July 28, 2011
PPSIG Provides Help With Complex and Evolving Billing Practices
If you are a PT in private practice, you are probably following what is happening with our profession on the national level. But are you up-to-speed – do you have the latest scoop – on the changes and happenings in Washington that affect your clinic? For instance, do you know…
- Which third party payers will now pay for physical therapy services provided under locum tenens arrangements (locum tenens are therapists who cover for PTs who are away from the clinic for vacations, medical leaves, CE, etc.)? Do you know how to bill for these services? Do you use a modifier? Are there limits on the amount of time you can use a locum tenens provider? Does L&I or Medicare allow PTs to bill for locum tenens services?
- About the recent change in Washington law to require health insurers that provide coverage for prescribed DME and mobility enhancing equipment to include the sales tax or calculated use tax in their payment to providers? Do you know how to calculate and bill the health plan for the tax? Do you invoice with a separate line item and what HCPCS code do you use? Who is responsible for remitting the tax to the state?
- That some MedAdvantage plans require specific documentation if you bill for services above the $1,870 cap on outpatient physical therapy? Do you know which plans require what documentation?
- That class action litigation has been filed in Washington on behalf of medical providers, including private practice PTs, against specific MVA carriers for automatically applying “UCR/geographic reductions” to providers’ billings in PIP claims using Ingenix as the basis for the reductions? Do you know how to keep current on the progress of this class action litigation?
- How to fight back when third party payers, such as MVA carriers and workers’ compensation third party administrators, apply a discount to your billings based on a PPO contract that you previously terminated or never even had?
Members of the PTWA Private Practice Special Interest Group (PPSIG) know the answers because PPSIG has the resources to keep its members informed. PPSIG takes the lead to solve problems and make changes to benefit our private practice members. We successfully took on the locum tenens issue and we’re now fighting on behalf of our members to stop unauthorized and improper PPO discounting. Our executive director, Diana Godwin, is an attorney who has spent the last 25 years representing private practice physical therapy clinics and she is available to help individual PPSIG members.
You can share in these benefits by becoming a member of PPSIG. Just go to our website, www.ppsig.org, and click on the “Renew Your Membership” tab in the left hand column. That will take you the application to join. Since we are half way through our membership year, we are offering new membership at just $150 for the principal member of the practice and $75 for associate members. Join today!
Shannon O’Kelley, PT
PTWA Private Practice Special Interest Group Chair
July 27, 2011
Consider Cultural Competency In Your Practice Setting
PTWA’s Cultural Competency Task Force invites you to consider how you might apply cultural competency to your practice. The task force’s mission is to heighten practitioners’ awareness of what cultural competency means in the workplace and community, and to facilitate and promote cultural diversity within the physical therapy profession.
What does cultural competence mean to you?
As you think about this, I thought it might be helpful for you to know the ethnic makeup of our state. According to the 2010 Census, there are more than 6.7 million residents in Washington, up 14 percent since 2000. King County is the largest county with a population of almost 2 million and Mason County the smallest with a population of about 61,000. According to the census, Washington is predominantly white with about 11 percent Hispanic or Latino, 7 percent Asian or Pacific Islander, 4 percent black, 2 percent American or Alaskan Indian Native and 3 percent mixed. While 69 percent white, 15 percent of King County’s population is Asian. Mason County is 86 percent white with an 8 percent Hispanic/Latino population.
Given this demographic information, can you think of ways to promote the cultural competency of the physical therapy profession in your community? And have you considered how gay, lesbian, bisexuals and transgender people fit into the concept of cultural competence? Think about how you can improve your awareness of cultural competency both in the workplace and in the community. We would love to hear any suggestions or ideas on the above facts.
Robert Cheng, PT, DPT, OCS, COMT
Chair, PTWA Cultural Competence Task Force
To share your thoughts and ideas with the task force contact Robert Cheng.
