Wiki Physical Therapy Scripts

[LLBS29XX]

I need some real insight as to updating a script from the doctor as far as renewing the dates. This would be regarding a second script. I cannot find any information or guidelines on how to calculate the date for a second script when first script has expired but not all of the visits have been used. I really need to understand this and I can't wrap my head around it so to speak. Any P.T. specialists out there? Thanks so much!

 

[honeybee]

It really can depend on the insurance plan and sometimes even your office policy or therapist preference on whether you carry over the unused visits. I don't know that there is a written policy on this anywhere. If you are dealing with an insurance plan that always requires you submit the RX with frequency/duration before they will pay claims (such as BCBS/Ameriben) then I would not carry over any unused visits as that plan tends to be very strict on the number of dates of service they will pay based on the date the RX was written as well as frequency/duration of the RX. Many plans use this to determine how many total visits they will cover within the timeframe of the RX.

Other plans are not as strict with the RX requirements or may not require RX, so this may be a situation in which you carry over the visits from the old RX or depending on the needs of the patient the therapist may decide to treat a visit or 2 within that timeframe that would technically have exceed the freq/dur of the newer RX. Again it really depends on the insurance plan and your office policies.

We generally do not carry over the prior visits and add them into the new referral when RX is required, we keep track of any prior visits used in order to count down from a patients visit limit under their insurance plan and then set up our new referral based on RX date and the freq/duration of the new RX. For example: 2nd RX written 10/1 good for 2xwk/4wk=8 visits, we would have a referral date range of 10/1 to 10/29 and use 8 as our visit count for the 2nd RX even if 3 visits under the 1st RX were still remaining. Not sure if you have a specific example..I hope this helps!

Missy Lupercio, CPC-A

Spooner PT
Phoenix AZ