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PTA Blog Talk


Published June 17, 2009 10:02 PM by Jason Marketti
I have never been hauled into court over what I have or have not done.  No jury has appraised me for what I look like and no attorney has battered me on the stand. 

I recently read Gloria Allred's book "Fight Back and Win."  I think if she took on the health care industry there would be a lot of people sweating under her scrutiny. 

I bring this up because the definition of "skilled" therapy seems skewed at times.  I have seen questionable services provided by therapists that could be given to the restorative nurses or the therapy aide. I guess it depends on the therapist and what is being provided. 

I refused to see a patient because I didn't think the service was skilled enough and there were other patients who required my time and would benefit more from the services I am able to provide. Was this the right thing to do?

Should I be the one deciding who gets seen and who doesn't? Maybe I should report the questionable services to the fraud department and let them sort it out. But we should all know when a patient has reached their max potential in the environment they are in. If we don't then we should ask another person and get feedback on whether what we are providing is skilled and can only be provided by a PT or PTA. 

Sometimes I wish lawyers would haul us into court and review our notes more often.  Insurance companies should question every bill they receive from us and ask for more supportive documents, if needed, that justify our services. I realize they already review cases and justification letters are written if requested. 

I certainly question every bill I receive from hospitals and clinics I go to. They may make an error (intentional or not).  I request all medical notes as well to ensure proper follow up is done and if it is not I ask why.  If I pay for a service I want to ensure I get my money's worth.      

If I do get hauled into court I am hiring Gerry Spence. I could sit back and relax a bit since he has never lost a jury trial since 1969.  (I have read most of his books as well.)


If a resident shows to have a significant status change and is documented by nursing then PT can be justified to pick up under Medicare. The question is if this resident should receive your time depending on interpretation of skilled service. When you can provide a service that can improve function, safety etc. that requires instructions and techniques that only a physical therapy professional can provide, this is skilled service no matter how high or low level as long as you can justify the need. When there is a change in functional status then that resident should at least be evaluated even if you feel to otherwise because they are not skilled enough. If you feel this resident has reached a maximum level of function, this should be conveyed to the evaluating PT, they need to decide if PT services is no longer required and proceed with D/C orders (if in house resident). I don't believe you should refuse to see a Pt because you feel they are not skilled enough. You may be surprised of surfacing  functional deficets that would benefit from your skills

Tom June 18, 2009 2:13 PM

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About this Blog

    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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