Wiki OP PT / Home Health

THK

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Providence, UT
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We are an out-patient physical therapy clinic with a scenario I would love some feedback on. We have a patient that has been treating at our out-patient physical therapy clinic for years. Recently, unknown to us, he was assigned to home health. During his home health confinement he left his home to obtain physical therapy services for some new stiffness, aches and pains. Again, we were not aware he was in home health status so treated him as out-patient. Medicare paid but are now taking their money back (rightfully so - and is how we even found out about home health.) We have reached out to home health and they are refusing to pay for the services stating they did not know patient was leaving home for therapy and also did not authorize this therapy. Unfortunately, we did not obtain an ABN from the patient has he has been a long-term patient and has always presented as Medicare. I would appreciate feedback if there is any way we can be reimbursed for our services rendered. Thank you!
 
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