{"id":7510,"date":"2019-12-31T10:07:34","date_gmt":"2019-12-31T15:07:34","guid":{"rendered":"https:\/\/systems4pt.com\/staging\/?p=7510"},"modified":"2020-02-21T09:30:56","modified_gmt":"2020-02-21T14:30:56","slug":"three-must-cover-tasks-for-the-2020-new-year","status":"publish","type":"post","link":"https:\/\/systems4pt.com\/staging\/three-must-cover-tasks-for-the-2020-new-year\/","title":{"rendered":"Three MUST COVER  PT\/OT Tasks for the 2020 New Year"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 1170px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:30px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><h1 style=\"text-align: center;\"><strong>Three <u>MUST COVER<\/u> PT\/OT Tasks for the 2020 New Year<\/strong><\/h1>\n<h3><strong>There are three tasks that MUST be covered for the new year:<\/strong><\/h3>\n<ol>\n<li>Update patient eligibility and benefits<\/li>\n<li>Establish your deductible\/co-insurance collection plan<\/li>\n<li>Initiate the new CMS assistant modifier and required defensive documentation<\/li>\n<\/ol>\n<h2><span style=\"color: #008080;\"><strong>UPDATE PATIENT ELIGIBILITY AND BENEFITS<\/strong><\/span><\/h2>\n<h3><strong>Systems 4PT <\/strong><strong>Practices:\u00a0 <\/strong><\/h3>\n<ul>\n<li>Use the PET (Patient Eligibility Tool) to verify patient eligibility, coverage end date, copay, deductibles, and co-insurance with one click<\/li>\n<li>Note that the Benefits used has been reset to 0 for all applicable Medicare patients<\/li>\n<li>Reset the Medicare cap to $2,080<\/li>\n<\/ul>\n<h3><strong>Non-Systems 4PT Practices:<\/strong><\/h3>\n<ul>\n<li>Contact the payer for each active patient\n<ul>\n<li>Verify that coverage is active, verify the end date<\/li>\n<li>Verify copay for 2020<\/li>\n<li>Verify co-insurance and deductible amounts for 2020<\/li>\n<li>Remove the KX modifier for all applicable Medicare patients<\/li>\n<li>Reset the Medicare cap to $2,080 for all Medicare patients<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><strong>All Practices:<\/strong><\/h3>\n<p>Update the number of authorized visits for all applicable commercial or WC patients<\/p>\n<h2><span style=\"color: #008080;\"><strong>ESTABLISH YOUR DEDUCTIBLE &amp; CO-INSURANCE COLLECTION PLAN<\/strong><\/span><\/h2>\n<h3><strong>Systems 4PT <\/strong><strong>Practices: <\/strong><\/h3>\n<p><strong>Because EMR and billing are integrated into a single database,<\/strong><\/p>\n<ul>\n<li>Confirm that all front desk staff are in \u201cNew Year Mode\u201d and are checking the automated \u201cco-insurance and deductibles due\u201d fields in the Patient Processing Screen<\/li>\n<li>Emphasize the need to collect these balances on intake with each visit<\/li>\n<li>Twice weekly, run integrated reports to monitor patient balances and react accordingly<\/li>\n<\/ul>\n<h3><strong>Non-Integrated EMR\/Billing (Web-based PT EMR):<\/strong><\/h3>\n<ul>\n<li>Assign front desk staff that must, <u>EVERY DAY<\/u>:\n<ul>\n<li>Identify which patients are scheduled for the day<\/li>\n<li>For each patient, log into the separate billing software and look up deductible and co-insurance due\n<ul>\n<li>You may need to pay for \u201cextra log ins\u201d in the separate billing software<\/li>\n<\/ul>\n<\/li>\n<li>Create a manual list of amounts due from each patient for that day<\/li>\n<li>Collect these amounts on intake\n<ul>\n<li>Repeat daily<\/li>\n<\/ul>\n<\/li>\n<li>Twice weekly, practice directors should log into the separate billing system\n<ul>\n<li>Review self-pay aging, by patient, if such a report is available<\/li>\n<li>React accordingly<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Reiterate EVERY DAY that deductibles and coinsurances have \u201creset.\u201d\u00a0 Maintain this aggressive co-insurance\/deductible collection focus.\u00a0 Constantly.