March 3, 2010
Dispatches from the Dominican Republic: Part Deux
PTWA member Bernice Kegel, PT, spent 10 days in the Dominican Republic with a team from Children of the Nations working with survivors of the Haiti earthquake. Here are excerpts from an email she sent PTWA Feb. 21:
I am starting to feel that we are making wonderful progress. The children are, for the most part, eager to learn and pick things up fairly quickly. You learn fast to be creative. Raye Pye sent me instructions on how to make parallel bars, and I have a fix-it guy out chopping down a tree to create that for us. The place has quite a few supplies, but nobody has the time to sort through any, so every now and again we make some wonderful discovery which makes us all excited. My big find today was an adult air cast, which is three times as big as I need, but with the two PTs, one on the floor and myself with the gait belt, we are able to give the two leg amputees that we have some sort of sense of what it feels like to walk with a prosthesis. I have brought with some flyers from Prosthetics Outreach Foundation, Amputee Coalition of America etc, which are generating much interest. We are using all sorts of things for purposes for which they were not designed, but it is fun. If any PT saw the stairway I was using for gait training, they would be aghast. One side is up against the building, but the other side is totally open and once you get to the top, it is about a 30-foot drop. I am trying to get someone to rig up a rope or something to make me feel better. It is pretty tiring, hot and sticky, but when you see the progress, it is really fun. It has been nice to have the group of counselors with us. They are available and willing to help out with throwing balls, balloons etc. I have learned one word in creole. A crutch is a “brekkie” and I would love to have a few more, and if they were pediatric, that would be a real bonus.
Thank you to everyone for your words of encouragement. My only real frustration (other than the HORRIBLE cold shower, and sometimes no water), is that one of my girl amputees is ready for a prosthesis, but I have no one to make it for her, or to train her how to use it. I am coming to terms with the fact that I am just here for 10 days, and someone else will hopefully take over where I leave off.
Time for bed.
Bernice
March 2, 2010
Pharmaco-Therapeutics at PTWA Spring Conference
I like drugs. And my dad sold drugs for almost 50 years until retiring this year. However, rather than selling them, I wanted to teach people how to use them…and that’s what I’ve been doing for the last 10 plus years.
As a pharmacist teaching at Idaho State University I have had the privilege of working with countless students, health care professionals and patients all the while trying to improve outcomes. Over the last six years I have worked with the DPT program at ISU teaching various topics to students in their therapeutic class and I must say that I initially thought, “Why does a PT or an OT need to know about drugs?” However, after working with them, I clearly understand how deep your understanding is of physiology, biochemistry and disease pathology…and more importantly that medications can play a significant role in either helping you reach your outcomes in patients, or prevent you because of side effects, sub therapeutic effects or other reasons.
And that’s why I’m excited to come to Tacoma and present on the basics of drug therapy to students, PTs and any one else willing to come and learn about medications. After reviewing some basic pharmacology for an hour or so, we’ll talk about legal issues and then get right into some meds for a variety of disease states like depression, anxiety, MS, HIV and others. Now, when I looked at the schedule and realized that I had six hours I knew that I had to do something to keep the audience engaged for this time…so I plan on bringing an audience response system for some question and answer time as well as cases where you can work with others during this session to discuss how you would handle a certain situation. Because if I had to listen to myself for six hours, I’d go crazy! See you in April!!
David M. Hachey, PharmD, BCPS
Clinical Associate Professor
Idaho State University
Dr. Hachey will present April 16 at PTWA Spring Conference. To register for his class, visit www.ptwa.org/conference.
February 25, 2010
One Member’s Olympic Experience
PTWA Editorial Advisory Committee member Joyce Middendorp spent some time at the Olympic Games last week and was kind enough to share her experience with us. Sounds like it was a great time!
Our journey started Wednesday when we took the Amtrak up to Vancouver, B.C. What a wonderful start to our experience, it was so beautiful along the sound with great views throughout. Once in Vancouver our first mission was find and get to the hotel, which was 30 minutes south of town and supposedly easily accessible by sky train. With all the helpers and great signs everywhere we were surprised how easy and convenient it really was to find.
Now onto our first adventure–a hockey game. The atmosphere was great, lots of local support, families, and of course both teams were well represented. It was very exciting with scoring back and forth right until the end when goals were being scored with ease for Switzerland. Overall it was a perfect start to our games! Again transit was a breeze with volunteers (or as the locals call them “smurfs,” because they are dressed in all blue) everywhere you looked. You couldn’t get lost if you wanted to. The only difficulty was getting used to being closer to people than you would like on the buses and trains but it wasn’t that bad.
The next day (Thursday) we were off to long track speed skating. After a great walk along the riverfront we enjoyed the speed skating. Being only two rows from the track was amazing… almost as amazing as getting an autograph and picture with Bonnie Blair! Which was a great way to spend the 15-minute break between the skaters! It was a little surprise perk that came with our package deal and I think it made everyone’s day.
