Wisconsin Private Practice Award
Awarded to a practice for innovation operation or a specific project which promotes a positive image of Physical Therapy in the community. Also acknowledges an individual member who has made outstanding and enduring contributions to the practice of Physical Therapy.
Eligibility: Practice owner/director/manager must be a current member of the WPTA in good standing.
Must have positively affected the shape, scope and a quality of physical therapy private practice in the community and be consistent with the Wisconsin PPSIG values:
1. We value business practices that promote the development of small business private practice.
2. We value the promotion of reimbursement for services commensurate with physical therapy as a doctoring profession that is patient centric.
3. We value collaboration and alliances among private practices that fosters growth, and continued advocacy of individual practices.
4. We value business model innovation that continues to promote private practice physical therapy and physical therapy as a doctoring profession.
5. We value our ability to work together; leveraging our group’s purchasing volume to negotiate better rates on goods and services for the benefit of our members.
6. We value direct access and the consumer’s right to choose their physical therapist as their preferred provider of neuromuscularskeletal care, without barriers.
7. Practice 51% PT owned
PROCEDURES FOR NOMINATION:
1. A typewritten set of all materials must be received in the Chapter office by January 31st for consideration for the award in the following year. Submitted materials will not be returned.
2. The nominator is responsible for submitting the following documents as a single packet:
Support statement from nominator
WI Medicaid held several trainings around the state to educate members on the use of the Forward Health Portal.
Provider Enrollment & Validation:
Be sure to keep your mailing address current with Medicaid so that you receive ALL notices for revalidation of your Medicaid Enrollment or you may have to reapply!
Provider Revalidation must be completed every 3 years due to the Affordable Care Act.
Group Provider Validation:
If you are part of an agency NPI- someone can go on through the agency NPI & validate providers in the group!
Medicaid Plans Eliminated: (March 31, 2014)
BadgerCare Plus Benchmark
BadgerCare Plus Core
BadgerCare Plus Basic
Current Medicaid Plan: ( April 1, 2014)
BadgerCare Plus is NOW one benefit Plan
Member Enrollment Verification:
Verify eligibility of Medicaid Enrollees before providing service! See: https://www.forwardhealth.wi.gov/WIPortal/Online%20Handbooks/Display/tabid/152/Default.aspx?ia=1&p=1&sa=87&s=8&c=126&nt=Fillable+Forms
Re-Verify eligibility AGAIN after the 20th of each month when re-enrollment is addressed.
Many Medicaid enrollees are switching from Fee-for-service to HMO & from one HMO to another!
Retroactive PAs are possible if an enrollee was enrolled during a PA period. However, if you are NOT a provider of the HMO in question- you may NOT be able to bill.
Using the Forward Health Provider Portal:
Portal Prior Authorizations are Highly Recommended!!! If you wish to be trained on the Portal- Contact your Provider Relation Field Representative! See: https://www.forwardhealth.wi.gov/kw/pdf/ProviderRelationsReps_Assigned_Territories_Aug2014.pdf
The Portal User Guides can be very helpful as references. See:
Provider Prior Authorization Questions:
We HIGHLY encourage Providers should actively call the Consultants with questions, concerns: CALL 800-947-9627 and ask to be put into the specific OT/PT/SLP consultant’s voice mail box with your best days/hours/phone numbers to return your call!
Provider Prior Authorization concerns, suggestions, concerns can be documented and sent via http://www.dhs.wisconsin.gov/forms/F0/F01016.pdf
We HIGHLY encourage providers to submit this form to DHS and a copy to WPTA. The Department MUST respond to your inquiry- please forward their response to WPTA as well.
Prior Authorization Amendments:
Amending a Currently Approved PA for 30 days ONLY if you plan to DC at the end of PA:
· Frequency of Rx
· Change rendering provider when the billing provider change
· Grant/Expire Dates
· Specific Rx Codes/Procedures
Must have a WI Medicaid Enrolled MD on Claims in order to be covered! Can be a Prescribing, Referring or Ordering Provider (PRO- Providers) that do NOT take Medicaid themselves.
