Measurable Solutions

Measurable Solutions asked one of their clients in California, Ida Hirst, of her experience with the rate reductions that Anthem has put forth.

"This has been a hot topic among practice owners since this only effects private practices, not hospital or physician owned clinics.  Many clinics have opted to terminate their provider relationships with Anthem BC.

I have decided to stay in.  A careful search through EOBs coming through my office finds that many of our PPO contracts and certainly our Work Comp visits are paying below the $75 per visit.  I then took an average of what we receive currently from our Anthem BC visits and found that due to the way they cascade for reimbursement that we have a hard time getting a significant amount more than this for the average visit if we are completely honest with our coding.  The only way to consistently get the good payment would be to perform the same procedure for a full 45 to 60 minutes every time.  This rarely happens.

I am not happy about this change, but it has spurred me to make decisions to gradually drop other low paying insurance contracts and to plug a way at converting to a cash based practice where people get a great service in a short amount of time for a very reasonable fee.  We will provide them with a super bill to submit directly to their carrier if they wish.  Unfortunately to drop Anthem BC would mean a drop in patient volume by almost 40% and we can not handle that dramatic of a change right now.  I am respectful of those practices who were able to either never depend on Anthem or are now ready to do so."

Ida Hirst
Pleasanton, CA

Another release from Measurable Solutions is the Solutions to Declining Reimbursements Course.

There are probably areas in your business that you have skipped or that you are paying less attention to that can make a BIG difference in your bottom line. This course help you fix this and will give you tools to get paid in a shrinking reimbursement environment. Read more at the website:
measurable-solutions.com

It's not a question of 'if' you'll be audited - it's a question of when.

To stay on top of the game, look out for Measurable Solutions' newest Newsletter hitting mail boxes this November. It will cover all things Medicare and Reimbursement related including:

Medicare Compliance: An Issue PTs Can’t Afford to Ignore
By Steve Ryland PT, DPT, Owner of Beachside Physical Therapy & Beachside Health Studio

Physical Therapists received a letter from HIP Emblem Insurance of New York where they announce a 20% rate decrease.

Ann Duffy, one of Measurable Solutions’ clients, was there at the rally in the beginning of May to support the practices that are being forced to drop out of HIP because of the drastic reductions to below the cost of being able to provide quality care.

Here you can play the full video from youtube (dimipt's Channel):

You can do something about declining reimbursements:

click to get your FREE report, 2 Simple Tactics That Actually Increase Reimbursements.

You can also get a FREE Reimbursement and Cash Flow Analysis, call us NOW at 800-491-2828.