denials. How Claim Denials Affect A/R Denied claims delay payments and increase administrative burden. Without an effective process to identify, appeal, and correct them, your A/R days will climb - and revenue will suffer. Top causes of denials include: Missing or incorrect ...
Read more

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

-
Image
Managing a medical practice comes with its fair share of challenges—from patient care to staffing and compliance. But one of the most overlooked factors impacting a practice’s financial health is inefficient billing . That’s where outsourced medical billing comes in—not just as a cost-cutting solution, but as a profitability booster . Here’s how outsourcing your medical billing can significantly improve your bottom line. 1. Reduced Administrative Costs Running an in-house billing department requires trained staff, billing software, continual updates, and compliance oversight. These overhead costs can add up quickly. Outsourcing eliminates the need for these expenses, allowing you to pay only for the services you use —often at a fraction of the cost. 2. Faster Claim Submission and Reimbursement Professional billing companies are equipped with experienced teams and advanced tools that ensure quick and accurate claim submission . This minimizes delays and accelerates cash flow , g...
Read more

Understanding the Differences Between Claim Denials and Rejections in Medical Billing

-
Image
In the world of medical billing, two terms often cause confusion for healthcare providers and billing staff alike: claim rejections and claim denials . While both impact revenue and delay reimbursements, they are not the same —and understanding the difference is key to faster, cleaner claim processing. Let’s break it down. What Is a Claim Rejection? A claim rejection occurs when a claim is never accepted into the payer’s adjudication system . It is blocked due to errors or missing information , such as: Incorrect patient demographics Invalid insurance ID numbers Incomplete CPT or ICD-10 codes Formatting errors (especially in EDI files) These claims must be corrected and resubmitted —but the good news is they haven't been officially processed yet, so no appeal is needed . What Is a Claim Denial? A claim denial happens after the payer reviews and processes the claim , then decides not to pay it . Reasons may include: Lack of medical necessity Services n...
Read more