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Re: Direct access states
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Re: Direct access states - September 1, 2005 7:02:00 AM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
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Falls,
How can you eval and treat for up to 30 days if diagnosis is prohibited? This is far from direct access. Don't worry about the insurance carriers they will follow suit when medicare allows it. In some states BCBS is already reimbursing without physician prescription. Get involved with your state chapter so that when the time comes and ins. companies are reimbursing without physician prescriptions you will be there to take advantage of it. Good luck.
MN- 1988
Provisions
· Medical diagnosis prohibited.
· Must have order or referral by a physician, chiropractor, podiatrist or dentist to continue treatment after 30 days.
· Must practice for 1 year under a physician’s orders before treating without referral.
· Must consult with patient’s health care provider before altering provider’s original written order.
· Must refer to a licensed health care professional when condition is beyond scope of practice.
· Must report other PT’s who fail to comply with practice act.
· Must submit reports to a licensed health care provider for periodic review at least every 2 years.
· PT with more than 1 year of clinical experience may initiate treatment of a patient for a condition not previously diagnosed for up to 30 calendar days once within a 4 month period without referring to a licensed health care provider. Does not apply to patients initially referred by provider.
· PT with more than one year of clinical experience may initiate treatment of a patient for a lifelong and ongoing previously diagnosed condition warranting physical therapy treatment. Verification of diagnosis must be obtained by licensed health care provider within 30 days of initial admission
_____________________________
Todd
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Re: Direct access states - September 1, 2005 10:34:00 AM
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ehanso
Posts: 355
Joined: September 14, 2004
From: Minnesota
Status: offline
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TLB, thanks for the specific information. I agree that this is not Direct Access. However, Minnesota is one of the states that Diane listed as having Direct Access. What we have is far from that. Ed
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Re: Direct access states - September 1, 2005 5:22:00 PM
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Jeffre
Posts: 130
Joined: August 18, 2005
From: Lafayette, LA
Status: offline
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We kinda, sorta, maybe have it here in Louisiana:
To an individual for a previously diagnosed condition or conditions for which physical therapy services are appropriate after informing the health care provider rendering the diagnosis. The diagnosis shall have been made within the previous ninety days. The physical therapist shall provide the health care provider who rendered such diagnosis with a plan of care for physical therapy services within the first fifteen days of physical therapy intervention.
To me this sounds like the if the MD diagnoses a pt but forgets to order PT the pt can go themselves if they think of it.
_____________________________
"You are as well as your insurance company is willing to allow."
- Dr. Hibbert
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Re: Direct access states - September 6, 2005 10:31:00 AM
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JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
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I think this nicely brings to light the true obstacle to PT evolution in the legislative arena, not the DCs (whom we do love to needlessly battle with), but from the physician lobby.
I have never met an individual physician who knew how restricted we were from seeing patients without referral, and I have never met an individual physician who thought it important that a patient see them before being referred to us. It is unfortunate that such sentiments are not borne out in the actions of their professional associations.
I agree with whomever stated in effect, as Medicare goes, so the ins companies go. This is true, but perhaps our best marketing tool, cash based patients, are not affected by reimbursement anyway. But if we cannot "diagnose" (whatever this really means) the problem to treat it, then we are restricted from those patients as well...
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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