FREQUENTLY ASKED QUESTIONS (FAQs)
Thank you for taking the time to learn more about Brookside Physical Therapy. We realize the time
our 3rd party payors spend on each patient account is a cost. For this reason we have posted
common questions and answers important to 3rd party payors. However, if you need more
information please contact us immediately.
_________________________________________________________________________________
Why is a physical therapy evaluation required when the physician has already evaluated the patient?
By law, physical therapists are required to perform evaluations on all patients despite the fact that they
may have previously been evaluated by a physician or another physical therapist. This law is
appropriate because without the evaluation, it is impossible for the physical therapist to set up a
specific program that would resolve the patient’s problem. Therefore, the patient would be on a more
generic program which would be ineffective.
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_________________________________________________________________________________
I thought all physical therapy treatments were the same. Aren't you required to follow the
physician's prescription?
Physical therapists are extensively trained in evaluative procedures that lead to a physical therapy
diagnosis and appropriate intervention. It is incumbent on the physical therapist set up a program that
will effectuate a rapid resolution. This also would include patient education to prevent recurrence.
Back to Top
_________________________________________________________________________________
How can you assure that the patient is ready to return to the normal work duties?
When a patient is first evaluated, their job duties are extensively discussed with the patient as well as
anticipated return to work goals. Right from the very first day we are directing our care at return to full
function or modifying the work environment so that the patient can return to work as soon as possible.
To that end, we work extensively with work simulation and conditioning activities with emphasis on
repetition in order to prepare the patient for his or her return to work. Additionally, we work closely
coordinating with the case managers to be sure all aspects of the patient’s care is covered.
Additionally, our physical therapists are certified in the Functional Capacity Evaluations system through
Work Well and DSI Solutions to determine the patient’s ability to return to their previous job duties.
These evaluations involve 3 to 5 hour testing designed to determine the patient’s ability to return to
previous job duties. Because FCE’s are already validated and reliable, this is important information for
the insurance company to have.
Back to Top
_________________________________________________________________________________
How can I control the length of time the patient requires physical therapy?
As mentioned previously, a complete evaluation is extremely important in determining the problems that
exist. Goals are developed so the patient can return to their normal daily activities as soon as possible.
Most importantly, at any physical therapy facility, the insurance company should be sure patient’s are
being re-evaluated and treatment programs are being progressed as appropriate to ensure attainment
of goals. If re-evaluation is not performed, and specific progress is not documented, insurance
company should not be required to pay for care. It is incumbent upon the physical therapist to show
progress. What is helpful in these situations are peer reviews done by a physical therapist to be sure
your patient is being treated appropriately. Please see our question regarding peer reviews on this
website.
Back to Top
_________________________________________________________________________________
What about patients who seem to have secondary gain? How do I know if this is a problem?
Because of the level of expertise in our clinic, our physical therapists, in addition to performing
subjective information and objective testing, the therapists work diligently to document any
inconsistencies that may manifest themselves as a behavioral component. To this end, we also
perform specific testing using validating and reliable testing tools to come up with positive signs for
behavioral patients. Therefore, we are able to identify these patients, coordinate with the physician
and/or case worker, in order to move the patient on to appropriate services, not keeping them in
physical therapy unnecessarily.
Back to Top
_________________________________________________________________________________
How do I assess what facility would be best to send my patient to?
An Insurance company has to be careful about sending patients to facilities that utilize a variety of
equipment generically. Although equipment has its place in rehabilitation, the most important aspect of
care is the therapists expertise and ability to evaluate and set up a treatment program designed to
resolving the patient’s problems. Treating patients generically in a “gym” type setting, whereby patients
go from equipment to equipment without specific needs addressed, is inappropriate. These facilities
will have very poor outcomes since their care is not directed to the specific problem at hand. At our
facility, we keep the claims managers and claims adjustors updated through periodic reports, if
requested. We also invite them to visit our facility and actually observe treatment of that patient.
Back to Top
_________________________________________________________________________________
What about peer reviews?
Peer reviews are extremely important in containing costs in physical therapy. Unfortunately, many
insurance companies utilize professionals eg: nurses or lay people to evaluate physical therapy notes
in order to determine if care and/or charges are appropriate. This causes the insurance company a
large disadvantage because these personnel are not trained to pick up inappropriate treatment,
excessive treatment, or inappropriate charges. We offer a service of peer review through our cost
containment companies.
