Gwen Simons

Gwen Simons is a lawyer and physical therapist at Simons & Associates Law in Scarborough, Maine.

AIM Pre-authorization – Effective 7/1/2019

AIM Pre-authorization required 7/1/2019 Anthem will begin requiring pre-authorization for physical therapy visits through AIM Specialty Health beginning 7/1/2019. Per Laura Pray, Network Relations Consultant at Anthem in Maine, the requirements will be implemented for both fully insured and self-insured plans.   Please note that your Anthem contract allows Blue Cross Blue Shield plans in other […]

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Dr. Bonnie Virag, PT, DPT, ATC to provide webinar on treating novice and competitive swimmers

We’re pleased to have Dr. Bonnie Virag, PT and expert swimmer, give our webinar on May 15, 2019! Dr. Bonnie Virag is currently a dual credentialed Doctor of Physical Therapy and Certified Athletic Trainer, practicing full time in Pittsburgh, Pennsylvania. She has her own history as a competitive swimmer and is on a mission to

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Anthem Audits & Documentation Requirements

Anthem is starting to do audits on PT services. Some providers are being put on “pre-payment review” because their documentation is not meeting Anthem’s standards. Please review Anthem’s Clinical UM Guideline for PT services (CG-REHAB-04) published on 10/17/2018 for documentation requirements and other coverage policies.  If you are audited and don’t agree with the outcome, especially

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Medicare For All, Speaker: Gwen Simons

Member Webinar What are the proposals and how might they affect your practice? In this webinar we discuss the various Medicare For All proposals that are currently being discussed. Some eliminate private insurance and some only provide Medicare as a “public option.”  The impact on providers varies with each proposal https://vimeo.com/336213667 Resources Medicare for All_slides_2019-03-20

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Evaluating, Treating and Coaching Runners, Speaker: Danielle Kroot

Member Webinar Guest speaker, Danielle Kroot, PT, DPT, is a USAT certified triathlon coach.  She has a cash practice focusing on evaluating, coaching and treating runners in Portland, Maine. https://vimeo.com/simonsassociateslaw/review/318836251/b6685823a0 Resources Evaluating, coaching & treating runners – Slides Danielle’s contact information

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OSHA Compliance

Member Webinar Pre-recorded October 17, 2018   https://vimeo.com/295852602Resources OSHA Model Bloodbornee Pathogens and Hazard Communications Policy –  editable Word Document.  Use this document as a template for your company policy. OSHA Blooborne Pathogens Fact Sheet OSHA Interpretive Guidance: Kinesiotaping is first aid Whether cold compression is first aid Use of rigid boot after injury is medical rx Whether work

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Community Health Options – New Pre-auth Procedure Training, Oct. 23 & 26

Community Health Options will implement new pre-authorization/notification requirements as of Nov. 1, 2018. Maggie Kelly, Assistant Vice President of Medical Management for CHO will be providing 2 on-line live training sessions that we recommend PTs and their billing staff attend. A recording of the session will be posted on the Webinars page of our website after the

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