*NEW* Employee Profile— Maritza |
Name: Maritza O. Wilson
Nick-name: M.O.W…pronounced “Moe”
Length of employment with Preferred: Brand new!
Job Title and responsibilities: Client Services: Payor file maintenance, MCO data upkeep, New MCO process, Fee Schedule |
maintenance, Renewal & Requested Grids, Provider Calls, Claims Resolution, Research, and Follow up outstanding contracts.
What you like most about your job: My position is still new, my co-workers are all great. I feel proud to be an employee of PREFERRED Therapy providers. |
Favorite Pastimes : I used to love to study the Martial Arts form of Shuri Ru.
About your family: I am originally from Tucson , Az and the oldest of three girls, who grew up very close in a loving family. |
|
 |
To Use or Not to Use Code 49 |
| |
Last month we ran an article regarding the new place of service code 49 which became effective October 1, 2003 . Although receiving conflicting responses from APTA and CMS, we would like for you to note that the definition clearly indicates providers “not described by any other place of service code.”
PREFERRED contacted CMS again, and the following is their response:
“The Centers for Medicare and Medicaid Services does not dictate policy regarding which place of service codes to use for a particular setting except in certain cases for Medicare claims. In some cases there are National policies to which the carriers must adhere. In other cases, there is no National policy, and the Medicare carriers are permitted to develop their own policies. Medicare does not have a National policy for 49 Independent Clinic, and in this case, an individual Medicare carrier would determine whether or not this particular code were appropriate for the setting. In general, a provider submitting a Medicare claim should apply the place of service code that his/her carrier has directed him/her to use because that advice will encompass both any applicable National policy and local policy as well. If you are a payer, you may develop your own policies regarding the appropriate place of service code to use, and these may or may not match the practices of a given Medicare carrier. If you are a clearinghouse, processing claims for various payers, you may wish to consult with them to determine their policies for the situation you describe.” |
|
|
|
Direct Access Success |
|
Congratulations to Louisiana for passing the Direct Access Bill. At the recent chapter meeting during the business luncheon, there was a great deal of excitement about the completion of this bill and discussion regarding the impact. Do you know what state was the first to have Direct Access, and the year it was completed?
Nebraska , 1957 |
|
|
PREFERRED Tidbits |
Gift Giving:
It's a beautiful thing!
The Foundation for Physical Therapy continues its fund raising, and PREFERRED is a proud sponsor. For $25.00, you may purchase a raffle ticket to win a brand new Mustang Convertible. Better yet, for $100.00, you receive five tickets. Do something special for your hard-working staff.
Call PREFERRED today and we will be happy to send the tickets to you. The raffle will end at Combined Sections Meeting, February, 2004 in Nashville . Come see us in booth # 849! |
Join Us... |
At the Private Practice Section Meeting, October 22nd through the 25th at the beautiful SawGrass Resort in Jacksonville , Florida . Celebrating National Physical Therapy Month, we will have special give-aways and prizes for our members and can provide you with up-to-date activities on our growing network. |
|
