Greater Than 720 Minutes
I like my new patient. He is very motivated, therapy-driven and has an extreme desire to get stronger as quickly as possible. He will not ask any therapy discipline to wait or check back for him later. He will stop what he's doing and go wherever he's asked to go. I love patients like this -- so cooperative, polite and willing to attempt any task given to him.
Here's the problem. He wants to do therapy with all three disciplines in excess of 720 minutes. When patients request more therapy, we can normally accommodate them but for this patient, wanting more therapy creates a financial problem. We will not get reimbursed for anything above 720 minutes so there's no financial incentive to treat someone greater than that. If we do treat the patient above those minutes, we'd actually lose money by giving away our therapy services. (We can thank Medicare and the insurance industry for this one).
So how should you tell a patient who's motivated to get better and works hard with all three disciplines that therapy will not get reimbursed beyond 720 minutes? I doubt the patient really cares about minutes. I can't blame him for wanting more therapy, especially if he sees the positive results in mobility and ADLs.
If we decide to take a loss and see him above 720 minutes, what do we do with the next patient who comes along and has the same motivation? Do we continue to take a loss? Eventually, after enough losses, the company and facility will no longer exist.