Gwen Simons – Page 3 – Simons & Associates Law, P.A.

New CPT Codes & Medicare Rules for 2020, Speaker: Robbie Leonard, PT, DPT, CHC

Dr. Leonard has provided continuing education seminars nationwide in the areas of administration, Medicare, billing and coding, compliance, and neurological rehabilitation. She is a past member of the APTA Public Policy and Advocacy Committee (PPAC) and is a current member of the Private Practice Section Annual Program Work Group and the SCAPTA Payment and Policy […]

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Plans not requiring AIM pre-authorization

Anthem BCBS, Client Alerts_Maine / Gwen Simons

We have reliable information that the following health plans DO NOT require AIM pre-authorization in Maine: Maine Health Maine Teacher’s Association (MEA Trust) CMP Federal BCBS AIM’s message when you try to obtain pre-auth for these plans tells you to call Anthem. You do not need to do this. I recommend, however, that you ask

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Can my patient submit a claim to their supplemental insurance plan?

Cash Practice, FAQs, Template Forms / Gwen Simons

Q: My patient has a Medicare Supplemental Insurance Plan. She wants to know if she can submit her claims to the supplemental insurance plan without submitting to Medicare first. Should I give her a statement to submit? A: Some supplemental plans may reimburse their insureds for medically necessary services provided by unenrolled providers without requiring

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Anthem/Aim Pre-auth Required Nov. 1, 2019

Anthem BCBS, Client Alerts_Maine / Gwen Simons

Anthem Requiring AIM Pre-authorization for All Commercial Claims as of Nov. 1, 2019 Anthem and AIM have announced that the new effective date for requiring AIM pre-authorization for commercial plans will be November 1, 2019. If you think you will be seeing existing commercial patients past Nov. 1, you will need to get pre-authorization before

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Anthem and CPT Code 97110

Anthem BCBS, Client Alerts_Maine / Gwen Simons

CLIENT ALERT Some Maine PT providers have received a letter from Anthem dated August 28, 2019 stating they did a review of claims between 2/1/2018 and 1/31/2019 and their utilization of CPT code 97110 was “outside the average utilization for your specialty.” The letter appears to be a template form. It is not even properly

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Advice on Superbill Content

Cash Practice, FAQs, Medicare, Private Pay Issues / Gwen Simons

Advice on Superbills When you agree to see a Medicare beneficiary who has elected to pay you cash instead of seeing a Medicare enrolled provider you are accepting some risk that the patient may try to submit your receipts to Medicare for reimbursement or to obtain a denial for a Medicare Supplemental Plan. If the patient

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Employment Law 101, Speaker: Gwen Simons

Webinars / Gwen Simons

Member Webinar In this webinar, Gwen Simons discusses general employment laws that business owners should know, including the Fair Labor Standards Act, OSHA and independent contractor issues. Employment Law 101 Resources Employment Law 101_Slide Handout

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Implementing Principles and Philosophies of Bodybuilding into Patient Care, Speaker Nicholas Licameli, PT, DPT

Webinars / Gwen Simons

Member Webinar Resources Slides_Implementing Bodybuilding into Patient Care

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Go Daddy Smart Line – is it HIPAA Compliant?

FAQs, Vendor Review / Gwen Simons

Go Daddy Smart Line is a phone app that gives you a second line phone number so you can separate your business and personal texts and calls while carrying just one phone. Some providers are using this app for their business line, which raises the question – is it HIPAA compliant? Even though the app is

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Documentation Essentials, Speaker: Gwen Simons

Webinars / Gwen Simons

Member Webinar In this webinar Gwen Simons discusses the standard of care for documentation and what is essential to document to support charges regardless of whether the PT is in or out-of-network. https://vimeo.com/347596338 Resources Slides_Documentation Essentials

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