Joyce (right) muggin' with Bonnie Blair
We then headed to explore the downtown, take in the scenes and of course see the Olympic Cauldron which was a “must do” on my list. Too bad you couldn’t get very close to it. Later that night we got to see several US athletes get their medals at the Vancouver Victory Ceremony including Shaun White and Scotty Lago for snowboarding, Shani Davis and Chad Hedrick for 1,000 meter speed skating, and the Canadian speed skater Christine Nesbitt who won by .02 seconds earlier that day in the 1000 meter distance. We then ventured down to the Olympic Superstore which we heard could have waits up to two to three hours but we got in 20 minutes. It was not as super as I had anticipated but of course we did spend some money there.
Then Friday (our long day) at Whistler started at 5 a.m. when we took a cab to catch our Olympic bus to the mountain (a two to three hour ride) where we saw ski jumping at 10 a.m. The entire venue rocked with a drum line on the sidelines, crowd trivia and lots of great jumps. Most importantly for me as a physical therapist, no one fell or got hurt! Some of the better European jumpers can really catch some air. This was most impressive. We even got to take some pictures of ourselves on a mock ski jumping setup and backdrop.
Bringing home the gold
After ski jumping we took another bus to Whistler Village where we walked around and saw several teams out and about. Whistler Village has a lot of hustle and bustle. After a bite to eat, we were off again up the mountain on the gondola to the Olympic Sliding Center to see skeleton. The higher you got the colder it was and as soon as we got to our seats (metal bleachers), we were not sure if having seats was such an advantage. The people on the ground standing at various turns, straight-aways and at the end seemed much warmer than we were. We enjoyed seeing the crazy sleds fly by so quick that it was hard to take many pictures. Unfortunately the Canadian (who was a favorite) did not place which bummed the crowd a little. It was not from a lack of support that’s for sure. After a long three hour ride down the mountain, we were able to take a short sea bus back to the train station which gave us more great view of the Olympic rings as well as the city lights and another view of the Olympic torch. Once back to the hotel, we collapsed and decided to sleep in the next day.
Saturday was quite the challenge in terms of taking the train due to MANY more people out and about. We first went to see the Ozone celebration site. There we saw the Olympic rings and a huge maple leaf all made out of cranberries which were unfortunately in a park instead of in the river as first planned due to fast currents. Nevertheless it was impressive. These celebration sites are everywhere in the surrounding cities and have many things to do, see, and partake in including a huge screen TV area where you can watch the events. Most of the day there is also live entertainment. After doing a little more shopping and grabbing our bags from the hotel we did manage to get to the Amtrak station although it did take some effort and some kind people to assure we succeeded.
Overall our experience was priceless. It was highlighted by seeing the Canadian spirit everywhere and across all age groups. The Canadians were full of pride especially after they won that first home turf gold medal. Canadians as a whole were very respectful, helpful, friendly and very polite. Overall it seemed as though the organizers did a great job in having enough buses, trains, etc to get everyone where they needed to be and on time. Of course a lot of our time was spent in lines for security, buses, trains, coffee, food and bathrooms but it was still fun and exciting. Everyone was in the same boat and really seemed to make the best of it. It was also nice to see the all the USA sweatshirts, flags, and memorabilia around the venues as we were well represented as expected. We were lucky enough to stand right next to an American luger and his family at the ski jump, we saw the speed skating team at the skeleton, got Bonnie Blair’s autograph and saw several other family members and USA Olympians out and about during the day which was all very exciting. I am so glad and thankful that we had the opportunity to partake in the games, thank you Canada for being such a great host!
Joyce Middendorp, MPT
February 24, 2010
Dispatches from the Dominican Republic
PTWA member Bernice Kegel, PT, is in the Dominican Republic with a team from Children of the Nations working with survivors of the Haiti earthquake. Here are excerpts from an email she sent PTWA Feb. 19:
We started our first day of work today. We are stationed at the Children of the Nations Clinic in Barahona, which is about three hours from Santo Domingo Airport. We are staying in a nice house, with good cooks, so our basic needs are taken care of.
From what I understand, a lot of surgeries were being done at a border town hospital in Jimani. Many, many surgeries were done, but there was no where for the patients to go. It was decided to take 10 pediatric patients from Jimani by helicopter to the Children of the Nations Clinic for post-op care. That number has flexed up and down since then. Some of the children have been sent back and forth to Santo Domingo for plastic surgery.
