Tag: Medicare
The Physical and Occupational Therapy Changes in Medicare for 2020
There has been no time more integral to the advancement of our society than the 21st century. The past 20 years have been essential to the technological increases that are impacting billions of people all across the globe. Many facets of our society have been affected in the modern era, and healthcare is one of the most impacted elements. There has been a transformation throughout the healthcare industry, as new technologies like procedural telemedicine, as well as new regulations, have become commonplace throughout the medical system. There is a multitude of different specialties in healthcare, but one of the top aspects is physical and occupational therapy. This facet is involved in helping people fix their bodily ailments without the use of more invasive procedures. What is Physical and Occupational Therapy? Physical and occupational therapy has become increasingly popular throughout the 21st century, as advancements in the field and a greater understanding of the body have helped to improve peoples’ wellbeing. Patients who frequently attend physical and occupational therapy often have chronic pain or muscular-skeletal issues that can be aided with different exercises and stretches that help to heal the body. Working as a physical or occupational therapist allows you to more effectively treat patients who need help and requires immense knowledge of the human body. As 2020 has already gotten underway, it has become evident that the many changes to the system, especially for Medicare patients, are continuing to affect physical and occupational therapy offices. Understanding these changes is essential if you work in this field. Learning about the 2020 Medicare Changes for PTA & OTA Modifiers Working as a PTA (physical therapy assistant) or OTA (occupational therapy assistant) has undergone immense change since the beginning of the new decade in 2020. The Centers for Medicare and Medicaid Services (CMS) has altered its billing policies, which has impacted the modifiers used in your office as well as the reimbursement procedures provided by PTAs and OTAs. Medicare changes 2020 has been implemented as a payment differential in the ways that PTAs and OTAs are paid. The payment rate is now 85% of the rate of what assistants are paid. CMS has noted that any care that exceeds 10% of the total time of care would now be subject to reduced billing. The payment differential has to be applied to all private practice facilities, home health agencies, hospital outpatient departments, as well as rehabilitation agencies. The codes that this can be applied include therapeutic services, as well as administrative or non-therapeutic services. Any timed or untimed coded procedures and modalities are also included, such as re-evaluations and initial evaluations. These many changes also include new documentation which provides a short description of the application of modifiers. While many of these changes may sound a bit challenging, understanding them is essential for the success of any physical or occupational therapy office. Final Thoughts Working in the physical or occupational therapy field can be very complex, especially when dealing with Medicare billing. Learning about the 2020 changes in Medicare billing is essential when running a physical or occupational therapy firm. Read Also: What Transaction Management Software Will Do to Aid Your Real Estate Business Recognizing How Important Inventory Management is to Your Ecommerce Store
READ MOREDetailsHow To Successfully Choose Medicare Plans
You must first decide which plan you want when you are deciding to compare Medicare plans. This means deciding whether you want Original Medicare or if you would like a Medicare advantage plan. Original Medicare includes part A, which is hospital insurance, and part B, which is medical insurance. These plans are provided by Medicare and will give you your choice of hospitals and doctors, as well as other providers. You will typically have to pay for a monthly premium, with plan B. After choosing one of these plans, you may decide if you want part D Medicare, which is prescription drug coverage. How To Successfully Choose Medicare Plans: Medicare Part A This is hospital insurance. Everyone who is eligible receives this portion. Medicare hospital insurance covers inpatient care. Inpatient care includes hospitals, skilled nursing facilities, and care, hospice facilities. Some home health care is also included. Long-term or custodial care is not covered by Part A. Most people do not have to pay a premium for this portion of Medicare. Medicare Part B This is medical insurance. The purpose of this portion is to cover medically necessary services. These include doctors' services, diagnostic tests, outpatient care, physical therapy, and some preventive screenings. Does Medicare cover hearing aids? If you have this question on your mind, this is the plan you need to go for. Part A does not cover these services, even if you are in the hospital. Medicare Part B is optional and you have to pay a premium. Medicare Part C This is otherwise known as Medicare Advantage. With C, you get at least the same coverage as you get with parts A and B combined. The difference is a private insurer has contracted with the government to take over the administration of your benefits. Your benefits are provided by the insurer, and you pay your premiums directly to this insurer. You can choose Part C in lieu of A and B, but you still pay the Part B premium. Medicare Advantage is similar to Medicare supplemental insurance in that it covers the gaps left by Medicare. You chose one or the other. The difference is that the Advantage program pays instead of Medicare and supplemental insurance pays after Medicare pays. Medicare Part D This is prescription drug coverage. This is usually approved and certified by the Centers for Medicare and Medicaid Services as this is well offered by private companies. It is optional and requires you to pay a premium directly to the private insurance company. Medicare helps defer the costs of health care for seniors and those with certain disabilities. The plan initially consisted of simply hospital insurance. It later evolved to pay for medical services and prescription drugs. This evolution had created four parts of the plan. Part A, B, and D are all about different facets of coverage. Medicare Advantage plans (Part C) are really a replacement policy for A, B, and D where you pay a private insurer. If you do not want original Medicare, your other option, while you compare, is to choose a Medicare advantage plan. These may include a PPO or an HMO plan. Part C of Medicare includes both part A and part