See the attached Medicaid Update: 2-013-34: New Requirements for Prescribing/Referring/ Ordering Providers Due to the Affordable Care Act at https://www.forwardhealth.wi.gov/kw/pdf/2013-34.pdf
If you are having problems with Medicaid HMOs- call the Medicaid Ombudsmen at 800-760-0001
Newly elected members of the Student Assembly Board of Directors - WPTA congratulates Rob Hofschulte!
President: Fred Gilbert, University of Alabama-Birmingham
Vice President: Rob Hofschulte, Marquette University
Secretary: Aimee Winston, Boston University
Director of Communications: Brooke McIntosh, University of St. Augustine-Florida
Director of Membership: Lang Ho, University of Minnesota
Student Physical Therapist Delegate: Dhara Shah, University of Alabama-Birmingham
Student Physical Therapist's Assistant Delegate: Jarrod Evans, Madisonville Community College
Nominating Committee Chair: Kait Bianco (Chair Elect from 2013-2014), University of Pittsburgh
Nominating Committee Chair Elect: Scott McAfee, University of Southern California
Nominating Committee Member: Jillian Carney, St. Catherine University
Please download and read the WPTA Member Newsletter for October:
A new website launched by APTA will support the profession’s effort to eliminate fraud, abuse, and waste in the health care system. The APTA Center for Integrity in Practice website (http://integrity.apta.org/home.aspx) houses information on how PTs, PTAs, and students can continue to uphold the profession's high standards. Resources include information and supporting evidence on the recently released Choosing Wisely® list of "5 Things Physical Therapists and Patients Should Question;” a primer on preventing fraud, abuse, and waste; a free course on compliance; and other information on regulation and payment systems, evidence-based practice, ethics, professionalism, and fraud prevention. The site is part of the association's Integrity in Practice Campaign, a broad initiative that seeks to position physical therapy as a leader in responsible patient-centered care. Plans are for the website to continue expanding its offerings, and APTA is seeking partners to share resources, work together on advocacy, and possibly develop joint educational offerings to bring the message of practice integrity to the widest possible audience.
Passive physical agents that aren’t part of an active treatment plan, under-dosed strength training for older adults, and the use of whirlpools for wound management are among the "5 Things That Physical Therapists and Patients Should Question," according to a list recently announced by APTA. The list, developed through member suggestions and refined by an expert panel, is now part of a national campaign that encourages patients and health care providers to talk about whether a given procedure is really necessary based on the patient's individual circumstances.
The list announced is part of APTA's partnership with the Choosing Wisely® campaign from the American Board of Internal Medicine (ABIM) Foundation. The initiative aims to help consumers make informed health care choices by providing lists of procedures that tend to be done frequently, yet whose usefulness is called into question by evidence. APTA is the first nonphysician group to release a list, joining more than 50 medical specialty societies. See http://www.apta.org/PTinMotion/News/2014/9/15/ChoosingWiselyRelease/ for more details.
Positions Statements Related to Physical Therapy Issued by the Physical Therapy Examining Board
As of January 1, 2014 (insert correct date) the state of Wisconsin requires that all physical therapists applying for license renewal complete a total of four hours of ethics and jurisprudence education. To help therapists comply, the WPTA is offering this course through the interactive platform of EDUCATA. WPTA members receive a 10% discount, see details at the link below.
Help recognize facilities for their commitment to APTA membership. Facilities that attain 100% APTA membership of PTs and PTAs should submit a Facility Challenge application. Annual renewal is required. Qualifying facilities receive a certificate, are featured on APTA.org, and included on banner displays at Combined Sections Meeting and NEXT Conference and Exposition.
The WCD is looking for volunteers to help out at the St.Clare Health Mission located at 916 Ferry Street in La Crosse. The Mission is open Tuesday, Wednesday and Thursday evenings from 5pm to 9pm. Please contact Mary Kerrigan at email@example.com for more details. Thanks,
Please contact District Chair, Jonathon Weiss, by email firstname.lastname@example.org with the following information:
4. Sponsorship amount being requested (Max limit of $250): ___________________________
(please list breakdown of league fees and t-shirt fees)