As I understand it, groups have been coming in and out every 10 days to assist. Today was changeover day, which means that there were many people sleeping here last night. Our group consists of an ER doc, a family practice doc from Issaquah, Bethany, a nurse from Virginia Mason, Eric Cairns, PT and myself. There is also a group of about six counselors, two who have already been here for a week, and another four from San Diego. There is an interest in getting children to talk about the trauma that they have sustained, without re-experiencing the trauma, which sounds really interesting to me. I wish I had better language skills to communicate with the parents. The Haitians speak French and Creole, and the Dominican Republic people speak Spanish. I speak none of the three. One of the children can speak English, and we have a few interpreters and parents who can help with this. I hear the children repeating “good job” already. The children have clearly been traumatized, and pain control issues are big. As a PT, we are never popular anyway. We are at five weeks post earthquake and I am shocked at how quickly the children have developed horrible flexion contractures. The lower extremity amputees sit with their hips and knees horribly flexed. I have been trying to explain to the parents that these issues need to be addressed before prosthesis can even be made. Needless to say, the parents are all asking when their child will get prosthesis. I hate to say it, but a few have shoulder disartics, and very high above elbow amputations, so the news that this will probably not happen needs to be broached. At the same time I have an above elbow amputee that is ready to be fit, but nobody available to fit her. One of the members of our team has carpenter, woodwork-type skills, so I am giving him a crash course in prosthetics and seeing if he can come up with some sort of knee weight bearing rig to try to take care of the hip flexion contracture. I also have a set of stairs to work with on the outside of the building, but there is no railing at all, and about a 30-foot drop. Scares me to death. I have one adult wheelchair which the children fight over, and two sets of adult crutches. I have no parallel bars, but rigged up two gurneys next to each other, with the side rails up. It sort of works. I have a small mirror, and some theraband. I don’t think I mentioned that the place we are working at is not a hospital. It was established as an outpatient day surgery center, I think for children with cleft palates. We have two dental chairs, an x-ray machine, and then the children are all in one big room. It is sort of organized chaos. Parents are put to work cooking and cleaning etc. All the children except two have someone with them. I think the adults are sleeping in the office building near by, and a few of the children are now “outpatients” but there is nowhere for them to go.
It has been a long day, and more emotional than I prepared myself for. Reading the charts (which are pretty incomplete), but it can break your heart if you try to think too far into the future.
*PTWA received an email from Children of the Nations this week expressing their desperate need for PTs and OTs to join their teams. Click here to find out how you can help.
December 8, 2009
PT Legislative Impact Day: Don’t Sit This One Out
It has been a while since your Manipulation Task Force (MTF) hit the road and shook the bushes for support on the spinal manipulation bill. However, don’t take the quiet for complacency. I can assure you that the legislative efforts have continued to be of primary importance to PTWA and the MTF. Over the summer and throughout this fall, negotiations have continued and legislators have been hearing from us. Now it’s time for all members of PTWA to jump back into the fight.
Legislative Impact Day is your day to show your support for the manipulation bill. On that day, January, 28 2010, we as a professional organization of highly qualified and ethical medical professionals will band together in support of our bill. It is no longer okay to sit and watch as a select few individuals carry the weight of your profession and your livelihood. I can’t fathom a situation where any one of us is satisfied with another profession deciding the care that you are capable of providing. Especially when the opponent is providing information that is inaccurate and simply not true, nor based on any supported evidence. How can we let that happen?! Obviously, we can’t.
So important is this fight that we have and continue to receive national attention. I get countless emails asking how the fight is going and offering support. Dr Tim Flynn, recent AAOMPT President wrote in a public statement: “Legislation in Washington state is currently being drafted to lift the regressive prohibition on physical therapists from utilizing spinal manipulation. It is time to bring health care in Washington into the 21st century.” Flynn continues, “The Department of Defense and the American Physical Therapy Association’s Scope of Practice, as well as 48 other states in our nation recognize physical therapists’ ability to perform spinal manipulation. Furthermore, the American College of Physicians and the American Pain Society (Chou, 2007) have published clinical practice guidelines recommending manipulation by physical therapists as the only proven treatment for patients suffering with acute low back pain.” So clearly the word is out and the support is at the national level.
