5 Billing & Coding Strategies to Improve Reimbursement

Question:  Dr. Kotlar, “I am seeing more patients this year compared to last year, but I’m not collecting more money. I’ve been documenting the same way for the last 8 years, and I think my recordkeeping, coding, and collection systems are outdated. Can you share some tips to help me improve?” Answer:  Yes, here are 5 ways to improve coding, …

Anthem, Aetna, Cigna Updates on TENS and Knee and Back Braces

UPDATE: T.E.N.S. & Anthem BC/BS FDA-approved T.E.N.S. units are considered medically necessary when prescribed as a treatment for pain for those who have not responded to other modalities, and the pain is related to a musculoskeletal condition or the pain associated with an active or post-trauma injury. FDA-approved T.E.N.S. garments are considered medically necessary when there is a large area …

Follow This 9-Step Action Plan for the Health of Your Clinic

Question: Dr. Kotlar, “I want to make sure I’m doing everything right from a compliance stand-point. What do you recommend?” Answer: I am a frequent speaker at many healthcare conferences nationwide and one of the most common statements I hear attendees say is that they want to make sure they’re doing everything right. My typical response is “make compliance a …

Insurance Reimbursement and the 35% Rule

Do you collect more than 35% of your income from one insurance company? When was the last time you calculated the amount of money you collect from the insurance companies you bill the most? Many physical therapists would close down if insurance didn’t exist. Making $40 per visit is not enough. Follow this simple action plan “just in case” Blue …

Deductibles, Co-pays & Co-insurance: Info you need to know

Deductibles Are Too High The recent increase in deductibles and co-pays has negatively affected many patients and practices. If you’re out-of-network, do you have to collect the full deductible? Is it possible to waive a portion of the co-insurance? Should you lower your fees to improve patient compliance? Let’s Discuss Fees Let’s begin by discussing fees. There are 3 factors that usually …

The Importance of Administrative Excellence

Reach Your Maximum Potential Through Administrative Excellence I was looking at job postings recently, and one literally asked: “Do you have 6 arms and 6 legs and can do ten things at once?” If you guessed that this job description was for a front desk assistant, then you’d be right. The front desk is the nerve center of the clinic …

Lori Allen

Featured Presenter and Educator

4 Reasons to have a Billing Policy Manual

For Staff Staff members want organization and leadership. They want to work in an ethical and trustworthy atmosphere. A billing & coding policy manual creates a culture of compliance and is an extension of your mission and values. Also, if you have a staff member who is accusing the business owner of wrongdoing, a policy manual can contain the ammunition …

Billing & Coding for Extremity Conditions

Question: “I treat a lot of extremity conditions. On some patients I will do soft tissue mobilization on a rotator cuff strain, therapeutic stretching on an inflamed elbow and myofascial release on a contracted and painful iliotibial band all on the same visit. If I spend approx. 45 minutes with the patient, how do I compliantly code and bill for this? …

Billing and Coding for Elastic Therapeutic Taping

Billing and Coding for Elastic Therapeutic Taping

Question:  Dr. Kotlar, “I just started using therapeutic taping on my patients. Is this a payable service by insurance companies? If yes, how do I bill for it?” Answer:  I have read differing opinions on how to bill and code for therapeutic taping. My opinion may differ from what you’ve heard, so please due your due diligence to educate yourself on this topic …