In June, the U.S. Department of Health and Human Services (HHS) formally asked for suggestions on how to reduce the administrative burden of health care. The move comes as part of the administration’s Patients over Paperwork initiative, a plan that aims to curtail or, at the very least trim, the burgeoning mountains of paperwork that health care providers are expected to complete on a daily basis.
As a physical therapist (PT) who has practiced in the Savannah area for the past 16 years, I can speak to the merits of this initiative. Over the last decade, the number of administrative tasks that my staff and I face has become staggering and, today, the load is larger than ever.
Much of the paperwork is benign and crucial to continuity of care. These are the types of documents that help us coordinate and execute a patient’s individual plan of care – which improves treatment outcomes.
Administratively, there are plenty of paperwork requirements that just don’t need to exist, period. It’s the kind that waste everyone’s time, pulling much needed attention away from what we as physical therapists do best: treating the chronic and acute pain of patients.
This ugly paperwork is what the administration’s initiative is trying to curtail through reform, and I can think of no better place to start than a current Medicare rule which forces my staff and I to spend countless hours on the phone or behind a keyboard hunting down doctor signatures instead of treating patients.
When Medicare patients are referred by their primary care doctor for physical therapy, I almost always receive the physician’s referral and work meticulously to create an individualized plan of care for the patient. More than 90% of my patients are referred to my practice in this way.
Unfortunately, this seemingly straightforward process is made significantly more burdensome by current Medicare policy, which requires physical therapists to secure the referring doctor’s signature again in order to get reimbursed for executing the patient’s plan of care.
If we don’t get the physician’s signature within 30 days, we don’t get reimbursed for services already provided to the patient. Contrary to the goals of the Patients over Paperwork Initiative, physical therapists are expected to get another stamp of approval from a doctor, even though that provider already approved PT in the first place—and it is maddening.
For my office, this means that we must spend excessive amounts of time trying to secure a signature from my patient’s doctor. Every week we send fax after fax and make call after call, anything to get that signature.
Opinion as originally published b
