As an OT in private-practice, I come across interesting situations involving insurance. Most situations, are less than encouraging and today is no exception.
First, I learned that an OT Evaluation is not billable under my provider type at an Assisted Living Facility. However, a PT evaluation is billable under my provider type. In trying to understand the reasoning behind this disparity, I was told by a Medicare Representative that OT is viewed as a type or subset of PT. She then went on to tell me that as fare as medicare was concerned, that I could bill for a PT evaluation whenever I do an evaluation at an assisted living facility. Secondly, Blue Cross/Blue Shield of Florida does not contract with OT. Between OT, PT and SLP, they only contract with PT. What this means is that as an OT, I can not be a participating provider with BCBS. I can be a non-participating provider but this has reduced benefits for the client. BCBS says that most (all) OT referrals are made by PT's working at facilities. Whenever,a PT sees a client who they think needs OT they then make a referral to OT. The facility then pays the OT, either as an employee or a sub-contractor. A friend of mine told me that they would never be an OT because we are treated as 'second class citizens'. It's times like this I tend to agree. Ron _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
