Medicare is a type of federal health insurance. It’s for people who are 65 years of age and above, young people with disabilities, and those with certain qualifying health conditions. Medicare may cover three different sectors. These are hospital insurance, medical insurance and prescription drug coverage.
Are you a physical therapy owner who frequently sees older patients? It’s likely that a large number of your patients will want to use Medicare to cover the costs of their sessions. You can choose to accept or deny Medicare at your clinic. If you accept it, you’ll need to ensure that your clinic remains compliant with Medicare billing guidelines. To learn more about these compliance guidelines, take a look at the checklist below.
A checklist: How your PT clinic can ensure compliance with Medicare regulations
- Give patients with conflicting insurance plans coverage from the stricter plan — Sometimes a patient who has both Medicare and Medicaid comes into your office for treatment. You might find that the coverage specifications can be different between the two. In the case that your patient has both Medicare and Medicaid, you’re expected to use the coverage plan that is more conservative.
- Keep up-to-date charts with records of medically necessary treatments — To determine if a session will be covered by Medicare, you must keep regular documentation on the patient's condition. Medicare will only cover physical therapy treatments that are medically necessary.
- Hire a compliance and billing professional — One of the best ways to ensure that your physical therapy clinic stays within Medicare’s compliance regulations is to hire a professional with experience in PT compliance and billing. They can keep you within the guidelines you need to be and prevent any issues you may miss on your own. They’re also a good resource for learning about the basics of any compliance program.
Alliance PTP can provide the complete Medicare compliance and billing checklist for your clinic
Alliance Physical Therapy Partners firmly believes that partnership means creating something that is greater than the sum of its parts. Alliance PTP is proud to bring together physical therapy clinics around the nation to help people get the kind of treatment they’re looking for and then exceed their expectations. Want to learn more about joining Alliance PTP’s growing list of partners? You can read more on our page for practice owners here. If you’d like to find out more from Alliance PTP, don't hesitate to reach out. We can help your physical therapy clinic stay compliant with the Medicare regulations not listed in this checklist. Not only this, but we can potentially help you get higher reimbursement rates from billing. We specialize in meeting the compliance and billing needs of several of our partners.
Contact our team today for more information about how we can help your practice or to find out how you can join our partnership in care.