Referrals & Cases
Does a new case need to be created when the secondary payer changes during active treatment for a patient?
No
What is considered a stat add on for evals?
scheduled within 24 hours
If you receive an audit request/ ADR/ TPE in the mail- where do these go?
medical.records@fyzical.com (include Kylie)
If a patient is requesting a payment plan, who are they directed to?
TPC Client Coordinator
Where is FYZICAL Headquarters?
Sarasota, FL
Does TPC review the credentialing reference guide to check INN/OON for the group, or individual therapist?
No, this is CCS responsibility prior to scheduling
How often should you run the auth report (or comparable report) in WebPT?
Daily
If a patient believes they are due a refund for overpaid copay, co-ins, deductibles- what are your next steps?
Add the note to TPC & Clinic Comm Spreadsheet for TPC Client Coordinator to review and request refund. Clinic must follow up with the patient on the final outcome
If a single case agreement is proposed for a clinic, where does this get sent to for approval?
Kylie
How many company clinics are there?
59
What providers can we NOT accept referrals from for Medicare patients
Chiropractors
Who is responsible for entering the amount to collect when co-ins or deductible are due or have been met?
CCS/ Clinic
When & Where do you send information for services needing to be invoiced?
When the clinic provides services that are not billed directly to an insurance company or patient. The invoice template must be filled out monthly and emailed to medical records
If a patient states that the benefits we are quoting/ collecting are incorrect, what should you do?
Take the patients word at first encounter. Let the patient know we will look into this for them, and if for some reason they do owe for todays visit we will catch up at their next visit/ they will receive a statement. Request a reverification through the VOB & Auth request SS- and let the patient know the update at their next visit.
If benefits did not change after reverification, and the patient is adamant they do not owe what we are quoting- clinic leadership will make a decision on how to proceed (CD, RD, RAS)- with documentation in chart notes
What year was FYZICAL founded?
If an active patient changes from BCBS primary to Medicare primary, what are the necessary steps for updating their account?
BCBS case must be discharged, New case created, scheduled visit as an eval, eval & POC completed, added to DMR as scheduled
What authorizations are the clinics responsible for obtaining themselves
VA, Work Comp, MVA, auth prior to IE when needed from PCP
If an attorney calls to find out the status of a medical record request, what should you do?
Provide them the MR email address & phone number. Could also get the attorney information and request that the MR clerk correspond back to them
If a patient is requesting information regarding their recent statement, how should we proceed?
request information/ call back from TPC client coordinator to patient through the TPC & Clinic Communication Spreadsheet
What is the FYZICAL Mission Statement?
To prevent people from falling and deliver greater physical health, wellness & lifelong vitality to every man, women, and child.
How do I know if a certain insurance can be scheduled with a therapist?
Review the regions credentialing reference guide in essential forms, locate the clinic & PT- if there is no "X" listed under the PT column on the insurance row, you can schedule. If there is an "X" on the row, but the color is yellow you can schedule. If there is an "X" on the row, and the color is green- you can schedule IF a therapist with no "X" for that insurance is available in the building during treatment ( co-treatment)
If a patient reports their PT is related to motor vehicle accident, what are the apporiate next steps?
Fill out the MVA form in its entirety, provide the form to Kylie, wait for approval from Kylie prior to scheduling
When can you refund a patient through WebPT?
When they have purchased retail items, paid with a card, are refunding the exact amount of the original transaction, and the transaction was made within 30 days
If a patient states they have called the number on their statement without a solution provided, and they are requesting more assistance. What should you do?
Request Kylie to contact the patient to resolve
How many states does FYZICAL have locations? Company clinics + Franchise
46