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Patient waiver form

 
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Patient waiver form - November 5, 2009 5:06:37 PM   
cowboybuboy

 

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Is it okay to have patients sign a waiver form if they come in for PT without MD prescription, and no insurance? I was wondering if I could have them try a modality for free for 1 treatment without MD prescription by signing a waiver.
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RE: Patient waiver form - November 5, 2009 6:49:10 PM   
Tom Peterson

 

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If you have direct access, you can do any treatment you deem appropriate. Of course, that treatment and scenario have to be under your state practice act. The waiver usually lets the pt know its their responsibility to pay for services. Not sure what a waiver for a "free" treatment would be though, unless you're trying to do something illegal or not covered by your state laws and want legal protection. Everything we're allowed to do is under the practice act. Anything outside of that practice act is out of our scope of practice, and no waiver or anything else can protect you. So its all down to your state laws. If your state practice act doesn't allow it, its like trying to give out meds or put a filling in someone's tooth. Its out of your scope and no waiver would save you.

If you give them 1 free treatment, then ethically everyone should be getting 1 free treatment. Why do they deserve a free treatment, yet someone who scrapes by and pays for insurance and has a high co-pay still has to pay for your services? Just because someone doesn't have insurance doesn't mean they're rich or poor. They could be loaded and say they're poor. If you're doing it because you think they're poor, do you do a credit report and check their financial statements on them to make sure? What is it about not having insurance makes you want to give them your services for free?

Basically, we all should treat everyone the same. Would you do different prices for things other than socialeconomic status? Like gender? Race? Religion? Sexual orientation? If not, then ask yourself why someone with or without insurance deserves a different price.

< Message edited by Tom Peterson -- November 6, 2009 2:52:33 AM >

(in reply to cowboybuboy)
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RE: Patient waiver form - November 6, 2009 7:34:43 AM   
cowboybuboy

 

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Response like this makes me want to respond in a very aggressive manner. However, I'll try to answer this with whatever patience I got left since this is just a forum.
First, let's not make this complicated. I did ask the APTA IL chapter and they will get back to me as the one who answered the phone does not know the answer.
Second, Tom, I didn't say that I'll give free treatments just because they didn't have insurance. I just mentioned the fact that many do not have insurance and would like to try a modality I'm marketing without going to their MDs. I was just trying to find out if I can give a free treatment without an MD prescription to try out a modality. Illinois does not have direct access. So, I don't know where you got the idea that we have direct access.
I treat everyone the same, I'm just asking about a different way of approach in a state that does not have direct access. I'm not doing anything illegal. In fact, I'm trying to find out if my idea is within the legal statute of the state.
Don't know if you're teaching, but nobody here is your student--you don't have to educate anyone. It's just a question.
Try to take it easy, okay?

< Message edited by cowboybuboy -- November 6, 2009 7:40:42 AM >

(in reply to Tom Peterson)
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RE: Patient waiver form - November 11, 2009 1:24:00 AM   
Tom Peterson

 

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Cowboy,

I didn't know what state you're practicing in, but if IL doesn't have DA and you're trying to do a treatment without a script by having them sign a waiver, then technically you could do manipulations or any PT treatment as long as you have the pt sign a waiver. I really doubt it would be that simple or that large of a loophole of direct access but the APTA-IL would be who to ask.

I didn't get the idea that you had DA, that's why I said "If" you have DA.

"Second, Tom, I didn't say that I'll give free treatments just because they didn't have insurance. I just mentioned the fact that many do not have insurance and would like to try a modality I'm marketing without going to their MDs"

There is nothing wrong with giving 1 person a free treatment, but ethically everyone who recieves that treatment shouldn't be charged that first time either then. That's completely fair and that's my opinion. If you give certain people something free then everyone should have it too.

What would you say if you needed to get a medicatation and the pharmacist charged everyone $10 for it, but decided you deserved a different price and charged you $60? Is that fair or ethical? I'm just saying, what you do for one person, it should be done for everyone. Its not about how the price goes up or down, its the fact it changes at all.

I would just be real careful about a waiver for treatment without a M.D. since you don't have DA. I've gotten wrong answers from various APTA's before and if something "bad" happened, just make sure you're butt is covered legally. All it would take is a nocebo and someone to "think" your modality did them harm and have them report it to their M.D. and you might get caught in some hot water.

< Message edited by Tom Peterson -- November 11, 2009 5:29:17 PM >

(in reply to cowboybuboy)
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RE: Patient waiver form - November 11, 2009 3:11:03 AM   
SJBird55

 

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The problem with doing a free treatment resides more in the fraud category than anything else. If you participate with Medicare (a federal program), I don't think you can undercut your services and offer a free treatment to anyone if it is a procedure reimbursed by Medicare.  I believe if the service would be deemed "valuable" by CMS or the OIG, you'd be potentially putting yourself at risk for fraud.  Last I knew, fraud was illegal.

(in reply to Tom Peterson)
Post #: 5
RE: Patient waiver form - November 11, 2009 7:13:48 PM   
SJBird55

 

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Free transportation can be an issue:  http://tinyurl.com/yf5wnlj

Not exactly what you are asking... but something somewhat similar where free services are provided.  This is how the OIG felt about it:
quote:

01-23-2008After it self-disclosed conduct to the OIG, University Health Services, Inc. d/b/a University Hospital (collectively UHS), Georgia, agreed to pay $137,429 for allegedly violating the Civil Monetary Penalties Law provisions applicable to kickbacks and physician self-referrals. The OIG alleged that UHS hired an athletic trainer to participate in a community service program to provide sports medicine coverage to area high school and middle school sports teams. If a student was injured, the trainer occasionally provided follow-up care for free at the offices of a local orthopedic practice. While in the practice's offices, the trainer would occasionally provide services to patients for the benefit of the practice. The agreement between UHS and the practice was never formalized in writing and the practice did not pay UHS for the services provided by the trainer for its benefit.

(in reply to SJBird55)
Post #: 6
RE: Patient waiver form - November 30, 2009 4:56:54 PM   
cowboybuboy

 

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Thanks Tom and SJ,

I did not plan to give a free treatment on select patients. I plan on giving free treatment for every new patient for the first visit, just to try if the modality works for them. I asked the APTA-IL chapter and DA issues still persists. What I plan on doing now is to do it in Wisconsin if they're after the first tx without a script as I'm just right at the state boarder and licensed in both states.
I'm not in contract with any insurance yet, so I think this might work.
I know, IL sucks due to lack of direct access, but this is where I live and I can have the best of both states anyway.
Thanks for the replies.

(in reply to Tom Peterson)
Post #: 7
RE: Patient waiver form - December 1, 2009 2:07:53 AM   
Tom Peterson

 

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Glad you have things sorted out and it looks like you're good to go.

BTW, I have no idea about this as I've never owned my own clinic, but if you practice in Wisconsin, do you have to be in an "official" brick-and-mortor clinic? Or can you practice anywhere you want? I have no idea if that's an issue or not and you probably already know or have it situated. Good luck.

(in reply to cowboybuboy)
Post #: 8
RE: Patient waiver form - December 1, 2009 12:33:36 PM   
SJBird55

 

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From: Michigan
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You may be licensed in both states, but the actual location of your clinic determines which state practice act you follow.

(in reply to Tom Peterson)
Post #: 9
RE: Patient waiver form - December 3, 2009 1:18:41 AM   
cowboybuboy

 

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Yes, I plan to lease a small place in Wisconsin so I'll be able to provide a "free clinic" every once in a while.

(in reply to SJBird55)
Post #: 10
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