Fraud, Waste and Abuse Part2: Q & A with an Attorney

How To Report Questionable Practices in Physical and Occupational Therapy. So let’s get right down to it! If you have not read Part 1 of this series, please do so here.  It gives some background into the terrible state of fraud, waste and abuse in physical any occupational therapy.  It also gives some good reason […]

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Fraud, Waste and Abuse in Skilled Care (Part 1)

A Big Problem in Physical and Occupational Therapy Part 1 This new year 2020 has every physical therapist, occupational therapist and speech therapist on pins and needles as to how clinics and rehab centers are going to stay open.  Opinions, rumors and even conspiracy theories abound in regards to the major payment changes Medicare introduced […]

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Top 7 Phrases to Avoid in PT/OT Documentation

“Don’t put that in your mouth!” “Don’t put your finger in there!” “Do you even know where that has been?” Since we were just tiny infants we have continuously been told things to avoid.  The fact that I have written this, and you are here reading it tells me we have both been relatively good […]

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Practice Guidelines In Rehab 2

A Tale of Two Guidelines – Part Deux Clinical Guidelines for Utilization Management and Authorization It was not until about 4 years ago that I learned about the second type of CPG we are going to learn about for this article.  Prior to my time working in utilization management I was very ignorant to the […]

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Practice Guidelines in Rehab

A Tale of Two Guidelines – Part One Clinical Practice Guidelines First – A HUGE Announcement !!! HUGE!  So I am using this post to go public.  This decision is HUGE. This HUGE innovation will be the best clinical combination the rehab world has ever known.  Are you ready for something huge? I have created […]

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The 80/20 Rule

The 80/20 Rule Of Managed Care By the raise of hands how many have ever been in a car accident?  No hands? Oh…yeah, I won’t be able to see hands raised in a blog post.  Well, let’s just assume that most of you have. What maybe around 80%?  The rest that have not, likely know […]

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Top 7 Mistakes Made In Utilization Review

When the utilization manager makes the ‘faux pas’ Before I write any further articles I really want to make something perfectly and publicly clear.   I MAKE MISTAKES More specifically, even in physical therapy clinical review I have made mistakes.  Mistakes are made everyday in rehab authorization review. As much as we in utilization management […]

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Skilled Maintenance Programs

It Takes The Skill of a Ninja Ninjas!!  That’s right, I got help from ninjas for this article.  All the other rehab blogs can just “suck-it” (like Shawn and Gus ‘Pysch’ style suck-it) because none are cool enough to hang with ninjas.  A Witty PT works hard to bring you the absolute best strategies for […]

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Top 8 Reasons Care Was Denied

Part 1, Reasons 1-4 “This is not a time for tact” Certain situations call for just the right amount of tact: Trying out a new anatomy based pick-up line at your next rehab conference “You know what muscle causes the lateral rotation of my cervical spine? Your gluteus maximus”; Your patient starting to explain their […]

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Medical Necessity In Rehab

Two Important Words Before I go too deep into the world of rehabilitation utilization and clinical review I think it important to establish an understanding of one very key phrase: Medical Necessity.  Just about all decisions involving the health care of an individual revolve around those two words. You would think, that with basically two […]

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