B, meaning you will have medical insurance and hospital insurance. If you choose this coverage, you will have access to private insurance companies that are Medicare-approved. Depending on your plan, the costs, rules, and extra coverage vary. You will usually pay a monthly premium in addition to the premium you pay for part B, as well as coinsurance and copayment. You may choose drug coverage for either plan when you compare each of these plans. For original Medicare, you are required to choose a prescription drug plan, which is run by Medicare-approved private companies. If it is not offered by your plan, you may choose to join a prescription drug plan offered by Medicare. For advantage plans, you do not need a Medigap policy. If you already have one, you cannot use it to pay for out-of-pocket expenses that you have under your advantage plan. Read Also: Medicare Pros And Cons: Everything You Need To Know Before Enrolling Have You Heard Of Upcoding? It’s A Big Part Of Medical Fraud 3 Top Tips to Keep Your Eyes Healthy
READ MOREDetailsMedicare Pros and Cons: Everything You Need to Know before Enrolling
Given that more than 40 million Americans benefit from what Medicare has to offer, there are many ways for older adults to stay healthy. Those with disabilities or who might be on the edge of the income limits should know the Medicare pros and cons before enrolling. There are plenty of reasons to choose Medicare or something else, so you need to know what suits your lifestyle. Here are some of the most common pros and cons that people bring up when they're struggling with this decision. Pro: Coverage for the Uncovered: One of the reasons that Medicare is such a powerful coverage tool is that it has offered coverage to millions of people who didn't have it. With this program, elder adults are covered and protected from medical catastrophes. With only half a million seniors uninsured from year to year now, it's made it so that almost no one over 65 has to live without protection. Because Medicare is for those who need it and have little means, it helps keep more Americans protected than ever. Without it, elderly Americans would be forced to pay for medical treatment they couldn't afford. Older people tend to need the most medical care, and so it's vital that they have affordable and manageable care. Since elderly Americans are often retired, they don't have the means to keep up with rising medical costs. People with disabilities get help under Medicare to pay for the challenging costs of care. Without this aid, they would be dependant on caretakers and stuck with few options for care. Con: There Are Massive Costs to Cover It: Put all the costs of Medicare together and you'll find that it costs nearly half a trillion dollars. While this might be a hard figure to quantify, it ends up being 15 percent of all of our federal spending. It's only going to continue to grow in the future. While there are several items in the federal budget that we don't question the cost of, this is one we have to consider in a realistic sense. The costs of medical care are constantly climbing ever higher and leading to insurmountable bills for the average American. Without any intervention by the federal government, the cost of healthcare and the cost of providing programs like Medicare will take a big cut out of taxes. Without Medicare, we would have a much bigger tax base. However, we would have people who are constantly sick and in need of care, clinics that are filled to the brim, and elderly people who had no way to care for themselves. While we could do some work to ensure that the money we have is spent more wisely, for now, we can imagine this money going to education or social justice. While it could help with programs to eliminate poverty, ultimately, more than half of bankruptcies are due to high medical bills. Pro: Get More with Medicare Advantage: For people who need more medical care than the average person, there are ways to supplement Medicare. Those people who find that they're at the limits of their Medicare coverage can sign up for the Medicare Advantage plan. Enrollment in this program is constantly growing and should be a powerful way for people to cover those massive increases in medical fees. Paying for private insurance is difficult if you're in the tax bracket eligible for Medicare. It's also redundant given that so much of what's covered by the standard medical plan is wrapped up in Original Medicare. However, with the help of Medicare Advantage, there is now a place for a third component that offers what many healthcare recipients need. The way this works is that insurance companies provide benefits related to what's missing from Medicare through a contract with the government. They offer them at competitive rates that are affordable to the average Medicare recipient. People taking advantage of these plans get everything they expect from Part A and Part B of Medicare but then get more dental and vision benefits. This extension provides some of what's missing in most of the other parts of this program. Con: Bad Health Is Expensive: If you're in poor health, you have an intimate view into just how expensive healthcare is. Even if you've got great insurance, you've seen the prices that come on the bill before you get your care deducted. You could be paying double or triple what a healthy person pays every year, even with healthcare. While you need to have great healthcare, you need to do what you can to stay healthy. Talk to your doctor about preventative care. You're never too old to take action to lower your healthcare costs and your need for supplemental care. There are many free preventative care programs that come standard with most Medicare plans. However, you need to take action to make sure you follow your doctors' recommendations and stay on top of your health. Many people who incur high bills with Medicare suffer from problems that preventative medicine could assist with. Even though this program costs very little from month to month, you need to manage your costs as they'll add up on a limited budget. If you're tight on money, Medicare supplements may be out of reach. This makes it all the more vital to staying on the good side of health. Medicare Pros and Cons Are Individual: Because everyone has their own healthcare needs and requirements, Medicare pros and cons vary from person to person. You need to get to know what you need and what you might need in the future before you decide on Medicare or any other insurance policy. As more people suffer more chronic health issues, check out our guide to watch the trend. Read Also: Finding The Right Hospital Complete Pregnancy Guide For Mumma’s To Be
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