<\/p>\n<ul>\n<li>This will increase\/decrease your first-quarter collections by tens of thousands of dollars<\/li>\n<\/ul>\n<h2><span style=\"color: #008080;\"><strong>INITIATE THE NEW CMS ASSISTANT MODIFIER AND REQUIRED DEFENSIVE DOCUMENTATION<\/strong><\/span><\/h2>\n<ul>\n<li>Confirm that therapists, assistants, and practice directors understand the new CMS modifiers, including the 10% \u201cde minimis\u201d rule<\/li>\n<li>Confirm that PTs, OTs, and assistants (PTAs, COTAs) understand the necessity to add the new modifiers on all applicable visits<\/li>\n<li>Confirm that therapists and assistants understand the necessity for defensive documentation, clarifying \u201cwho delivered how much content for each CPT code\u201d<\/li>\n<\/ul>\n<h3><span style=\"color: #008080;\"><strong>Refer to the Actual Wording for the CMS Final Rule<\/strong><\/span><\/h3>\n<p><em>\u201cCorrect billing requires sufficient documentation in the medical record to support the codes and units reported on the claim, including those reported with and without an assistant modifier\u2026 the documentation in the medical record must be sufficient to know whether a specific service was furnished independently by a therapist or a therapist assistant, or was furnished \u201cin part\u201d by a therapist assistant in sufficient detail to permit the determination of whether the 10 percent standard was exceeded.\u201d<\/em><\/p>\n<h3><strong>Systems 4PT <\/strong><strong>Practices:\u00a0 <\/strong><\/h3>\n<ul>\n<li>Advise staff that the CMS\u2019 assistant modifiers and defense are automated\n<ul>\n<li>Refer staff to Systems 4PT Software Support Services if they have questions<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><strong>All Other Practices: <\/strong><\/h3>\n<ul>\n<li>Review the 10% de minimis rule\n<ul>\n<li>Print the Systems 4PT 10-question quiz to determine if therapists understand this rule\n<ul>\n<li><strong><em>Hint:<\/em><\/strong> On average, therapists are getting 6 out of 10 questions correct for this new CMS requirement, which means they\u2019re \u201caudit bait.\u201d<\/li>\n<li><strong><em>Here\u2019s the link:<\/em><\/strong><\/li>\n<li><a href=\"https:\/\/systems4pt.com\/staging\/can-you-pass-the-cms-assistant-modifier-quiz\/\">https:\/\/systems4pt.com\/staging\/can-you-pass-the-cms-assistant-modifier-quiz\/<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Review the CQ vs. CO modifier and how to add it to all applicable patient visits: evals, daily notes, and re-evals<\/li>\n<li>Reiterate the protocols for adding modifiers when assistants treat, and reiterate the necessity to document \u201cwho delivered what content for each CPT code,\u201d even if assistants were not involved<\/li>\n<li>Finally, demonstrate examples of compliant documentation (25- 50 words on each note)<\/li>\n<\/ul>\n<h3>These New Year protocols beg the question:<\/h3>\n<p style=\"text-align: center;\"><strong><span style=\"color: #008080;\">When it comes to unpaid patient balances, declining collections, Medicare compliance, therapist homework and burnout,<\/span><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><span style=\"color: #008080;\">Is your EMR\/billing\u00a0 part of the problem?<\/span><\/strong><\/p>\n<p style=\"text-align: center;\"><strong><span style=\"color: #008080;\">Or are they the solution?<\/span><\/strong><\/p>\n<p>Systems 4PT cares about your collections.\u00a0 We care about your therapists.\u00a0 And we care about your compliance.<\/p>\n<p>Here\u2019s to a fantastic 2020!<\/p>\n<h2 style=\"text-align: center;\"><span style=\"color: #78be20;\"><strong>Treat More, Type Less<\/strong><strong>&#x2122;<\/strong><\/span><\/h2>\n<\/div><div class=\"fusion-text fusion-text-2\"><h2 style=\"text-align: center;\"><strong>Sign-Up for a Free Demo<\/strong><\/h2>\n<\/div>[contact-form-7 id=\"5393\" title=\"Free Demo_copy\"][fusion_blog layout=&#8221;grid&#8221; blog_grid_columns=&#8221;&#8221; blog_grid_column_spacing=&#8221;&#8221; blog_masonry_grid_ratio=&#8221;&#8221; blog_masonry_width_double=&#8221;&#8221; equal_heights=&#8221;yes&#8221; 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hide_on_mobile=&#8221;small-visibility,medium-visibility,large-visibility&#8221; class=&#8221;&#8221; id=&#8221;&#8221; \/]<\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":7511,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[56],"tags":[49],"class_list":["post-7510","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-emr"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.4 (Yoast SEO v26.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Three MUST COVER PT\/OT Tasks for the 2020 New Year - Systems4PT<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta 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