NHAPTA hosts first annual Physical Therapy Insurance Forum

12/21/2009

By Willem Verweij, PT, COMT, NH APTA Reimbursement Committee

NHAPTA recently hosted New Hampshire’s first annual Physical Therapy Insurance Forum entitled “Payer and Provider Partnerships: Opening the Door of Understanding.” The purpose of this forum was to foster relationships between physical therapy providers and payers in NH. This inaugural event was well attended by a mixture of third party payer representatives including Medicare, Medicaid, several Worker’s Compensation insurances as well as private insurers.

The three speakers covered topics to help create a better understanding of physical therapy practice and how physical therapy providers can assist the payer in claims processing and cost effective care delivery.

Keynote speaker Erik van Doorne, PT, DPT, APTA’s Senior Director of Payment Policy and Advocacy explained clinical decision making in physical therapy and the role of evidence based medicine aided by the “Guide to Physical Therapy Practice.” All attendees received a copy of “the Guide” and had the opportunity to get hands on experience in its use through case studies. Some practice patterns were reviewed more closely illustrating the variations that are possible within each pattern. He also spoke about the physical therapist perspective on CPT coding. He explained how CPT coding does not fully describe the practice or scope of physical therapy (wellness and prevention programs for example), how coding and payment policy are not necessarily the same (correct coding may not result in reimbursement depending on individual insurance companies’ payment policies), and how descriptions of CPT codes relate to the PT goals (neuromuscular re-ed vs. therapeutic exercise for example).

Laurie Clute, PT, MS, Chair of the New Hampshire Governing Board presented on the NH Statute, Rules, and Regulations. Her presentation emphasized the legitimacy of our profession as she explained the role of the Physical Therapy Governing Board in protecting the public via licensure for PTs and PTAs as well as investigation of complaints and disciplinary actions against PTs and PTAs. The role of PT, PTAs, and PT Aides, their level of education, and type of supervision required was clarified. Both Erik and Laurie discussed proper documentation and use of timed and non timed CPT codes.

Josh Cleland, DPT, PhD, OCS, FAAOMPT brought to life the level of skill and clinical decision making that is involved in daily practice through a lunch time presentation about the examination and treatment of shoulder dysfunction.

Many questions were answered by the speakers as well as Kathleen Hanlon, PT, CHT, Chair of the NHAPTA reimbursement committee and driving force in the realization of this forum. The many questions, positive comments, and requests to make this a yearly event suggest that there is a desire for information about our profession and ongoing dialogue between physical therapy and insurance representatives. A first step to opening that “door to understanding” has been made.

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