Hello Joe: Are you a home health agency or OT in private practice?
Ron ================================================================= On Tuesday, March 30, 2004, you wrote: J> Hi Ron: J> I do apologize for the late post but yes...way to go, congratulations!!!! J> I believe that it was probably an LMRP issue with your local intermediary/ J> carrier. I have always been reimbursed for my evals in ALFs. My intermediary J> is Adminastar / carrier is PGBA. With your work, states that are similarly J> effected as yours must seek a revision of the LMRP to allow 97003. I did J> face this problem with some private insurance (can't recall which one). They J> covered other codes but not an OT eval. I stayed quite because I got the J> rest paid and didn't want the hassle. But next time I will not give in. J> Joe J> ----- Original Message ----- J> From: "Ron Carson" <[EMAIL PROTECTED]> J> To: "Lehman, David" <[EMAIL PROTECTED]> J> Sent: Tuesday, March 30, 2004 8:20 AM J> Subject: Re[2]: [OTnow] GREAT NEWS! >> Hello David: >> >> Thanks for the 'thanks'. Why is it that a PT is the ONLY person to J> have >> responded to the message??????? People in my profession can be J> such >> weinies.... Don't they even care about stuff like this..... I get J> so >> frustrated with being an OT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! >> >> >> What's happening with you???????????? >> >> >> Ron >> >> ================================================================= >> >> On Tuesday, March 30, 2004, you wrote: >> >> LD> You go Ron.....just saw this post and thought I would congratulate you >> LD> on getting somewhere with the gov't:) >> >> LD> Hope you are well. >> >> LD> David A. Lehman, PhD, PT >> >> LD> Associate Professor >> >> LD> Tennessee State University >> >> LD> Department of Physical Therapy >> >> LD> 3500 John A. Merritt Blvd. >> >> LD> Nashville, TN 37209 >> >> LD> 615-963-5946 >> >> LD> [EMAIL PROTECTED] >> >> >> LD> -----Original Message----- >> LD> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On >> LD> Behalf Of Ron Carson >> LD> Sent: Monday, March 29, 2004 7:21 PM >> LD> To: [EMAIL PROTECTED] >> LD> Subject: [OTnow] GREAT NEWS! >> >> LD> Hello: >> >> LD> A while back, I ran into a Medicare situation where my company was >> LD> unable to >> LD> receive payment for OT evaluations provided at assisted living >> LD> facilities. >> LD> The problem had nothing to do with my company, but it was a Medicare >> LD> policy >> LD> that did not allow procedure code 97003 (OT eval) to be billed at J> an >> LD> ALF >> LD> place of service. I was very disappointed in this policy >> LD> because it >> LD> effectively prevented me from seeing clients in ALF's. It was >> LD> particularly >> LD> disappointing because, procedure code 97001 (PT eval) was reimbursable >> LD> at an >> LD> ALF. >> >> LD> So, after several long conversations with Medicare, I was given an >> LD> e-mail >> LD> address in which to address my inquiry as to why OT could not be >> LD> reimbursed >> LD> for procedure code 97003. >> >> LD> After several weeks, I received the following message: >> >> >> Dear Mr. Carson, >> >> >> I was assigned your correspondence originally dated 1/29/04, >> LD> regarding >> >> billing 97003 in an ALF. This is an appropriate place of service >> LD> for >> >> 97003. I will have a system change request done to have an ALF >> LD> added to >> >> the system to allow code 97003. I will let you know the effective >> LD> date, >> >> once I have one. Thank you, Diane >> >> >> >> Diane Prevatt, RN, BSN >> >> Medical Policy and Procedures >> >> First Coast Service Options, Inc. >> >> LD> I just found out today, that it is now effective that procedure code >> LD> 97003 >> LD> can be billed at ALF's. >> >> LD> Now, I wonder if it can be this easy to get Medicare to let OT J> open >> LD> home >> LD> health cases!! >> >> LD> Ron >> >> >> >> >> LD> _______________________________________________ >> LD> To unsubscribe, visit: >> LD> http://otnow.com/mailman/listinfo/otlist_otnow.com >> >> LD> The OTnow Mail Archive: >> LD> www.mail-archive.com/[EMAIL PROTECTED] >> LD> =============================================== >> >> >> >> LD> _______________________________________________ >> LD> To unsubscribe, visit: >> LD> http://otnow.com/mailman/listinfo/otlist_otnow.com >> >> LD> The OTnow Mail Archive: >> LD> www.mail-archive.com/[EMAIL PROTECTED] >> >> >> >> _______________________________________________ >> To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com >> >> The OTnow Mail Archive: >> www.mail-archive.com/[EMAIL PROTECTED] >> =============================================== >> J> _______________________________________________ J> To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com J> The OTnow Mail Archive: J> www.mail-archive.com/[EMAIL PROTECTED] J> =============================================== _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