Thank you for taking the time to learn more about Brookside Physical Therapy. We realize the time
our 3rd party payors spend on each patient account is a cost. For this reason we have posted
common questions and answers important to 3rd party payors. However, if you need more
information please contact us immediately.
_________________________________________________________________________________
Why is a physical therapy evaluation required when the physician has already evaluated the patient?
By law, physical therapists are required to perform evaluations on all patients despite the fact that they
may have previously been evaluated by a physician or another physical therapist. This law is
appropriate because without the evaluation, it is impossible for the physical therapist to set up a
specific program that would resolve the patient’s problem. Therefore, the patient would be on a more
generic program which would be ineffective.
Back to Top
_________________________________________________________________________________
I thought all physical therapy treatments were the same. Aren't you required to follow the
physician's prescription?
Physical therapists are extensively trained in evaluative procedures that lead to a physical therapy
diagnosis and appropriate intervention. It is incumbent on the physical therapist set up a program that
will effectuate a rapid resolution. This also would include patient education to prevent recurrence.
Back to Top
_________________________________________________________________________________
How can you assure that the patient is ready to return to the normal work duties?
When a patient is first evaluated, their job duties are extensively discussed with the patient as well as
anticipated return to work goals. Right from the very first day we are directing our care at return to full
function or modifying the work environment so that the patient can return to work as soon as possible.
To that end, we work extensively with work simulation and conditioning activities with emphasis on
repetition in order to prepare the patient for his or her return to work. Additionally, we work closely
coordinating with the case managers to be sure all aspects of the patient’s care is covered.
Additionally, our physical therapists are certified in the Functional Capacity Evaluations system through
Work Well and DSI Solutions to determine the patient’s ability to return to their previous job duties.
These evaluations involve 3 to 5 hour testing designed to determine the patient’s ability to return to
previous job duties. Because FCE’s are already validated and reliable, this is important information for
the insurance company to have.
Back to Top
_________________________________________________________________________________
How can I control the length of time the patient requires physical therapy?
As mentioned previously, a complete evaluation is extremely important in determining the problems that
exist. Goals are developed so the patient can return to their normal daily activities as soon as possible.
Most importantly, at any physical therapy facility, the insurance company should be sure patient’s are
being re-evaluated and treatment programs are being progressed as appropriate to ensure attainment
of goals. If re-evaluation is not performed, and specific progress is not documented, insurance
company should not be required to pay for care. It is incumbent upon the physical therapist to show
progress. What is helpful in these situations are peer reviews done by a physical therapist to be sure
your patient is being treated appropriately. Please see our question regarding peer reviews on this
website.
Back to Top
_________________________________________________________________________________
What about patients who seem to have secondary gain? How do I know if this is a problem?
Because of the level of expertise in our clinic, our physical therapists, in addition to performing
subjective information and objective testing, the therapists work diligently to document any
inconsistencies that may manifest themselves as a behavioral component. To this end, we also
perform specific testing using validating and reliable testing tools to come up with positive signs for
behavioral patients. Therefore, we are able to identify these patients, coordinate with the physician
and/or case worker, in order to move the patient on to appropriate services, not keeping them in
physical therapy unnecessarily.
Back to Top
_________________________________________________________________________________
How do I assess what facility would be best to send my patient to?
An Insurance company has to be careful about sending patients to facilities that utilize a variety of
equipment generically. Although equipment has its place in rehabilitation, the most important aspect of
care is the therapists expertise and ability to evaluate and set up a treatment program designed to
resolving the patient’s problems. Treating patients generically in a “gym” type setting, whereby patients
go from equipment to equipment without specific needs addressed, is inappropriate. These facilities
will have very poor outcomes since their care is not directed to the specific problem at hand. At our
facility, we keep the claims managers and claims adjustors updated through periodic reports, if
requested. We also invite them to visit our facility and actually observe treatment of that patient.
Back to Top
_________________________________________________________________________________
What about peer reviews?
Peer reviews are extremely important in containing costs in physical therapy. Unfortunately, many
insurance companies utilize professionals eg: nurses or lay people to evaluate physical therapy notes
in order to determine if care and/or charges are appropriate. This causes the insurance company a
large disadvantage because these personnel are not trained to pick up inappropriate treatment,
excessive treatment, or inappropriate charges. We offer a service of peer review through our cost
containment companies.
| BROOKSIDE PHYSICAL THERAPY |
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| © 2006 Brookside Physical Therapy -- 8859 Fox Dr. -- Thornton, CO 80260 -- Phone: 303.428.4646 -- Fax: 303.429.6255 |
