Physical therapy/occupational therapy/speech-language pathology services
Medicare Part B (Medical Insurance) helps pay for medically necessary, see clinical guidelines!, outpatient physical medicare.gov/physical-therapy Medicare Coverage Physical Therapy #10988
and. Speech-language pathology services
- Your medical record must include information to explain why the services are medically necessary
A Medicare contractor like Livanta may review your medical records to be sure your therapy services were medically necessary. This happens when your bills go over say $2k cms.gov/theraphy caps
Your therapist or therapy provider must give you a written notice before providing services that aren’t medically necessary. This includes therapy services that are generally covered but aren’t medically reasonable and necessary for you at the time. This notice is called an “Advance Beneficiary Notice of Noncoverage” (ABN). The ABN lets you choose whether or not you want the therapy services. If you choose to get the medically unnecessary services, you agree to pay for them.
Who’s eligible?
All people with Part B are covered as long as the services are medically reasonable and necessary.
Your costs in Original Medicare
You pay 20% of the Medicare-approved amount, and the Part B deductible applies. If you have a Medi Gap or Medicare Advantage plan, those will pay all or part of the 20%.
Medicare #Appeals 11525
Filing an appeal with Medicare
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- How to Appeal a Denial of your Health Claim - VIDEO Kantor & Kantor Attorneys
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Video's trying to explain Medical Necessity
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Top 5 - 10 causes of Long Term Disability Claims
Lower back disorders ♦ Depression ♦ Coronary heart disease, arthritis and pulmonary diseases (Met Life) ♦ Disability Can Happen ♦ CDC Statistics
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Shoulder Injury – Frozen Shoulder
70% of patients will improve with non-surgical care. Initial treatment involves anti-inflammatory medication, ice, avoiding over shoulder reaching and lifting activities. In the very acute painful phase exercises are avoided. When pain subsides somewhat, rotator cuff exercises are begun. The primary goal of the exercises is to work the uninjured portion of the rotator cuff. This is accomplished by emphasizing internal and external rotation exercises using an elastic tubing. Scapula stabilizers are also strengthened. Deep tissue work by a physical therapist can help relieve associated spasm. Isolated strengthening of the most commonly injured supraspinatous tendon should be avoided. If there is no response to this treatment program, an injection of cortisone is provided. Cortisone is a strong anti-inflammatory medication that, when used appropriately and sparingly, is safe and can be dramatically beneficial. iasm.com
Resources & Links
The pressure may be the result of repetitive motions. Or it may happen from holding your body in one position for long periods, such as keeping elbows bent while sleeping.
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen may reduce swelling.
Cartoon Explanation
Not Acetomenifin, but you can’t use it if you are allergic to aspirin Cleveland Clinic
Back Pain – What can be done?
Physical Therapy
tinhtamvn.net/how-to-use-a-tennis-ball-to-relieve-sciatic-nerve-pain-and-back-pain/
Anthem Blue Cross Muscoloskeletal Fitness Program
Epidural
wikipedia.org/Epidural_steroid_injection
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