Chapter 14

Question 1

What % of APTA members report working in private outpatient or group practice settings?

Answer 1

33.6%

Question 2

CORF?

Answer 2

• certified outpatient rehabilitation facilities

Question 3

The difference between a CORF and a rehabilitation agency?

Answer 3

• CORF’s = physician services, PT, psychology/vocational counseling, typically OT and speech/language pathology.
• Rehab agency = (office or home) PT or speech/language pathology, social or vocational counseling, typically OT.

Question 4

CARF?

Answer 4

• the Commission on Accreditation of Rehabilitation Facilities

Question 5

The certification process includes (3)?

Answer 5

• on site survey and ongoing attention to recertification
• seek Medicare number to bill Medicare for services
• (voluntary) seek CARF

Question 6

What is direct access?

Answer 6

• consumers can directly access PT’s without the need of a physicians referral (according to each states practice act rules)
• *ongoing efforts to convince Congress that Medicare payment for PT services without physicians referral be accepted, currently is not.

Question 7

What is the “Stark law?”

Answer 7

• prohibits a physician from referring a Medicare patient to any organization for certain designated health services if the physician holds a financial interest in the organization.

Question 8

What are ancillary services and are they allowed under the “Stark law?”

Answer 8

• yes (it depends)
• ancillary services are services necessary to support the primary service to the patient.
• PT services must be provided in the same building as the physician’s and the physician no longer needs to provide direct supervision of the services to be reimbursed.

Question 9

What law was passed to address kickbacks and what is it?

Answer 9

• the Medicare and Medicaid Patient Protection Act of 1987
• law prohibits the offer or receipt of any kickback, bribe, or rebate directly or indirectly in the form of cash or referrals by physicians (or recommendations to purchase or lease supplies and services) of patients insured under Medicare and Medicaid.

Question 10

What may be the most valuable marketing tool for outpatient managers?

Answer 10

• work of mouth communication about the success and efforts of the staff in the practice.

Question 11

What are the results of the study of patient satisfaction in outpatient PT services (4)?

Answer 11

• high quality interaction with therapist
• time spent with patient
• adequate explanations and instructions to patients
• less use of support personnel