*Names have been changed according to HIPPA policies
Severe hip dysfunction and pain that caused years of suffering brought Dan to physical therapy. After the completion of his initial evaluation with Mike, his therapy began. Most of his therapy time was spent on pain management—laser, ultrasound, massage, and hip mobilizations were used to attempt to relieve his years of pain. After his first month of treatment, Dan met with Mike for his 30-day reevaluation. When he realized Mike would be taking measurements followed by a shortened treatment session, Dan became irate and left the clinic without receiving any treatment, never to return. Subsequent phone calls to Dan proved fruitless.
Reevaluations are state, insurance, and Medicare mandated. Every 30 calendar days or 10th visit, whichever comes first, a reevaluation by the assigned Physical Therapist must be performed. Payors will only continue to approve physical therapy for their insured if progress is made, so objective measurements like range of motion and strength testing, along with subjective documentation of the patients’ function and pain must be recorded. This report is then sent to the payor and the referring physician for signing. If this reevaluation is not completed in a timely manner, insurance companies may refuse payment and professional sanctions and fines may be placed against the treating Physical Therapist. So, next time you see Mike for YOUR reevaluation, remember this is the law and how YOU get more physical therapy visits.
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