New Year FAQ: Get answers to the most commonly asked questions to start the year off right!
As we ring in 2023, here are some common questions and answers to help your clinic easily transition into the new year.
IN THIS ARTICLE:
PROVIDERS/USERS
Review your current providers located in your Provider List. If needing to add or remove a license, please contact support@therabill.com to make the request. Please ensure you review the bottom of this article, to know when it is safe to delete a provider from Therabill.
The admin of the account should review the users located under Admin > User Accounts. Please ensure all listed should have access to your Therabill account. For more information on user permissions and accounts, check this out!
Who needs a provider license in Therabill?
Only therapists who sign or finalize notes in the WebPT EMR will need a license.
INSURANCE
How do I add a new insurance for a current patient?
You can add a new insurance within the Patient Info section of the WebPT EMR. When adding a new insurance for a patient, it is recommended to create a new case with a new Initial Evaluation. Don’t forget to click Save Patient to ensure the transmission is sent in to Therabill. To learn more about adding a new insurance, click here.
Will insurance policy dates and visit counts auto-reset for patients whose insurance did not change?
No. You will need to manually update Insurance Policy dates. Be sure to verify the reset date is set to the appropriate year. If you would like to generate a patient list report of expiring policy dates, click here to learn more.
Can I leave the policy dates blank?
Policy dates in the WebPT EMR do not integrate into Therabill as the effective dates on the insurance card. If adjustments are made in the EMR, please remember to make the updates in Therabill too. Updating the effective dates, or archiving the termed policy insurance card in Therabill helps to ensure the right insurance is invoiced.
We highly recommend re-verifying your patients' insurances at the start of the year. Many plans run on a calendar year and benefits reset as of January 1st. You can keep a record of the verification in the chart notes in the patient chart, as a simple note or Post It note in the client chart in Therabill. 
What about the previous amount spent for Medicare? If I entered an amount for 2022, do I have to remove it for 2023?
Yes, you need to remove the Therapy Cap amount for 2022 both in the WebPT EMR and on the insurance card in Therabill, if added.
In Therabill, open the client’s Medicare insurance card, and remove the Therapy Cap amount in the Advanced Information section. 
Do I need to add in the deductible for Medicare?
No, it is optional to add the deductible for all insurances, including Medicare. This field does not integrate into Therabill and is informational only. If you want to add a Post It Note to keep a record of the deductible amount in the client chart in TB, please review how here.
The deductible amount for Medicare Part B for 2023 is $226.00.
If a patient has met the deductible for 2022, and we have checked the Deductible Met checkbox in the WebPT EMR, will it automatically uncheck itself after January 1, 2023?
No. You need to manually uncheck the Deductible Met checkbox. Navigate to the Patient’s Information section in the WebPT EMR, and edit the Insurance to uncheck the box. 
Will WebPT’s Medicare cap tracker be reset on January 1, 2023?
WebPT’s Medicare cap tracker will reset on January 1, 2023, for all Members.
Will the KX Modifier reset?
Yes. The modifier will reset on January 1, 2023. You can manually turn on the KX modifier if you need to by going to Patient Info, then editing the case.
Important: If you need to addend a note from 2022 to include the KX modifier, please ensure new documentation is not added while the 2022 note is being addended.
- Navigate to the Patient’s Info section in the EMR and select the Edit icon to edit the case.
- Under Apply Modifier, select KX to apply. Be sure to click Save at the bottom right corner of the patient’s chart.
- Navigate to the Patient’s Chart to add an addendum for the specific note. When finalizing, remember to select the option to Finalize and Rebill. Selecting Finalize and Rebill will send an alert to your biller in Therabill to manually make the changes.
- Once you have completed the addendum, go back into the patient’s case to turn off the KX modifier.
Click here to learn more about adding the KX modifier.
What are the Medicare Thresholds for 2023?
The annual dollar amount for the Medicare threshold resets on January 1, 2022. Although the hard therapy cap has been repealed, there is still a soft therapy cap—meaning all therapists must apply the KX modifier once the threshold amount has been reached in order to receive payment for medically necessary services.
- The 2023 therapy threshold is $2,230 for physical therapy and speech-language pathology services combined and $2,230 for occupational therapy services alone.
- The targeted medical review (MR) threshold will remain at $3,000
AUTHORIZATIONS
Ensure authorizations are kept up to date. Remember, the insurance name on the authorization must match the name on the insurance card in order for it to be included on the claim. If there is a new authorization for this year, make sure your end dates of any previous do not overlap the most recent.
CORRECTED CLAIMS
If you need to send a corrected claim, please make sure the daily note has been addended in the EMR. The changes will need to be entered manually on the session in Therabill. Follow these steps to correctly send corrected claims from Therabill.
CLIENT STATEMENTS
To ensure patients are kept up to date and that you are paid timely, run your Statement Balance report and apply unassigned client balances to those patients with outstanding finalized charges. After assigning, rerun the Balance Aging by Client (with the finalized charges box checked) to see what clients need statements (hint, you can minimize this report).
- Navigate to your client statement area and select Batch.
- For Show clients with, select a balance and check the box to Exclude Credit Balances.
Note: The clients with blue checkboxes will print statements once you click Run Batch. - Feel free to check your Balance Aging Report to the Batch List to ensure all are included or remove those you aren’t ready to invoice.
Note: If you want to shorten your invoices, go into your Settings and choose the box next to Balance Due under the Do not show sessions with $0.00 amount in…. section. Selecting this will only print service lines showing a balance.
BUSINESS CHANGES
If you are making or have made changes to insurance contracts or credentialing, changed owners, or need to bill with different NPI or TIN information, please consider the below.
- Are your changes payer specific? If so, read here.
- If NPI, TIN or ownership changes, please reach out to your Success Manager to recommend the best path forward.
- If you need to change the information populating in box 32 or 33, please reach out to your Success Manager as this may indicate a need for a new EMR and/or Therabill account.
WORLDPAY
WebPT has partnered with Worldpay from FIS—an industry leader for payment processing—to offer this service. You must be credentialed with Worldpay from FIS before using this solution.
The solution is fully integrated with the scheduler, and patient chart, and allows Patient payments to flow directly into integrated billing solutions such as Therabill, saving you time on reconciling payments.
Learn More: Worldpay - Account Setup and Device Overview
ALERTS
Your dashboard will guide you to tasks needing attention. Be sure to work your EDI Rejections, Addendum Added alerts, and Payment Updates to keep your accounts updated and accurate. 
REPORTS
Run the following reports to get a year-end summary of billing activity.
- Provider Code Summary: Compare the productivity of your therapists for the last year.
- Monthly AR Summary: See your charges, insurance & patient payments, and adjustments for the year, by month.
- Payment Method: Break down your insurance payments by payer.
- Insurance Mix: See who your biggest payers are.
- Key Indicators: Compare your performance year-over-year.
MIPS
Check out our 2023 New Year FAQ for MIPS here.
CPT CODES
No. While we aren’t adding any new CPT codes, there are some updates to existing codes:
- PT and OT user types in all states have an updated list of L codes, and the GP, GO, and GN modifiers are no longer applied to L codes.
- The CO and CQ modifiers are no longer applied to RTM codes 98976 and 98977
SUPPORT
I don’t see my question answered. Can I get more help?
Of course! For more assistance, please contact the WebPT + Therabill Support Team at support@therabill.com or call 866-221-1870 and select option 2.
Comments
0 comments
Please sign in to leave a comment.