Advocacy + Billing and Coding Flashcards
What are some reasons OT’s would be involved in advocacy?
Pass legislation and policies protecting our profession
Scope of practice expansion or infringement
Pay/reimbursement
Licensure
Supervision requirements
Why a company should hire an OTP versus someone else
Supporting clients to get the care they need
Pre-approval for insurance
Discharging patients
Educating family and friends
This AOTA group has 5 team members dedicated to monitoring and lobbying the US Congress and selected federal agencies to influence public policy initiatives
Federal Congressional Affairs
What is value-based care? Why is it important?
Pay for performance (quality over quantity) or service (quantity over quality)
Importance: How your services are reimbursed will influence the type of services you are encouraged to provide.
What is the AOTA Political Action Committee? What does it do?
political action committee solely dedicated to OT
contributes money to political candidates who support OT
contributes campaign money to OTs, OTAs, or OT students who are running for public office
Not a Super PAC
No AOTA dues fund AOTA PAC
Limitation of $5K per donor
What historical legislation influenced the OT practice overall?
A
Medicare/Medicaid Act of 1965
OR
Education and Handicapped Act of 1975
OR
OT Practice Act
May be wrong!
What is the Service Code Payment Cycle?
Skilled OT services > Documentation > Coding > Billing > Reimbursement
What are ICD codes and how are they categorized?
International Classification of Diseases
Categorized by body systems and condition types
What are CPT Codes?
Current Procedural Technology
Commonly used codes for rehab providers
What is the significance of documentation?
Justify needs for services!
What is the 8-minute rule and how do you apply it?
States: to receive Medicare reimbursement, you must provide treatment for at least eight minutes.
Using the “rule of eights,” billing units that are normally based on 15-minute increments spent with a patient can be standardized.