However, though the attention is national, it can only be fought at the local level. That means you, as well as your colleagues, must take action and show your support for the spinal manipulation bill. Here is my challenge to each of you:
1) Invite your local legislators to your clinic. Show them what you do and what PTs are all about. Believe me, they don’t know what you do or the service you provide. Unfortunately, the public thinks all you do is offer massage. How sad is that?
2) You MUST attend Legislative Impact Day! To not come is inexcusable.
- I’ve tired of the excuse that you can’t afford to close your clinic for a day. The economic impact on your business and profession that you can gain from manipulation will pay for itself.
- Many of you are proud to say you’ve reached a certain skill level or certification and brag that you are a “manual therapist”. And yet, I fail to see you attend or give support. You prefer to rest on the work of others. Yes, I’m calling you out to “walk the walk” not just “talk the talk”. You should be setting the example as leaders in the cause.
3) Finally, bring a colleague along with you. Last year we had more than 600 attendees! As impressive as that was, we are shooting for 1,000 or more this year. We will be visible and we will be a force to be reckoned with.
I appreciate everyone’s work, especially the tireless dedication to those on the Manipulation Task Force and the Legislative Committee. We owe them a huge “thank-you” and pat on the back.
I hope you all have a wonderful and peaceful holiday season. Enjoy the family, friends and fruits of your labor. I will see you in Olympia on January 28, 2010.
Dr. Bob Boyles, PT, DSc, OCS, FAAOMPT
Clinical Associate Professor of Physical Therapy
University of Puget Sound
To register for PT Legislative Impact Day, visit www.ptwa.org/LegislativeImpactDay
November 16, 2009
Now or Never? Why You Need to Attend Legislative Impact Day in 2010
It is vital for our profession that we get our spinal manipulation bill heard and passed in 2010. As some of you know, PTWA member Richard Wright/Columbia Physical Therapy’s lawsuit against Benton Franklin Orthopedics regarding physician ownership of physical therapy services will probably be decided by the Washington state Supreme Court in 2010. If Columbia PT wins the lawsuit, PTWA might be forced to shift all of its legislative efforts away from spinal manipulation. This underscores the importance of a strong showing at this year’s Legislative Impact Day.
Last year, the chiropractors scoffed at our lobbyist when they heard we expected 400 people to attend our Legislative Impact Day. After that conversation, the Washington State Chiropractic Association scheduled their legislative day in Olympia on the same day as ours.
Imagine their surprise and frustration when, instead, 650 PTs, PTAs, students and supporters showed up. There were so many of us visiting with our legislators, that the 20 or so chiropractors there that day had a hard time getting in the door.
What would the impact be if we doubled that number?
Legislators love to hear from us. We want every legislator to know the PTs and PTAs in his or her district. Take the day off and come join us in Olympia.
Dr. Elaine Armantrout, PT, DSc, ECS
PTWA Legislative Committee Chair
It is free to attend Physical Therapy Legislative Impact Day. Please sign up online at: www.ptwa.org/LegislativeImpactDay.
October 29, 2009
PTs help out with Mary Meyer’s Get Out and Tri
Jason Steere, PT, ATC and Erik Moen, PT, of Corpore Sano PT (www.BikePT.com) in Kenmore, Wash. organized and headed medical coverage for Mary Meyer’s Get Out and Tri triathlon series (www.MaryMeyerLifeFitness.com) at Cottage Lake, Woodinville, Wash. June 27 and September 19, 2009. Members of the medical coverage team included PTs, physicians, nurses and EMTs. This sprint triathlon series was designed to facilitate family participation in an athletic event.
There were at least 300 participants at each event. The September 19 race was truly for the hardy soul. Rain and temperatures in the mid 50s to low 60s. This made the 5 a.m. wake-up call pretty tough. Setting up tents and the medical station in the dark, cold, heavy rain was not too fun. A warm up of sorts for the cyclocross season which runs from September through December.
We had the good fortune of not being needed as health care professionals all that much. A great time was had by all and we thoroughly enjoyed supporting efforts to facilitate age-spectrum and family fitness.
Erik Moen, PT
Corpore Sano
October 6, 2009
From Russia, with Flowers
Cyndi Robinson, MS, PT , PTWA member and academic coordinator of clinical education for University of Washington, made headlines in the Bashkir Republic last week! Robinson presented “Physical Therapist Education, Roles and Responsibilities in the United States” to the university board at Bashkir State Medical University and was presented with flowers by the school’s chancellor. Click here to download a PDF of the story, but good luck reading it!
