I do both. I do ALF under home health if they are homebound and were started or need one of the other 'qulifying' discipline or, else I seem them under 'outpatient' billing.
Joe ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: "Joe" <[EMAIL PROTECTED]> Sent: Tuesday, March 30, 2004 5:13 PM Subject: Re[4]: [OTnow] GREAT NEWS! > 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] > =============================================== > _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
