> Jeffery, I have cc your below inquiry to:
> Andrew A. Guccione, PT, PhD, FAPTA
> Senior Vice President – Practice and Research
> American Physical Therapy Association
> e: [email protected]
> whom maybe helpful in providing you and the other subscribers of the
> Listserve, with a better understanding of the compliance or lack thereof
> to the Florida Statue. I am confident the national PT organization would
> have interest in addressing your concerns and nowledge of any suspected
> activities of their members.
> You also have not only have the option but the responsibility required by
> the statue to report suspected unlicensed activities of providers of O&P
> services in the state of Florida.
> See http://www.fdhc.state.fl.us/hqasub3.html
> Tony Barr
> Barr Foundation
> —– Original Message —–
> Sent: Friday, June 20, 2003 1:11 PM
> Subject: [OANDP-L] ILLEGAL OR NOT
> > We have O & P licensure in the state of Florida and I recently had a
> > disturbing conversation with a parent about a physical therapist casting
> for an AFO.
> > Cascade DAFO company billed the insurance company with L1960 as the base
> > When I called the therapist, she stated I am not making or billing for
> > brace “I only cast and fit these braces” She also stated that she does
> > during therapy sessions. DOUBLE BILLING? Evaluating, Casting, Fitting
> and a 3
> > month follow-up period is included in all L codes. I believe this
> > practice to be double billing and violating the licensure law enforced
> > Florida dept. of health.
> > When I spoke to Cascade Dafo, They informed me that they use a “special
> > modifier” to these L codes stating their fee is excluding fitting and
> > and also send a letter stating this with the HCFA bill. I asked the
> > Dafo representative what this special modifier is and where I can find
> info on
> > it. Their response was that they did a lot research and that I should
> > same. If the insurance commission and the department of insurance has
> OK’d a
> > special modifier it would be public knowledge. I have never heard of
> > modifiers. Since when can L codes be stripped down to not include
> > follow up adjustments? Can you imagine how much these insurence
> > getting ripped off when P. T. charges for their time for casting,
> > adjusting braces.
> > This particular patient was sent to me after the brace the P. T.
> > Cascade made and P. T. fit caused the patient to walk worse than prior
> > brace. Patient needed an adjustment to an old brace and the P. T. told
> the h
> > usband to trim the AFO with scissors. Ouch! What a lawyer could do with
> > case.
> > 1. Not licensed O & P professional
> > 2. Billing? All parties involved can be held liable.
> > Is Cascade Dafo knowingly helping P.T.’s do what I understand to be
> > Oh, The P. T. also stated that Cascade Dafo will not bill for medicaid
> > patients. I wonder Why?????
> > Jeffrey Price, CPO