Payment Issues & Resources

APTA Michigan’s Payment Committee is continually meeting with health care professionals and various insurance companies throughout the state of Michigan to keep our members notified of any changes coming and to advocate for our physical therapy professionals. As a benefit to our membership, APTA Michigan members are notified immediately of any policy changes or deadlines to an insurance plan or group.

Not all Payment questions can be treated the same way. Please email contact@aptami.org or paymentspecialist@aptami.org if you have a specific question as it relates to Payment.

APTA Michigan Payment Leaders
Contact APTA Michigan Payment Specialist

Implicit Bias Training – Update on Requirements

posted: November 02, 2021

The Michigan Department of Licensing and Regulatory Affairs (LARA) recently posted a set of FAQs to clarify requirements related to Implicit Bias Training.

The entire document can be viewed here: Download file

Items to note:

  • This requirement is separate from and in addition to the requirement for 24 PDR credits for renewal.  For a 2 year renewal cycle you will need 2 hours of Implicit Bias Training.
  • The new requirement takes effect June 1, 2022.  If you are renewing in 2022 and renew BEFORE June 1 the training is not required. If you renew AFTER June 1 you will need 1 hour of training for this renewal only.  For subsequent renewals you will need  2 hours – 1 hour for each year in the renewal cycle.

eviCore Clinical Criteria Guidelines Effective 2/14/20
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eviCore Clinical Criteria Guidelines Effective 2/14/20

BCBSM Correspondence
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  • APTA MI Letter to BCBSM RE Direct Access
  • APTA MI Letter to BCBSM RE Dry Needling
 

Michigan Medicaid
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  • APTA Michigan Comments on Proposed Home Health Policy Changes – July 10, 2019

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  • APTA Michigan Letter to BCBSM August 18, 2020
  • APTA Michigan Email to BCBSM Re Direct Access Resources August 24, 2019
  • APTA Michigan Letter to BCBSM July 26, 2019
  • APTA Michigan Letter to BCBSM 3.22.19
  • APTA Michigan Letter to eviCore – October 15, 2018
  • APTA Michigan Email to BCBSM October 15, 2018
  • BCBSM Meeting Minutes – May 11, 2018
  • Summary of Meeting with BCBSM May 11, 2018
  • APTA Michigan Letter to BCBSM April 24, 2018
  • APTA Michigan Meeting with BCBSM and eviCore March 9, 2018
    • Summary – March 9 Meeting
    • Overview of corePath Survey Data
    • APTA Michigan eviCore/corePath Narrative Themes
    • corePath Survey Data Analysis
  • APTA Michigan Letter to BCBSM October 24, 2017
  • APTA Michigan Complaint to Michigan Department of Insurance and Financial Services
  • APTA Michigan Letter to Senator Stabenow
  • eviCore – Update on APTA Michigan Strategies and Related Actions
  • APTA Michigan Letter to BCBSM June 30, 2017
  • APTA Michigan Letter to Priority Health June 6, 2017
  • APTA Michigan Letter to BCBSM May 12, 2017
  • BCBSM Minutes from Meeting March 13, 2017
  • APTA Michigan Letter to BCBSM March 13, 2017
  • APTA Michigan Letter to BCBSM October 17, 2016
  • APTA Michigan Letter to BCBSM June 23, 2016

Medicaid Resources

The Michigan Department of Community Health is a source of information on Health Care coverage, programs, and policy. The Michigan Medical State Plan is available to read up on eligibility, services and reimbursement coverages under Michigan’s Medicaid Program.

You can also reach Provider Specific Information to research your health care questions and recieve information on billing and reimbursement. Medicaid Policy and Forms are also available from this resource.

Contact APTA Michigan Payment Specialist

Medicare Claims Update

Fiscal Intermediaries (FI’s) process Medicare claims for services provided in facilities such as Hospitals, Skilled Nursing Facilities (SNF’s), Outpatient Rehabilitation Facilities (ORF’s), and Comprehensive Outpatient Rehabilitation Facilities (CORF’s). These FI’s have web sites that provide a vast amount of information regarding Medicare coverage and billing. Your billing office will know the identity of the FI that processes your claims.

United Government Services (UGS) is the largest Medicare Part A Intermediary processing over 30 million claims nationwide each year. UGS serves customers in (insert association’s state MI or WI) as well as many other states. The following UGS website contains valuable information that includes: the publication “Physical Therapy, Occupational Therapy and Speech-Language Pathology Outpatient Services Educational Update”, Frequently Asked Questions (FAQs), Local Medical Review Policies, Medicare Memos (the monthly newsletter from UGS), links to Centers for Medicare and Medicaid (CMS) websites and more.

Medicare Links